Association between cerebrospinal fluid biomarkers of neuronal injury or amyloidosis and cognitive decline after major surgery.
Aged
Amyloid beta-Peptides
/ cerebrospinal fluid
Amyloidosis
/ cerebrospinal fluid
Arthroplasty, Replacement, Hip
/ adverse effects
Arthroplasty, Replacement, Knee
/ adverse effects
Biomarkers
/ cerebrospinal fluid
Brain Injuries
/ cerebrospinal fluid
Cognition
Female
Humans
Male
Neurofilament Proteins
/ cerebrospinal fluid
Peptide Fragments
/ cerebrospinal fluid
Phosphopyruvate Hydratase
/ cerebrospinal fluid
Postoperative Cognitive Complications
/ cerebrospinal fluid
Prospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
tau Proteins
/ cerebrospinal fluid
amyloidosis
biomarker
cognitive dysfunction
neuronal injury
orthopaedic surgery
postoperative neurocognitive dysfunction
spinal anaesthesia
Journal
British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
26
06
2020
revised:
16
09
2020
accepted:
19
09
2020
pubmed:
14
11
2020
medline:
2
2
2021
entrez:
13
11
2020
Statut:
ppublish
Résumé
Postoperative neurocognitive decline is a frequent complication in adult patients undergoing major surgery with increased risk for morbidity and mortality. The mechanisms behind cognitive decline after anaesthesia and surgery are not known. We studied the association between CSF and blood biomarkers of neuronal injury or brain amyloidosis and long-term changes in neurocognitive function. In patients undergoing major orthopaedic surgery (knee or hip replacement), blood and CSF samples were obtained before surgery and then at 4, 8, 24, 32, and 48 h after skin incision through an indwelling spinal catheter. CSF and blood concentrations of total tau (T-tau), neurofilament light, neurone-specific enolase and amyloid β (Aβ1-42) were measured. Neurocognitive function was assessed using the International Study of Postoperative Cognitive Dysfunction (ISPOCD) test battery 1-2 weeks before surgery, at discharge from the hospital (2-5 days after surgery), and at 3 months after surgery. CSF and blood concentrations of T-tau, neurone-specific enolase, and Aβ1-42 increased after surgery. A similar increase in serum neurofilament light was seen with no overall changes in CSF concentrations. There were no differences between patients having a poor or good late postoperative neurocognitive outcome with respect to these biomarkers of neuronal injury and Aβ1-42. The findings of the present explorative study showed that major orthopaedic surgery causes a release of CSF markers of neural injury and brain amyloidosis, suggesting neuronal damage or stress. We were unable to detect an association between the magnitude of biomarker changes and long-term postoperative neurocognitive dysfunction.
Sections du résumé
BACKGROUND
Postoperative neurocognitive decline is a frequent complication in adult patients undergoing major surgery with increased risk for morbidity and mortality. The mechanisms behind cognitive decline after anaesthesia and surgery are not known. We studied the association between CSF and blood biomarkers of neuronal injury or brain amyloidosis and long-term changes in neurocognitive function.
METHODS
In patients undergoing major orthopaedic surgery (knee or hip replacement), blood and CSF samples were obtained before surgery and then at 4, 8, 24, 32, and 48 h after skin incision through an indwelling spinal catheter. CSF and blood concentrations of total tau (T-tau), neurofilament light, neurone-specific enolase and amyloid β (Aβ1-42) were measured. Neurocognitive function was assessed using the International Study of Postoperative Cognitive Dysfunction (ISPOCD) test battery 1-2 weeks before surgery, at discharge from the hospital (2-5 days after surgery), and at 3 months after surgery.
RESULTS
CSF and blood concentrations of T-tau, neurone-specific enolase, and Aβ1-42 increased after surgery. A similar increase in serum neurofilament light was seen with no overall changes in CSF concentrations. There were no differences between patients having a poor or good late postoperative neurocognitive outcome with respect to these biomarkers of neuronal injury and Aβ1-42.
CONCLUSIONS
The findings of the present explorative study showed that major orthopaedic surgery causes a release of CSF markers of neural injury and brain amyloidosis, suggesting neuronal damage or stress. We were unable to detect an association between the magnitude of biomarker changes and long-term postoperative neurocognitive dysfunction.
Identifiants
pubmed: 33183737
pii: S0007-0912(20)30844-8
doi: 10.1016/j.bja.2020.09.043
pii:
doi:
Substances chimiques
Amyloid beta-Peptides
0
Biomarkers
0
MAPT protein, human
0
Neurofilament Proteins
0
Peptide Fragments
0
amyloid beta-protein (1-42)
0
neurofilament protein L
0
tau Proteins
0
Phosphopyruvate Hydratase
EC 4.2.1.11
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
467-476Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.