Preoperative thalamus volume is not associated with preoperative cognitive impairment (preCI) or postoperative cognitive dysfunction (POCD)
Marinus Fislage, Insa Feinkohl, Friedrich Borchers, Tobias Pischon, Claudia Spies, Georg Winterer, Norman Zacharias, Alissa Wolf, Anika Müller, Daniel Hadzidiakos, Fatima Yürek, Gunnar Lachmann, Kwaku Ofosu, Maria Heinrich, Rudolf Mörgeli, Jürgen Gallinat, Simone Kühn, Arjen J. C. Slooter, Edwin van Dellen, Ilse Kant, Jeroen de Bresser, Jeroen Hendrikse, Simone van Montfort, David Menon, Emmanuel A. Stamatakis, Jacobus Preller, Laura Moreno-López, Stefan Winzeck, Daniela Melillo, Diana Boraschi, Giacomo Della Camera, Paola Italiani, Reinhard Schneider, Roland Krause, Karsten Heidtke, Peter Nürnberg, Anja Helmschrodt, Axel Böcher, Bettina Hafen, Franz Paul Armbruster, Ina Diehl, Jana Ruppert, Katarina Hartmann, Marion Kronabel, Marius Weyer, Thomas Dschietzig, Malte Pietzsch, Simon Weber, Bernd Ittermann, Ariane Fillmer
Abstract
Abstract A growing body of literature suggests the important role of the thalamus in cognition and neurodegenerative diseases. This study aims to elucidate whether the preoperative thalamic volume is associated with preoperative cognitive impairment (preCI) and whether it is predictive for postoperative cognitive dysfunction at 3 months (POCD). We enrolled 301 patients aged 65 or older and without signs of dementia who were undergoing elective surgery. Magnetic resonance imaging was conducted prior to surgery. Freesurfer (version 5.3.) was used to automatically segment the thalamus volume. A neuropsychological test battery was administered before surgery and at a 3 month follow-up. It included the computerized tests Paired Associate Learning (PAL), Verbal Recognition Memory (VRM), Spatial Span Length (SSP), Simple Reaction Time (SRT), the pen-and-paper Trail-Making-Test (TMT) and the manual Grooved Pegboard Test (GPT). Using a reliable change index, preCI and POCD were defined as total Z-score > 1.96 (sum score over all tests) and/or Z-scores > 1.96 in ≥ 2 individual cognitive test parameters. For statistical analyses, multivariable logistic regression models were applied. Age, sex and intracranial volume were covariates in the models. Of 301 patients who received a presurgical neuropsychological testing and MRI, 34 (11.3%) had preCI. 89 patients (29.5%) were lost to follow-up. The remaining 212 patients received a follow-up cognitive test after 3 months, of whom 25 (8.3%) presented with POCD. Independently of age, sex and intracranial volume, neither preCI (OR per cm 3 increment 0.81 [95% CI 0.60–1.07] p = 0.14) nor POCD (OR 1.02 per cm 3 increment [95% CI 0.75–1.40] p = 0.87) were statistically significantly associated with patients’ preoperative thalamus volume. In this cohort we could not show an association of presurgical thalamus volume with preCI or POCD. Clinical Trial Number: NCT02265263 ( https://clinicaltrials.gov/ct2/show/results/NCT02265263 ) .