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Association of sleep and anaesthesia EEG biomarkers with preoperative MoCA score: A pilot study
Authors:Cyril Touchard  Pauline Guimard  Karim Guessous  Oriane Saint Aubin  Charlotte Levé  Jona Joachim  Kenza Elayeb  Alexandre Mebazaa  Étienne Gayat  Joaquim Mateo  Fabrice Vallée  Jérôme Cartailler
Affiliation:1. Department of Anesthesiology and Intensive Care, Lariboisière – Saint Louis Hospitals, Paris, France;2. Department of Anesthesiology and Intensive Care, Lariboisière – Saint Louis Hospitals, Paris, France

Université Paris Cité, Boulogne-Billancourt, France;3. Department of Anesthesiology and Intensive Care, Lariboisière – Saint Louis Hospitals, Paris, France

Sorbonne Université, Paris, France;4. Department of Anesthesiology and Intensive Care, Lariboisière – Saint Louis Hospitals, Paris, France

Université Paris Cité, Boulogne-Billancourt, France

Inserm, UMRS-942, Paris Diderot University, Paris, France;5. Department of Anesthesiology and Intensive Care, Lariboisière – Saint Louis Hospitals, Paris, France

Inserm, UMRS-942, Paris Diderot University, Paris, France

Abstract:

Introduction

Preoperative cognitive impairments increase the risk of postoperative complications. The electroencephalogram (EEG) could provide information on cognitive vulnerability. The feasibility and clinical relevance of sleep EEG (EEGsleep) compared to intraoperative EEG (EEGintraop) in cognitive risk stratification remains to be explored. We investigated similarities between EEGsleep and EEGintraop vis-a-vis preoperative cognitive impairments.

Methods

Pilot study including 27 patients (63 year old [53.5, 70.0]) to whom Montreal cognitive assessment (MoCA) and EEGsleep were administered 1 day before a propofol-based general anaesthesia, in addition to EEGintraop acquisition from depth-of-anaesthesia monitors. Sleep spindles on EEGsleep and intraoperative alpha-band power on EEGintraop were particularly explored.

Results

In total, 11 (41%) patients had a MoCA <25 points. These patients had a significantly lower sleep spindle power on EEGsleep (25 vs. 40 μv2/Hz, p = .035) and had a weaker intraoperative alpha-band power on EEGintraop (85 vs. 150 μv2/Hz, p = .001) compared to patients with normal MoCA. Correlation between sleep spindle and intraoperative alpha-band power was positive and significant (r = 0.544, p = .003).

Conclusion

Preoperative cognitive impairment appears to be detectable by both EEGsleep and EEGintraop. Preoperative sleep EEG to assess perioperative cognitive risk is feasible but more data are needed to demonstrate its benefit compared to intraoperative EEG.
Keywords:cognitive function  general anaesthesia  intraoperative alpha-band band  MoCA  sleep spindles
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