Postoperative Neurocognitive Disorders

  • STATUS
    Recruiting
  • participants needed
    50
  • sponsor
    University of California, Los Angeles
Updated on 19 February 2024
brain injury
cognitive assessment
apnea
polysomnography
delirium
apnea-hypopnea index
confusion
neurocognitive disorders
robotic surgery
brain scan

Summary

The purpose of this study is to examine the mechanisms of brain injury contributing to postoperative neurocognitive disorders (PNCD) in an at-risk population (obstructive sleep apnea (OSA)) undergoing surgery. The investigators will enroll 50 OSA patients scheduled for surgery. All patients will have a brain scan (fMRI) within five days before surgery and two days and six months after surgery. During this visit cognitive function will be assessed using the Wide Range Assessment of Memory and Learning (WRAML2) and Montreal Cognitive Assessment (MoCA) tests. Patients will also be asked to participate in a blood draw during the first 2 visits for fMRI (within five days of surgery and two days after surgery). The Confusion Assessment Method (CAM-S) test, will be used to examine postoperative delirium.

Description

The investigators will examine the potential mechanisms of brain injury contributing to postoperative neurocognitive disorders (PNCD) in an at-risk population (obstructive sleep apnea (OSA)). This study proposes that neuro-inflammation is associated with measurable tissue changes that can be examined with MD measures and blood biomarkers.

On the day of surgery, standard of care procedures will take place. Hemodynamic vitals will be continuously monitored. As per the latest guidelines and recommendations from the American Society of Anesthesiologists (ASA), mean arterial pressure (MAP) will be targeted to > 60 mmHg or within 20% of baseline values, and processed EEG-guided anesthesia will be monitored to maintain a patient state index between 20-50. Electronic medical records and intraoperative integrated physiologic waveform will be collected.

In summary, the investigators will examine the potential mechanisms of brain injury contributing to postoperative delirium (POD) and acute and long-lasting neurocognitive deficits in an at-risk population (OSA).

Details
Condition Obstructive sleep apnea, Neurocognitive Disorders
Age 40-75 years
Treatment Brain Imaging, Cognitive testing, Blood Biomarkers
Clinical Study IdentifierNCT04244162
SponsorUniversity of California, Los Angeles
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

Subjects with a diagnosis of moderate-to-severe OSA (apnea hypopnea index
[AHI]>15 events/hour confirmed by overnight polysomnography), scheduled for
open or robotic surgery (abdominal, gynecologic, or urologic), and upper or
lower extremity orthopedic procedures
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