Neurocognitionanesthesia
ions | Bruxelles Woluwe, Louvain-la-Neuve
Research
Perioperative neurocognitive disorders including postoperative delirium (POD) and delayed neurocognitive disorders remain among major neurological complications after surgery. The pathophysiology of these disorders is currently under extensive investigation.
In a prospective clinical research project, our group added new evidence on the link between olfactory function and perioperative cognition. We found that poor preoperative cognitive performance was independently associated with an immediate postoperative decline in olfactory identification function. Additionally, we highlighted the correlation between poor preoperative olfactory function and baseline cognition. Lastly, our work suggested that preoperative olfactory testing would be a way to assess cognitive reserve and, thus, in some cases, to unveil brain frailty in apparently cognitively healthy individuals. Indeed, olfactory dysfunction was an independent predictor of postoperative neurocognitive disorder, primarily through the presence of subjective cognitive concerns.
In another extensive research project, the pathophysiology of POD in cardiac surgery patients has been studied. POD is among the most prevalent complications after cardiac surgery and is associated with increased morbidity and mortality. Although pre-existing cognitive impairment is a major predisposing risk factor, patients’ cognitive status is not systematically assessed during preoperative clinical examination. With the POD-01 study, we aimed to prospectively investigate promising electroencephalographic (intraoperative EEG frontal alpha-band power under general anesthesia), biological (perioperative course of serum neurofilament light, a biomarker of axonal injury) and genetic (apolipoprotein Ee4 carrier status) predictors of POD in order to help identify patients at risk and to potentially provide reasonable alternatives to a comprehensive neuropsychological evaluation.