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困惑的倾向:手术前的微观结构损伤与手术后的妄想有关

Tyler H Reekes¹, Vinith R Upadhya², Jenna L Merenstein³

¹Department of Anesthesiology, Duke University Medical Center, Durham, NC.

medRxiv : the preprint server for health sciences

|January 20, 2025

概括

患有术后痴呆症的老年人显示在后带带皮层 (PCC) 的手术前大脑差异. 这些微观结构变化,独立于阿尔茨海默病的病理,与注意力缺陷有关,增加了妄想风险.

科学领域:

神经科学是一个神经科学.
老年医学老年医学
放射学放射学是一门学科.

背景情况:

手术后妄 (POD) 在老年人中很常见,增加了痴呆症的风险.
将POD与长期认知衰退联系起来的神经基础尚不清楚.
神经元导向分散和密度成像 (NODDI) 检测到微妙的微观结构性脑损伤.

研究的目的:

在易患POD的老年人中调查手术前的大脑微观结构异常.
检查这些异常,POD和手术前认知功能之间的关系.
确定POD易感性是否与阿尔茨海默氏症 (AD) 病理学有关.

主要方法:

在111名老年手术患者手术前和手术后分析的扩散MRI (包括NODDI).
专注于后带带皮层 (PCC),这是一个涉及AD和痴呆症的区域.
与POD发育和手术前认知表现相关的扩散指标.

主要成果:

患有POD的患者在手术前表现出自由水 (FISO) 和神经质密度指数 (NDI) 的增加,并在背部PCC中降低了方向分散指数 (ODI).
术后FISO差异持续存在;NDI和ODI差异没有.
手术前的PCC NDI和ODI与注意力/度相关,独立于年龄,教育和缩,但与CSF Aβ水平无关.

结论:

背部PCC中术前的微观结构异常可能会使个体易患POD,而不论AD病理.
这些PCC异常与手术前注意力缺陷有关,这是POD的核心特征.
PCC中的微结构脆弱性可能解释了老年人注意力缺陷和POD风险之间的联系.

关键词:

手术后妄症术后妄症缩性缩 (英语:Atrophy atrophy) 是一种损伤.关注注意力注意力注意力注意力扩散权重成像技术的使用.神经质密度的神经质密度

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