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The Thalamus in Perioperative Neurocognitive Disorders
Marinus Fislage1,2, Norman Zacharias3, Insa Feinkohl4,5
1Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, Berlin, 10117, Germany. Marinus.fislage@charite.de.
Neuropsychology Review
|September 22, 2023
Summary
Thalamus structure and function predict neurocognitive disorder (NCD) risk. This review examines how preoperative and postoperative thalamus imaging relates to NCD, like delirium and cognitive dysfunction, after surgery.
Area of Science:
- Neuroscience
- Gerontology
- Radiology
Background:
- Thalamus structure and function are established predictors of age-related neurocognitive disorders (NCD), including dementia.
- The role of the thalamus in the perioperative setting, particularly concerning neurocognitive outcomes, remains underexplored.
- Understanding thalamic contributions is crucial for identifying individuals at risk for perioperative neurocognitive decline.
Purpose of the Study:
- To conduct a narrative review of brain-imaging studies investigating thalamus scanning parameters.
- To assess the association between preoperative and postoperative thalamus characteristics and the risk of perioperative NCD.
- To discuss findings within the framework of cognitive reserve capacity.
Main Methods:
- Systematic literature search for brain-imaging studies focusing on the thalamus.
- Review of studies examining preoperative and postoperative thalamus scanning parameters.
- Analysis of associations between thalamic findings and the development of postoperative delirium (POD) and postoperative cognitive dysfunction (POCD).
Main Results:
- Identified studies linking specific preoperative and postoperative thalamus imaging parameters to increased risk of perioperative NCD.
- Evidence suggests thalamic alterations may precede or accompany the development of POD and POCD.
- Findings highlight the potential of thalamus imaging as a biomarker for perioperative neurocognitive risk.
Conclusions:
- Thalamus structure and function are relevant to perioperative neurocognitive outcomes, extending beyond age-related NCD.
- Preoperative and postoperative thalamus imaging parameters may help predict the risk of developing POD and POCD.
- The concept of cognitive reserve capacity provides a valuable lens for interpreting the thalamus's role in surgical patients.
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