Our Summary

This study looked at cognitive decline (a decrease in mental functions such as memory, attention, and problem-solving) after non-heart-related surgery. The researchers hypothesized that this decline might be linked to signs of brain damage that could be detected by looking at the levels of certain proteins in the patients’ blood.

They tested this by monitoring 149 patients who underwent shoulder surgery, running mental tests before and a month after the surgery and taking blood samples before and after anesthesia. They then analyzed the blood samples for levels of three proteins - S100β, neuron-specific enolase (NSE), and glial fibrillary acid protein (GFAP) - and compared these levels with the results of the mental tests.

The results showed that about 10% of the patients had noticeable cognitive decline a month after surgery. They also found that higher levels of GFAP in the blood were linked to poorer performance on the mental tests. However, there was no such link found with the other two proteins.

In simple terms, the study suggests that a drop in mental abilities after shoulder surgery might be linked to brain cell damage, as indicated by higher levels of the GFAP protein in the blood.

FAQs

  1. What was the main focus of this study on cognitive decline after surgery?
  2. How were the levels of certain proteins in the blood linked to signs of brain damage in the study?
  3. What does the study suggest about the link between a drop in mental abilities after shoulder surgery and brain cell damage?

Doctor’s Tip

Therefore, it is important for patients undergoing brain surgery to discuss potential risks and complications with their doctor. They may also be advised to follow post-operative care instructions carefully, including rest, medication management, and follow-up appointments to monitor for any signs of cognitive decline. It’s important to communicate any concerns or changes in mental function to your healthcare provider to ensure proper management and treatment.

Suitable For

Patients who are at higher risk for cognitive decline after non-heart-related surgery, such as shoulder surgery, may be recommended brain surgery if they show signs of brain damage as indicated by higher levels of certain proteins in their blood. These patients may include those who are older, have preexisting cognitive impairments, or have other risk factors for postoperative cognitive decline. Brain surgery may be recommended to address any underlying brain damage and improve cognitive function.

Timeline

Before brain surgery:

  1. Patient consults with a neurosurgeon and undergoes various tests and imaging scans to determine the need for surgery.
  2. Pre-operative preparations such as fasting, medication adjustments, and psychological counseling may be required.
  3. On the day of surgery, the patient is admitted to the hospital, undergoes pre-surgical procedures, and is taken to the operating room.

After brain surgery:

  1. The patient wakes up in the recovery room and is monitored closely for any complications.
  2. Depending on the type of surgery, the patient may stay in the hospital for a few days to a few weeks for recovery.
  3. Post-operative care includes pain management, physical therapy, and rehabilitation to regain cognitive and physical functions.
  4. Follow-up appointments with the neurosurgeon are scheduled to monitor the patient’s progress and address any concerns.
  5. Over time, the patient may experience improvements in symptoms related to the underlying condition that required surgery.

What to Ask Your Doctor

Questions a patient should ask their doctor about brain surgery include:

  1. What specific type of brain surgery will I be undergoing?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery process expected to be, and what can I do to aid in my recovery?
  4. Will there be any cognitive decline or changes in mental function after the surgery?
  5. How will my cognitive function be monitored before and after the surgery?
  6. What measures will be taken to minimize the risk of brain damage during the surgery?
  7. Are there any specific proteins or markers that will be monitored in my blood to assess for brain damage?
  8. How will any cognitive decline be managed or treated if it occurs?
  9. Are there any lifestyle changes or therapy options that can help improve cognitive function after the surgery?
  10. How frequently will follow-up appointments be scheduled to monitor my cognitive function post-surgery?

Reference

Authors: Rappold T, Laflam A, Hori D, Brown C, Brandt J, Mintz CD, Sieber F, Gottschalk A, Yenokyan G, Everett A, Hogue CW. Journal: Br J Anaesth. 2016 Jan;116(1):83-9. doi: 10.1093/bja/aev415. PMID: 26675953