Association of Plasma Neurofilament Light with Postoperative Delirium.
Aged
Aged, 80 and over
Cognition
Cognitive Dysfunction
/ etiology
Cohort Studies
Elective Surgical Procedures
/ adverse effects
Emergence Delirium
/ blood
Female
Glial Fibrillary Acidic Protein
/ blood
Humans
Incidence
Male
Neurofilament Proteins
/ blood
Neuropsychological Tests
Postoperative Complications
/ psychology
Prospective Studies
Psychomotor Performance
tau Proteins
/ blood
Journal
Annals of neurology
ISSN: 1531-8249
Titre abrégé: Ann Neurol
Pays: United States
ID NLM: 7707449
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
13
04
2020
revised:
21
08
2020
accepted:
21
08
2020
pubmed:
4
9
2020
medline:
15
12
2020
entrez:
4
9
2020
Statut:
ppublish
Résumé
To examine the association of the plasma neuroaxonal injury markers neurofilament light (NfL), total tau, glial fibrillary acid protein, and ubiquitin carboxyl-terminal hydrolase L1 with delirium, delirium severity, and cognitive performance. Delirium case-no delirium control (n = 108) pairs were matched by age, sex, surgery type, cognition, and vascular comorbidities. Biomarkers were measured in plasma collected preoperatively (PREOP), and 2 days (POD2) and 30 days postoperatively (PO1MO) using Simoa technology (Quanterix, Lexington, MA). The Confusion Assessment Method (CAM) and CAM-S (Severity) were used to measure delirium and delirium severity, respectively. Cognitive function was measured with General Cognitive Performance (GCP) scores. Delirium cases had higher NfL on POD2 and PO1MO (median matched pair difference = 16.2pg/ml and 13.6pg/ml, respectively; p < 0.05). Patients with PREOP and POD2 NfL in the highest quartile (Q4) had increased risk for incident delirium (adjusted odds ratio [OR] = 3.7 [95% confidence interval (CI) = 1.1-12.6] and 4.6 [95% CI = 1.2-18.2], respectively) and experienced more severe delirium, with sum CAM-S scores 7.8 points (95% CI = 1.6-14.0) and 9.3 points higher (95% CI = 3.2-15.5). At PO1MO, delirium cases had continued high NfL (adjusted OR = 9.7, 95% CI = 2.3-41.4), and those with Q4 NfL values showed a -2.3 point decline in GCP score (-2.3 points, 95% CI = -4.7 to -0.9). Patients with the highest PREOP or POD2 NfL levels were more likely to develop delirium. Elevated NfL at PO1MO was associated with delirium and greater cognitive decline. These findings suggest NfL may be useful as a predictive biomarker for delirium risk and long-term cognitive decline, and once confirmed would provide pathophysiological evidence for neuroaxonal injury following delirium. ANN NEUROL 2020;88:984-994.
Identifiants
pubmed: 32881052
doi: 10.1002/ana.25889
pmc: PMC7581557
mid: NIHMS1633160
doi:
Substances chimiques
GFAP protein, human
0
Glial Fibrillary Acidic Protein
0
MAPT protein, human
0
Neurofilament Proteins
0
tau Proteins
0
Types de publication
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
984-994Subventions
Organisme : NIA NIH HHS
ID : R01 AG051658
Pays : United States
Organisme : NIA NIH HHS
ID : R03 AG061582
Pays : United States
Organisme : NIA NIH HHS
ID : K24 AG035075
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG062421
Pays : United States
Organisme : NIA NIH HHS
ID : K07 AG041835
Pays : United States
Organisme : NIA NIH HHS
ID : K01 AG057836
Pays : United States
Organisme : NIA NIH HHS
ID : P01 AG031720
Pays : United States
Organisme : NIA NIH HHS
ID : R21 AG057955
Pays : United States
Organisme : NIA NIH HHS
ID : R24 AG054259
Pays : United States
Informations de copyright
© 2020 American Neurological Association.
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