Rebecca Y Klinger1, Olga G James, Salvador Borges-Neto, Tiffany Bisanar, Yi-Ju Li, Wenjing Qi, Miles Berger, Niccolò Terrando, Mark F Newman, P Murali Doraiswamy, Joseph P Mathew. 1. From the Department of Anesthesiology (R.Y.K., T.B., M.B., N.T., M.F.N., J.P.M.), Department of Radiology (O.G.J., S.B.-N.), Department of Biostatistics and Bioinformatics (Y.-J.L., W.Q.), and the Department of Psychiatry and Behavioral Science (P.M.D.), Duke University, Durham, North Carolina. University of California, San Francisco University of Southern California University of California, San Francisco University of Southern California Mayo Clinic, Rochester Mayo Clinic, Rochester University of California, Berkeley University of Pennsylvania University of Southern California University of California, Davis Brigham and Women's Hospital/Harvard Medical School Indiana University Washington University St. Louis University of Pennsylvania Prevent Alzheimer's Disease 2020 (Chair) Siemens Alzheimer's Association University of Pittsburgh Washington University St. Louis Cornell University Albert Einstein College of Medicine of Yeshiva University AD Drug Discovery Foundation Acumen Pharmaceuticals Washington University St. Louis Northwestern University National Institute of Mental Health Brown University Eli Lilly (Chair) BWH/HMS (Chair) University of Washington (Chair) Mayo Clinic, Rochester (Core Principal Investigator) University of Southern California University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, Davis (Core Principal Investigator) University of California, Davis University of California, San Diego Mayo Clinic, Rochester (Core Principal Investigator) Mayo Clinic, Rochester University of London University of California, Los Angeles School of Medicine University of California, San Francisco Magnetic Resonance Imaging University of California, Davis Mayo Clinic Mayo Clinic Mayo Clinic Mayo Clinic Mayo Clinic Mayo Clinic Mayo Clinic University of California, Berkeley (Core Principal Investigator) University of Michigan University of Utah Banner Alzheimer's Institute Banner Alzheimer's Institute University of Pittsburgh University of California, Berkeley Washington University St. Louis Washington University St. Louis Washington University St. Louis Washington University St. Louis (ASCP) - Past Investigator University of Pennsylvania School of Medicine University of Pennsylvania School of Medicine University of Pennsylvania School of Medicine University of Pennsylvania School of Medicine University of Pennsylvania School of Medicine University of Southern California (Core Principal Investigator) University of Southern California University of Southern California Indiana University Indiana University University of California, Irvine Indiana University Indiana University Indiana University Indiana University University of California, San Francisco University of California, San Diego Prevent Alzheimer's Disease 2020 University of California, San Diego National Institute on Aging University of California, San Francisco Brown University National Institute of Mental Health Cornell University Johns Hopkins University Richard Frank Consulting Prevent 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of Pennsylvania University of Southern California Perelman School of Medicine, University of Pennsylvania University of California, San Francisco Rehabilitation Institute of Chicago, Feinberg School of Medicine, Northwestern University University of Washington (Chair) Core Principal Investigator Mayo Clinic, Rochester (Core Principal Investigator) University of Southern California University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Diego University of California, San Francisco University of California, San Francisco University of California, San Francisco Neylan Davis (Core Principal Investigator) Neylan San Diego Mayo Clinic, Rochester (Core Principal Investigator) Mayo Clinic, Rochester Mayo Clinic Mayo Clinic Mayo Clinic Mayo Clinic Mayo Clinic Senjem Berkeley (Core Principal Investigator) 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Abstract
BACKGROUND: Amyloid deposition is a potential contributor to postoperative cognitive dysfunction. The authors hypothesized that 6-week global cortical amyloid burden, determined by F-florbetapir positron emission tomography, would be greater in those patients manifesting cognitive dysfunction at 6 weeks postoperatively. METHODS: Amyloid deposition was evaluated in cardiac surgical patients at 6 weeks (n = 40) and 1 yr (n = 12); neurocognitive function was assessed at baseline (n = 40), 6 weeks (n = 37), 1 yr (n = 13), and 3 yr (n = 9). The association of 6-week amyloid deposition with cognitive dysfunction was assessed by multivariable regression, accounting for age, years of education, and baseline cognition. Differences between the surgical cohort with cognitive deficit and the Alzheimer's Disease Neuroimaging Initiative cohorts (normal and early/late mild cognitive impairment) was assessed, adjusting for age, education, and apolipoprotein E4 genotype. RESULTS: The authors found that 6-week abnormal global cortical amyloid deposition was not associated with cognitive dysfunction (13 of 37, 35%) at 6 weeks postoperatively (median standard uptake value ratio [interquartile range]: cognitive dysfunction 0.92 [0.89 to 1.07] vs. 0.98 [0.93 to 1.05]; P = 0.455). In post hoc analyses, global cortical amyloid was also not associated with cognitive dysfunction at 1 or 3 yr postoperatively. Amyloid deposition at 6 weeks in the surgical cohort was not different from that in normal Alzheimer's Disease Neuroimaging Initiative subjects, but increased over 1 yr in many areas at a rate greater than in controls. CONCLUSIONS: In this study, postoperative cognitive dysfunction was not associated with 6-week cortical amyloid deposition. The relationship between cognitive dysfunction and regional amyloid burden and the rate of postoperative amyloid deposition merit further investigation.
BACKGROUND: Amyloid deposition is a potential contributor to postoperative cognitive dysfunction. The authors hypothesized that 6-week global cortical amyloid burden, determined by F-florbetapir positron emission tomography, would be greater in those patients manifesting cognitive dysfunction at 6 weeks postoperatively. METHODS: Amyloid deposition was evaluated in cardiac surgical patients at 6 weeks (n = 40) and 1 yr (n = 12); neurocognitive function was assessed at baseline (n = 40), 6 weeks (n = 37), 1 yr (n = 13), and 3 yr (n = 9). The association of 6-week amyloid deposition with cognitive dysfunction was assessed by multivariable regression, accounting for age, years of education, and baseline cognition. Differences between the surgical cohort with cognitive deficit and the Alzheimer's Disease Neuroimaging Initiative cohorts (normal and early/late mild cognitive impairment) was assessed, adjusting for age, education, and apolipoprotein E4 genotype. RESULTS: The authors found that 6-week abnormal global cortical amyloid deposition was not associated with cognitive dysfunction (13 of 37, 35%) at 6 weeks postoperatively (median standard uptake value ratio [interquartile range]: cognitive dysfunction 0.92 [0.89 to 1.07] vs. 0.98 [0.93 to 1.05]; P = 0.455). In post hoc analyses, global cortical amyloid was also not associated with cognitive dysfunction at 1 or 3 yr postoperatively. Amyloid deposition at 6 weeks in the surgical cohort was not different from that in normal Alzheimer's Disease Neuroimaging Initiative subjects, but increased over 1 yr in many areas at a rate greater than in controls. CONCLUSIONS: In this study, postoperative cognitive dysfunction was not associated with 6-week cortical amyloid deposition. The relationship between cognitive dysfunction and regional amyloid burden and the rate of postoperative amyloid deposition merit further investigation.
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