Postoperative Delirium Linked to Hippocampal Loss

Publications

medRxiv

One-Year Brain Structural Changes Are Associated with Postoperative Delirium and Delayed Resolution of Interleukin-6

Product:

CNS Disease Panel 120

Topic:

CNS

Disease Area:

Postoperative Delirium

Sample Type:

Plasma

Topic/Product:

CNS Disease Panel 120

Disease Area:

Postoperative Delirium

Sample Type:

Plasma

Abstract

Background
Postoperative delirium is a common complication in older adults and is associated with neuroinflammation and cognitive decline. Previous studies have shown that the number of surgical procedures is associated with hippocampal volume loss in older adults in a large-scale UK Biobank study. However, it remains unclear whether hippocampal volume loss within one year after surgery is associated with postoperative delirium.

Methods
Longitudinal structural MRI data and blood biomarkers were collected before surgery and one year postoperatively from 62 participants (>65 years, 27 females) undergoing major non-intracranial surgery. Hippocampal and other subcortical volumes were quantified using FreeSurfer. Cortical thickness was measured for cortical regions defined by the Desikan–Killiany (DK) atlas. One-year structural changes were examined in relation to peak Delirium Rating Scale (DRS) scores and one-year changes in plasma interleukin (IL)-6 levels.

Results
One-year volume loss in the right hippocampus was significantly correlated with postoperative peak DRS scores and the one-year change in IL-6. Additional gray matter reductions were observed in the right putamen and the right superior parietal cortex. Right putamen volume loss was also associated with the one-year change in IL-6, while cortical thinning in the right superior parietal cortex was associated with peak DRS scores.

Conclusions
Postoperative delirium is associated with longitudinal gray matter loss following surgery. Delayed resolution of inflammation may also contribute to postoperative brain structural changes.

Authors & Affiliations

Jinglei Lv1 2 3 *, Jenniffer Taylor1, Samantha Curtis4, Kaitlin Kramer4, David Kunkel5, Shalini Thakur5, Veena Nair6, Matthew I. Banks5, Robert A. Pearce5, Vivek Prabhakaran6, Richard Lennertz5 and Robert D. Sanders1 3

¹Central Clinical School, Faculty of Medicine & Health, The University of Sydney, Camperdown, NSW, Australia

²School of Biomedical Engineering, Faculty of Engineering, The University of Sydney, Camperdown, NSW, Australia

³Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia

⁴Royal Prince Alfred Hospital, Camperdown, NSW, Australia

⁵Department of Anaesthesiology, University of Wisconsin, Madison, WI, USA

⁶Department of Radiology, University of Wisconsin, Madison, WI, USA

Steve Williams, MD, PhD

CSO

Dr. Willams serves as the company’s Chief Scientific Officer. He was previously Chief Medical Officer at Standard Biotools and at SomaLogic where he pioneered the discipline for discovery and validation of predictive, diagnostic and prognostic models using machine-learning applied to large-plex proteomics. 20 such tests were used for drug characterization, safety and efficacy when incorporated in clinical drug trials at Pharma/Biotech and 17 different multivariate tests were validated and translated into regulated healthcare uses. Prior to SomaLogic, Dr. Williams was at Pfizer in the UK and the USA as a clinical triallist in Translational Medicine, and subsequently as VP, Global Clinical Technology. He sat on the National Advisory Council for the National Institute of Biomedical Imaging and Bioengineering, the Executive Committee for the FNIH Biomarkers Consortium, and worked with FDA and PhRMA on developing evidentiary standards for biomarker qualification. Dr. William’s medical training was in London, at Charing Cross and Westminster Medical School, followed by a PhD in medicine/physiology at the same institution and training in Radiology at the University of Newcastle Upon Tyne. Steve is co-inventor on 26 proteomics patents and author/coauthor on multiple foundational proteomics manuscripts.

Justin McAnear

CFO

Mr. McAnear serves as the company’s Chief Financial Officer. He brings over 25 years of operational and financial leadership experience across various sectors and was instrumental in taking 10x Genomics public in 2019, serving as its CFO for over five years. Mr. McAnear served for over 3 years as Tesla’s VP of Worldwide Finance and Operations, supporting landmark initiatives such as the Model X and Model 3 launches and Solar City acquisition. He also held various roles at Apple and J&J earlier in his career and served as a naval officer and aviator for over 9 years.