Higher Grade Glioma Increases the Risk of Postoperative Delirium: Deficient Brain Compensation Might Be a Potential Mechanism of Postoperative Delirium.

Huang, Hua-Wei; Zhang, Xiao-Kang; Li, Hao-Yi; Wang, Yong-Gang; Jing, Bin; Chen, You; Patel, Mayur B; Ely, E Wesley; Liu, Ya-Ou; Zhou, Jian-Xin; Lin, Song; Zhang, Guo-Bin

Huang, Hua-Wei; Zhang, Xiao-Kang; Li, Hao-Yi; Wang, Yong-Gang; Jing, Bin; Chen, You; Patel, Mayur B; Ely, E Wesley; Liu, Ya-Ou; Zhou, Jian-Xin; Lin, Song; Zhang, Guo-Bin.

Afiliação

Huang HW; Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Zhang XK; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Li HY; Beijing Key Laboratory of Brain Tumor, Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
Wang YG; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Jing B; Beijing Key Laboratory of Brain Tumor, Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
Chen Y; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Patel MB; Beijing Key Laboratory of Brain Tumor, Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
Ely EW; School of Biomedical Engineering, Capital Medical University, Beijing, China.
Liu YO; Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, United States.
Zhou JX; Department of Electrical Engineering & Computer Science, Vanderbilt University, Nashville, TN, United States.
Lin S; Section of Surgical Sciences, Department of Surgery and Neurosurgery, Division of Trauma, Surgical Critical Care, and Emergency General Surgery, Vanderbilt University Medical Center, Nashville, TN, United States.
Zhang GB; Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.

Front Aging Neurosci ; 14: 822984, 2022.

Article em En | MEDLINE | ID: mdl-35493935

ABSTRACT

ABSTRACT

Objective:

The brain compensation mechanism in postoperative delirium (POD) has not been reported. We uncovered the mechanism by exploring the association between POD and glioma grades, and the relationship between preoperative brain structural and functional compensation with POD in patients with frontal glioma.

Methods:

A total of 335 adult patients with glioma were included. The multivariable analysis examined the association between tumor grade and POD. Then, 20 patients with left frontal lobe glioma who had presurgical structural and functional MRI data and Montreal Cognitive Assessment (MoCA) in this cohort were analyzed. We measured the gray matter volume (GMV) and functional connectivity (FC) in patients with (n = 8) and without (n = 12) POD and healthy controls (HCs, n = 29) to detect the correlation between the structural and functional alteration and POD.

Results:

The incidence of POD was 37.3%. Multivariable regression revealed that high-grade glioma had approximately six times the odds of POD. Neuroimaging data showed that compared with HC, the patients with left frontal lobe glioma showed significantly increased GMV of the right dorsal lateral prefrontal cortex (DLPFC) in the non-POD group and decreased GMV of right DLPFC in the POD group, and the POD group exhibited significantly decreased FC of right DLPFC, and the non-POD group showed the increasing tendency. Partial correlation analysis showed that GMV in contralesional DLPFC were positively correlated with preoperative neurocognition, and the GMV and FC in contralesional DLPFC were negatively correlated with POD.