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. 2014:2014:302824.
doi: 10.1155/2014/302824. Epub 2014 Apr 30.

Cognitive dysfunction after on-pump operations: neuropsychological characteristics and optimal core battery of tests

Anna G Polunina  1 , Elena Z Golukhova  2 , Alla B Guekht  3 , Natalia P Lefterova  2 , Leo A Bokeria  2
Affiliations

Cognitive dysfunction after on-pump operations: neuropsychological characteristics and optimal core battery of tests

Anna G Polunina et al. Stroke Res Treat. 2014.

Abstract

Postoperative cognitive dysfunction (POCD) is a mild form of perioperative ischemic brain injury, which emerges as memory decline, decreased attention, and decreased concentration during several months, or even years, after surgery. Here we present results of our three neuropsychological studies, which overall included 145 patients after on-pump operations. We found that the auditory memory span test (digit span) was more effective as a tool for registration of POCD, in comparison with the word-list learning and story-learning tests. Nonverbal memory or visuoconstruction tests were sensitive to POCD in patients after intraoperative opening of cardiac chambers with increased cerebral air embolism. Psychomotor speed tests (digit symbol, or TMT A) registered POCD, which was characteristic for elderly atherosclerotic patients. Finally, we observed that there were significant effects of the order of position of a test on the performance on this test. For example, the postoperative performance on the core tests (digit span and digit symbol) showed minimal impairment when either of these tests was administered at the beginning of testing. Overall, our data shows that the selection of tests, and the order of which these tests are administered, may considerably influence the results of studies of POCD.

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Figures

Figure 1
Figure 1
Changes of performance on auditory/verbal memory tests in three groups (Study 1; statistical results are presented in Table 2).
Figure 2
Figure 2
Changes of performance on nonverbal memory and visuoconstruction tests in three groups at follow-up (Study 1; statistical results are presented in Table 2).
Figure 3
Figure 3
Changes of global cognitive status and psychomotor speed in three groups at follow-up (Study 1; statistical results are presented in Table 2).
Figure 4
Figure 4
Changes of performance on neuropsychological tests in three groups at follow-up (Study 2; statistical results are presented in Table 4).
Figure 5
Figure 5
Effects of a test ordinal position on results of a study: the first position of the digit span forward (F = 4.03, P = 0.03), digit symbol, or TMT B in the battery of tests showed significantly different results from trials with the position of a test in the middle or end of the battery.
See this image and copyright information in PMC

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