title: Cognitive dysfunction after on-pump operations: neuropsychological characteristics and optimal core battery of tests.
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.
authors: A. N. Bakulev Research Center for Cardiovascular Surgery, Russian Academy of Medical Sciences, Rublevskoe shosse 135, Moscow 121552, Russia ; Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Ul. Donskaya 43, Moscow 115419, Russia.
authors: Anna G
authors: AG
authors: Polunina
authors: A. N. Bakulev Research Center for Cardiovascular Surgery, Russian Academy of Medical Sciences, Rublevskoe shosse 135, Moscow 121552, Russia.
authors: Elena Z
authors: EZ
authors: Golukhova
authors: Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Ul. Donskaya 43, Moscow 115419, Russia ; Department of Neurology and Neurosurgery of Russian National Research Medical University, Leninsky pr-t 8-8, Moscow 119049, Russia.
authors: Alla B
authors: AB
authors: Guekht
authors: A. N. Bakulev Research Center for Cardiovascular Surgery, Russian Academy of Medical Sciences, Rublevskoe shosse 135, Moscow 121552, Russia.
authors: Natalia P
authors: NP
authors: Lefterova
authors: A. N. Bakulev Research Center for Cardiovascular Surgery, Russian Academy of Medical Sciences, Rublevskoe shosse 135, Moscow 121552, Russia.
authors: Leo A
authors: LA
authors: Bokeria