Exploring EEG Biomarkers to Predict Delirium Risk in Elderly Patients

Published on September 25, 2023

Imagine your brain is like a car engine, idling at different speeds depending on its state. In a similar way, our brains have an idle state that can be measured using electroencephalography (EEG) – a process of recording electrical activity in the brain. This study focused on elderly patients who underwent surgery and aimed to investigate the relationship between preoperative EEG and postoperative delirium (POD). By analyzing a specific resting-state EEG biomarker called median dominant frequency (MDF), associated with alpha oscillations in the prefrontal regions of the brain, researchers found that a lower MDF on preoperative EEG was linked to an increased risk of POD. They also discovered that postoperative cognitive disorders could persist for up to a year in patients with POD. These findings suggest that EEG could be a valuable tool for identifying individuals at high risk of developing POD. To learn more about this exciting research and its implications for improving outcomes in elderly surgical patients, delve into the full article!

Postoperative delirium (POD) is associated with adverse outcomes in elderly patients after surgery. Electroencephalography (EEG) can be used to develop a potential biomarker for degenerative cerebral dysfunctions, including mild cognitive impairment and dementia. This study aimed to explore the relationship between preoperative EEG and POD. We included 257 patients aged >70 years who underwent spinal surgery. We measured the median dominant frequency (MDF), which is a resting-state EEG biomarker involving intrinsic alpha oscillations that reflect an idle cortical state, from the prefrontal regions. Additionally, the mini-mental state examination and Montreal cognitive assessment (MoCA) were performed before surgery as well as 5 days after surgery. For long-term cognitive function follow up, the telephone interview for cognitive status™ (TICS) was performed 1 month and 1 year after surgery. Fifty-two (20.2%) patients were diagnosed with POD. A multivariable logistic regression analysis that included age, MoCA score, Charlson comorbidity index score, Mini Nutritional Assessment, and the MDF as variables revealed that the MDF had a significant odds ratio of 0.48 (95% confidence interval 0.27–0.85). Among the patients with POD, the postoperative neurocognitive disorders could last up to 1 year. Low MDF on preoperative EEG was associated with POD in elderly patients undergoing surgery. EEG could be a novel potential tool for identifying patients at a high risk of POD.

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