Left Frontal Connectivity Moderates the Relationship between Inflammation and Cognitive Performance in Patients...

Area of Science:

• Neuroscience
• Cardiology
• Cognitive Psychology

Background:

• Cardiac surgery patients often experience neurocognitive deficits.
• Cognitive reserve (CR) is a known protective factor against cognitive decline.
• Global left frontal cortex (gLFC) connectivity is a neural correlate of CR.

Purpose of the Study:

• To investigate if gLFC connectivity modulates the relationship between postoperative inflammation and cognitive recovery in cardiac surgery patients.
• To examine the role of neural markers of cognitive reserve in mitigating neurocognitive deficits.

Main Methods:

• Neuropsychological assessments, MRI, and cytokine levels were measured in 25 heart valve replacement patients and controls at 3 time points.
• Linear regression analyzed the link between postoperative inflammation (ΔIL-6) and cognitive changes (ΔNeuropsychological assessment).
• Moderation analysis with Johnson-Neyman testing assessed gLFC connectivity's role in the inflammation-cognition relationship.

Main Results:

• Patients showed significant cognitive decline (executive function, memory) and reduced gLFC connectivity post-surgery, with partial recovery by day 30.
• Increased postoperative inflammation (ΔIL-6) negatively correlated with cognitive recovery in memory (Corsi block test) and processing speed (Digit symbol test).
• gLFC connectivity significantly moderated the impact of inflammation on cognitive recovery, with effects apparent within specific connectivity ranges.

Conclusions:

• gLFC connectivity, as a proxy for CR, plays a crucial role in cognitive resilience following cardiac surgery.
• Interventions targeting gLFC connectivity could enhance neurocognitive recovery in this patient population.
• This study highlights the interplay between neural reserve, inflammation, and cognitive outcomes in perioperative settings.