Preoperative electroencephalographic alpha-power changes with eyes opening are associated with postoperative attention impairment and inattention-related delirium severity

脑电图 优势比 谵妄 逻辑回归 阿尔法(金融) 医学 听力学 置信区间 麻醉 外科 内科学 精神科 结构效度 患者满意度
作者
Leah Acker,Megan K. Wong,Mary Cooter Wright,Melody Reese,Charles M. Giattino,Kenneth Roberts,Sandra Au,Cathleen Colón‐Emeric,Lewis A. Lipsitz,Michael J. Devinney,Jeffrey N. Browndyke,Sarada Eleswarpu,Eugene W. Moretti,Heather E. Whitson,Miles Berger,Marty G. Woldorff
出处
期刊:BJA: British Journal of Anaesthesia [Elsevier BV]
卷期号:132 (1): 154-163 被引量:1
标识
DOI:10.1016/j.bja.2023.10.037
摘要

In the eyes-closed, awake condition, EEG oscillatory power in the alpha band (7-13 Hz) dominates human spectral activity. With eyes open, however, EEG alpha power substantially decreases. Less alpha attenuation with eyes opening has been associated with inattention; thus, we analysed whether reduced preoperative alpha attenuation with eyes opening is associated with postoperative inattention, a delirium-defining feature.Preoperative awake 32-channel EEG was recorded with eyes open and eyes closed in 71 non-neurological, noncardiac surgery patients aged ≥ 60 years. Inattention and other delirium features were assessed before surgery and twice daily after surgery until discharge. Eyes-opening EEG alpha-attenuation magnitude was analysed for associations with postoperative inattention, primarily, and with delirium severity, secondarily, using multivariate age- and Mini-Mental Status Examination (MMSE)-adjusted logistic and proportional-odds regression analyses.Preoperative alpha attenuation with eyes opening was inversely associated with postoperative inattention (odds ratio [OR] 0.73, 95% confidence interval [CI]: 0.57, 0.94; P=0.038). Sensitivity analyses showed an inverse relationship between alpha-attenuation magnitude and inattention chronicity, defined as 'never', 'newly', or 'chronically' inattentive (OR 0.76, 95% CI: 0.62, 0.93; P=0.019). In addition, preoperative alpha-attenuation magnitude was inversely associated with postoperative delirium severity (OR 0.79, 95% CI: 0.65, 0.95; P=0.040), predominantly as a result of the inattention feature.Preoperative awake, resting, EEG alpha attenuation with eyes opening might represent a neural biomarker for risk of postoperative attentional impairment. Further, eyes-opening alpha attenuation could provide insight into the neural mechanisms underlying postoperative inattention risk.
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