MRI Markers of Neurodegenerative and Neurovascular Changes in Relation to Postoperative Delirium and Postoperative Cognitive Decline

Ilse M J Kant, Jeroen de Bresser, Simone J T van Montfort, Arjen J C Slooter, Jeroen Hendrikse

Research output: Contribution to journalReview articlepeer-review

Abstract

Postoperative delirium (POD) and postoperative cognitive decline (POCD) are common in elderly patients. The aim of the present review was to explore the association of neurodegenerative and neurovascular changes with the occurrence of POD and POCD. Fifteen MRI studies were identified by combining multiple search terms for POD, POCD, and brain imaging. These studies described a total of 1,422 patients and were all observational in design. Neurodegenerative changes (global and regional brain volumes) did not show a consistent association with the occurrence of POD (four studies) or POCD (two studies). In contrast, neurovascular changes (white matter hyperintensities and cerebral infarcts) were more consistently associated with the occurrence of POD (seven studies) and POCD (five studies). In conclusion, neurovascular changes appear to be consistently associated with the occurrence of POD and POCD, and may identify patients at increased risk of these conditions. Larger prospective studies are needed to study the consistency of these findings and to unravel the underlying pathophysiological mechanisms.

Original languageEnglish
Pages (from-to)1048-1061
Number of pages14
JournalThe American Journal of Geriatric Psychiatry
Volume25
Issue number10
DOIs
Publication statusPublished - Oct 2017

Keywords

  • Postoperative delirium
  • postoperative cognitive decline
  • neurovascular brain changes
  • neurodegenerative brain changes
  • magnetic resonance imaging
  • Neurodegenerative Diseases/diagnostic imaging
  • Delirium/diagnostic imaging
  • Humans
  • Postoperative Complications/diagnostic imaging
  • Cerebrovascular Disorders/diagnostic imaging
  • Brain/diagnostic imaging
  • Magnetic Resonance Imaging
  • Cognitive Dysfunction/diagnostic imaging

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