Decreasing postoperative cognitive deficits after heart surgery: protocol for a randomized controlled trial on...

Area of Science:

• Cardiology
• Neurology
• Rehabilitation Medicine

Background:

• Postoperative cognitive deficits (PCDs) are common after heart surgery, impacting daily life, social functioning, and earning capacity.
• These deficits can significantly decrease patients' quality of life.

Purpose of the Study:

• To investigate the efficacy of early postoperative cognitive training in reducing subjective and objective cognitive deficits following heart surgery.
• To assess the impact of cognitive training on quality of life, depression, and the influence of perioperative cerebral ischemia.

Main Methods:

• A multicenter, randomized controlled trial involving 144 elderly patients undergoing elective heart-valve surgery.
• Patients were assigned to either an 18-day paper-and-pencil cognitive training group or a control group.
• Cognitive functions, quality of life, and depression were assessed pre-surgery, at discharge, and 3 and 12 months post-discharge. Perioperative cerebral ischemia was evaluated using MRI.

Main Results:

• The primary outcome is the training effect on objective cognitive functions at rehabilitation discharge.
• Secondary outcomes include effects on subjective cognitive functions, depression, and quality of life at 3 and 12 months post-discharge.
• The study will also analyze the impact of perioperative cerebral ischemia on training effectiveness.

Conclusions:

• If effective, cognitive training could be integrated into early cardiac surgery rehabilitation programs.
• Investigating perioperative ischemia via MRI may enhance understanding of neurobiological factors in postoperative cognitive plasticity.