The influence of preoperative cognitive impairment on the changes in the brain's electrical activity in patients 1 year after coronary artery bypass grafting HTML

Authors: I.V. Tarasova, O.A. Trubnikova, I.N. Kukhareva, O.L. Barbarash, L.S. Barbarash

Company: Research Institute for Complex Issues of Cardiovascular Diseases, Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation

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Heading: Original articles

UDC: 616.132.2-089.843:616.831-005
DOI: https://doi.org/10.24022/1997-3187-2018-12-4-304-315

For citation: Tarasova I.V., Trubnikova O.A., Kukhareva I.N., Barbarash O.L., Barbarash L.S. The influence of preoperative cognitive impairment on the changes in the brain's electrical activity in patients 1 year after coronary artery bypass grafting. Creative Cardiology. 2018; 12 (4): 304–15 (in Russ.). DOI: 10.24022/1997-3187-2018-12-4-304-315.

Received / Accepted:  26.10.2018/12.11.2018

Key Words: electroencephalography theta rhythm preexisting cognitive impairments coronary artery bypass grafting

Abstract

Objective. To study the brain electrical activity changes at 1 year after coronary artery bypass grafting (CABG) in patients with and without preoperative cognitive impairment.

Material and methods. Sixty-five patients (aged 45 to 69 years) after CABG were enrolled to the study. All the patients were divided into two groups before surgery: with mild cognitive impairment (MCI) (n=27, Mini mental state examination (MMSE) scores 26.2±0.95) and without MCI (n=38, MMSE scores 28.5±0.69). All patients underwent clinical and neuropsychological examination, as well as multichannel computer electroencephalography (EEG) 3–5 days before surgery and 1 year after CABG. Monopolar EEG recording in the range 0–50 Hz was performed from sixty-two sites according to the international 10–20 system. The EEGs recorded in the resting states with the eyes open and closed.

Results. We revealed that the patients without preexisting cognitive impairment had better cognitive functions at 1 year after CABG as compared with preoperative data (p=0.0007), whereas in the MCI group there was no improvement in cognitive status. MCI patients demonstrated diffuse theta-activity increase with eyes open state (p<0.05), and an alpha activity increase in the left hemisphere with eyes closed in comparison with preoperative EEG values (p=0.01). In addition, the patients with preexisting cognitive impairment had frontal alpha activity increase with eyes open at 1 year after CABG as compared with preoperative values (p<0.05).

Conclusions. It is suggested that the cortical dysfunction detected by computer EEG data at 1 year after CABG may be associated with worse postoperative recovery of cognitive functions in patients with preexisting cognitive impairment.

References

  1. Stroobant N., Vingerhoets G. Pre-existing cognitive impairment in candidates for cardiac surgery: an overview. Heart. 2009; 95 (22): 1820–5. DOI: 10.1136/hrt.2009.168237
  2. Maekawa K., Goto T., Baba T., Yoshitake A., Katahira K., Yamamoto T. Impaired cognition preceding cardiac surgery is related to cerebral ischemic lesions. J. Anesth. 2011; 25 (3): 330–6. DOI: 10.1007/s00540-011-1108-5
  3. Trubnikova O.A., Mamontova A.S., Syrova I.D., Maleva O.V., Barbarash O.L. Does preoperative mild cognitive impairment predict postoperative cognitive dysfunction after on-pump coronary bypass surgery? J. Alzheimers Dis. 2014; 42 (Suppl. 3): S45–51. DOI: 10.3233/JAD-132540
  4. Babiloni C., Frisoni G.B., Vecchio F., Lizio R., Pievani M., Cristina G. et al. Stability of clinical condition in mild cognitive impairment is related to cortical sources of alpha rhythms: an electroencephalographic study. Hum. Brain. Mapp. 2011; 32 (11): 1916–31. DOI: 10.1002/hbm.21157
  5. Moretti D.V., Zanetti O., Binetti G., Frisoni G.B. Quantitative EEG markers in mild cognitive impairment: degenerative versus vascular brain impairment. Int. J. Alzheimers Dis. 2012; 2012: 917537. DOI: 10.1155/2012/917537
  6. López M.E., Turrero A., Cuesta P., López-Sanz D., Brun~a R., Marcos A. et al. Searching for primary predictors of conversion from mild cognitive impairment to Alzheimer’s disease: a multivariate follow-up study. J. Alzheimers Dis. 2016; 52 (1): 133–43. DOI: 10.3233/JAD-151034
  7. Яхно Н.Н., Захаров В.В., Локшина А.Б., Коберская Н.Н., Мхитарян Э.А. Деменции: руководство для врачей. 3-е изд. М.: МЕДпреcс-информ; 2011.
  8. Бокерия Л.А., Гудкова Р.Г. Сердечно-сосудистая хирургия – 2015. Болезни и врожденные аномалии системы кровообращения. М.: НЦССХ им. А.Н. Бакулева РАМН; 2016.
  9. Трубникова О.А., Тарасова И.В., Мамонтова А.С., Сырова И.Д., Малева О.В., Барбараш О.Л. Структура когнитивных нарушений и динамика биоэлектрической активности мозга у пациентов после прямой реваскуляризации миокарда. Российский кардиологический журнал. 2014; 8 (112): 57–62. DOI: 10.15829/1560-4071-2014-8-57-62
  10. Трубникова О.А., Каган Е.С., Куприянова Т.В., Малева О.В., Аргунова Ю.А., Кухарева И.Н. Нейропсихологический статус пациентов со стабильной ишемической болезнью сердца и факторы на него влияющие. Комплексные проблемы сердечно-сосудистых заболеваний. 2017; 4 (1): 112–21. DOI: 10.17802/2306-1278-2017-1-112-121
  11. Evered L.A., Silbert B.S., Scott D.A., Maruff P., Ames D., Choong P.F. Preexisting cognitive impairment and mild cognitive impairment in subjects presenting for total hip joint replacement. Anesthesiology. 2011; 114 (6): 1297–304. DOI: 10.1097/ALN.0b013e31821b1aab
  12. Crosby G., Culley D.J., Hyman B.T. Preoperative cognitive assessment of the elderly surgical patient: a call for action. Anesthesiology. 2011; 114 (6): 1265–8. DOI: 10.1097/ALN.0b013e31821b1bc8
  13. Pandya S.Y., Clem M.A., Silva L.M., Woon F.L. Does mild cognitive impairment always lead to dementia? A review. J. Neurol. Sci. 2016; 369: 57–62. DOI: 10.1016/j.jns.2016.07.055
  14. Eckenhoff R.G., Laudansky K.F. Anesthesia, surgery, illness and Alzheimer's disease. Prog. Neuropsychopharmacol. Biol. Psychiatry. 2013; 47: 162–6. DOI: 10.1016/j.pnpbp.2012.06.011
  15. Klinger R.Y., James O.G., Wong T.Z., Newman M.F., Doraiswamy P.M., Mathew J.P. Cortical β-amyloid levels and neurocognitive performance after cardiac surgery. BMJ Open. 2013; 3 (9): e003669. DOI: 10.1136/bmjopen-2013-003669
  16. Pendlebury S.T., Cuthbertson F.C., Welch S.J., Mehta Z., Rothwell P.M. Underestimation of cognitive impairment by Mini-Mental State Examination versus the Montreal Cognitive Assessment in patients with transient ischemic attack and stroke: a population-based study. Stroke. 2010; 41 (6): 1290–3. DOI: 10.1161/STROKEAHA.110.579888
  17. Dag E., Örnek N., Örnek K., Günay F., Türkel Y. Mini mental state exam versus Montreal cognitive assessment in patients with age-related macular degeneration. Eur. Rev. Med. Pharmacol. Sci. 2014; 18 (20): 3025–8.
  18. Заржецкий Ю.В., Аврущенко М.Ш., Волков А.В. Нейрофизиологические механизмы постреанимационного повреждения мозга. Общая реаниматология. 2006; 2 (5–6): 101–10. DOI: 10.15360/1813-9779-2006-6-101-110
  19. Funder K.S., Steinmetz J., Rasmussen L.S. Cognitive dysfunction after cardiovascular surgery. Minerva Anestesiol. 2009; 75 (5): 329–32.
  20. Alosco M.L., Gunstad J., Jerskey B.A., Xu X., Clark U.S., Hassenstab J. et al. The adverse effects of reduced cerebral perfusion on cognition and brain structure in older adults with cardiovascular disease. Brain. Behav. 2013; 3 (6): 626–36. DOI: 10.1002/brb3.171
  21. Nagata T., Shinagawa S., Ochiai Y., Aoki R., Kasahara H., Nukariya K., Nakayama K. Association between executive dysfunction and hippocampal volume in Alzheimer's disease. Int. Psychogeriatr. 2011; 23 (5): 764–71.
  22. Overdorp E.J., Kessels R.P., Claassen J.A., Oosterman J.M. Cognitive impairments associated with medial temporal atrophy and white matter hyperintensities: an MRI study in memory clinic patients. Front. Aging Neurosci. 2014; 6: 98.

About Authors

  • Irina V. Tarasova, Leading Researcher, Cand. Med. Sc., orcid.org/0000-0002-6391-0170;
  • Ol’ga A. Trubnikova, Head of Laboratory, Dr Med. Sc., orcid.org/0000-0001-8260-8033;
  • Irina N. Kukhareva, Researcher, orcid.org/0000-0002-6813-7017;
  • Ol’ga L. Barbarash, Corresponding Member of Russian Academy of Sciences, Director, orcid.org/0000-0002-4642-3610;
  • Leonid S. Barbarash, Chief Researcher, Academician of Russian Academy of Sciences, orcid.org/0000-0001-6981-9661

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery