Resting-state prefrontal EEG biomarker in correlation with postoperative delirium in elderly patients

Jeongmin Kim; Sujung Park; Keung-Nyun Kim; Yoon Ha; Sang-Jun Shin; Wonseok Cha; Ki-Young Lee; Jungmi Choi; Bon-Nyeo Koo

doi:10.3389/fnagi.2023.1224264

Resting-state prefrontal EEG biomarker in correlation with postoperative delirium in elderly patients

Front Aging Neurosci. 2023 Sep 25:15:1224264. doi: 10.3389/fnagi.2023.1224264. eCollection 2023.

Authors

Jeongmin Kim^{1

2}, Sujung Park^{1

2}, Keung-Nyun Kim³, Yoon Ha^{3

4}, Sang-Jun Shin⁵, Wonseok Cha⁶, Ki-Young Lee^#^{1

2}, Jungmi Choi^#⁶, Bon-Nyeo Koo^#^{1

2}

Affiliations

¹ Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
² Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
³ Department of Neurosurgery, Spine and Spinal Cord Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁴ POSTECH Biotech Center, Pohang University of Science and Technology, Pohang, Republic of Korea.
⁵ Department of Biomedical Systems Informatics, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁶ Human Anti-Aging Standards Research Institute, Gyeongsangnam-Do, Republic of Korea.

^# Contributed equally.

Abstract

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.

Keywords: elderly; electroencephalography; median dominant frequency; postoperative complications; postoperative delirium.

Grants and funding

The Basic Science Research Program supported this study through the National Research Foundation of Korea, by the Korea Government (MSIT) (NRF-2020R1A2C1012166 to B-NK and NRF-2022R1C1C100962212 to JK), a Severance Hospital Research fund for Clinical Excellence (SHRC) (C-2019-0030, C-2020-0033 to K-YL).