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

Publication ,  Journal Article
Acker, L; Wong, MK; Wright, MC; Reese, M; Giattino, CM; Roberts, KC; Au, S; Colon-Emeric, C; Lipsitz, LA; Devinney, MJ; Browndyke, J ...
Published in: Br J Anaesth
January 2024

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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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Published In

Br J Anaesth

DOI

EISSN

1471-6771

Publication Date

January 2024

Volume

132

Issue

1

Start / End Page

154 / 163

Location

England

Related Subject Headings

  • Postoperative Complications
  • Humans
  • Emergence Delirium
  • Electroencephalography
  • Cognitive Dysfunction
  • Cognition
  • Attention
  • Anesthesiology
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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ICMJE
MLA
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Acker, L., Wong, M. K., Wright, M. C., Reese, M., Giattino, C. M., Roberts, K. C., … INTUIT and PRIME study groups. (2024). Preoperative electroencephalographic alpha-power changes with eyes opening are associated with postoperative attention impairment and inattention-related delirium severity. Br J Anaesth, 132(1), 154–163. https://doi.org/10.1016/j.bja.2023.10.037
Acker, Leah, Megan K. Wong, Mary C. Wright, Melody Reese, Charles M. Giattino, Kenneth C. Roberts, Sandra Au, et al. “Preoperative electroencephalographic alpha-power changes with eyes opening are associated with postoperative attention impairment and inattention-related delirium severity.Br J Anaesth 132, no. 1 (January 2024): 154–63. https://doi.org/10.1016/j.bja.2023.10.037.
Acker, Leah, et al. “Preoperative electroencephalographic alpha-power changes with eyes opening are associated with postoperative attention impairment and inattention-related delirium severity.Br J Anaesth, vol. 132, no. 1, Jan. 2024, pp. 154–63. Pubmed, doi:10.1016/j.bja.2023.10.037.
Acker L, Wong MK, Wright MC, Reese M, Giattino CM, Roberts KC, Au S, Colon-Emeric C, Lipsitz LA, Devinney MJ, Browndyke J, Eleswarpu S, Moretti E, Whitson HE, Berger M, Woldorff MG, INTUIT and PRIME study groups. Preoperative electroencephalographic alpha-power changes with eyes opening are associated with postoperative attention impairment and inattention-related delirium severity. Br J Anaesth. 2024 Jan;132(1):154–163.
Journal cover image

Published In

Br J Anaesth

DOI

EISSN

1471-6771

Publication Date

January 2024

Volume

132

Issue

1

Start / End Page

154 / 163

Location

England

Related Subject Headings

  • Postoperative Complications
  • Humans
  • Emergence Delirium
  • Electroencephalography
  • Cognitive Dysfunction
  • Cognition
  • Attention
  • Anesthesiology
  • 3202 Clinical sciences
  • 1103 Clinical Sciences