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Quantitative Electroencephalogram Changes before and after Postoperative Delirium: A Prospective, Multicenter Cohort
Julia Van der A1, Yorben Lodema2, Lotus Ten Bosch1
1Department of Intensive Care Medicine, University Medical Center Utrecht Brain Center, and Department of Psychiatry, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Anesthesiology
|March 10, 2026
Summary
Reduced preoperative beta connectivity may indicate a risk for postoperative delirium (POD) in older adults. Quantitative EEG analysis found no persistent changes three months after surgery, suggesting potential recovery.
Area of Science:
- Neuroscience
- Geriatric Medicine
- Surgical Outcomes
Background:
- Postoperative delirium (POD) is common in older adults after major surgery and linked to long-term cognitive decline.
- Electroencephalography (EEG) changes occur during acute POD, but pre-existing or persistent quantitative EEG alterations remain unclear.
- Identifying EEG markers could elucidate mechanisms and risks for cognitive dysfunction following surgery.
Purpose of the Study:
- To investigate whether quantitative EEG alterations precede or persist after POD in older adults.
- To identify potential neurophysiological risk markers for POD and long-term cognitive dysfunction.
Main Methods:
- A prospective, multicenter cohort study involving patients aged ≥65 undergoing major elective surgery and non-surgical controls.
- Quantitative EEG measures (relative power, functional connectivity, spectral variability, signal complexity) were analyzed preoperatively and three months postoperatively.
- Linear mixed models assessed the impact of time, surgery, and POD on EEG measures.
Main Results:
- Future POD patients (18%) showed significantly lower preoperative beta amplitude-based connectivity compared to controls.
- No other significant EEG differences were found at baseline between groups.
- No persistent quantitative EEG changes related to POD or surgery were observed three months postoperatively.
Conclusions:
- Reduced preoperative beta amplitude-based connectivity may serve as a neurophysiological vulnerability marker for POD.
- The lack of significant longitudinal EEG changes suggests functional recovery or compensation of resting-state networks by three months postoperative.
