title: Resting-State Functional Connectivity and Cognition After Major Cardiac Surgery in Older Adults without Preoperative Cognitive Impairment: Preliminary Findings.
abstract: To look for changes in intrinsic functional brain connectivity associated with postoperative changes in cognition, a common complication in seniors undergoing major surgery, using resting-state functional magnetic resonance imaging.
  
  
  
  Objective cognitive testing and functional brain imaging were prospectively performed at preoperative baseline and 6 weeks after surgery and at the same time intervals in nonsurgical controls.
  
  
  
  Academic medical center.
  
  
  
  Older adults undergoing cardiac surgery (n = 12) and nonsurgical older adult controls with a history of coronary artery disease (n = 12); no participants had cognitive impairment at preoperative baseline (Mini-Mental State Examination score >27).
  
  
  
  Differences in resting-state functional connectivity (RSFC) and global cognitive change relationships were assessed using a voxel-wise intrinsic connectivity method, controlling for demographic factors and pre- and perioperative cerebral white matter disease volume. Analyses were corrected for multiple comparisons (false discovery rate P < .01).
  
  
  
  Global cognitive change after cardiac surgery was significantly associated with intrinsic RSFC changes in regions of the posterior cingulate cortex and right superior frontal gyrus-anatomical and functional locations of the brain's default mode network (DMN). No statistically significant relationships were found between global cognitive change and RSFC change in nonsurgical controls.
  
  
  
  Clinicians have long known that some older adults develop postoperative cognitive dysfunction (POCD) after anesthesia and surgery, yet the neurobiological correlates of POCD are not well defined. The current results suggest that altered RSFC in specific DMN regions is positively correlated with global cognitive change 6 weeks after cardiac surgery, suggesting that DMN activity and connectivity could be important diagnostic markers of POCD or intervention targets for potential POCD treatment efforts.
authors.affiliation: Geriatric Behavioral Health Division, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.|Institute for Brain Sciences, Duke University, Durham, North Carolina.|Brain Imaging and Analysis Center, Duke University, Durham, North Carolina.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Browndyke
authors.affiliation: Division of Neuroanesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Miles
authors.initials: M
authors.lastname: Berger
authors.affiliation: Brain Imaging and Analysis Center, Duke University, Durham, North Carolina.|Department of Radiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Todd B
authors.initials: TB
authors.lastname: Harshbarger
authors.affiliation: Behavioral Medicine Division, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Smith
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: William
authors.initials: W
authors.lastname: White
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Tiffany L
authors.initials: TL
authors.lastname: Bisanar
authors.affiliation: Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: John H
authors.initials: JH
authors.lastname: Alexander
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Gaca
authors.affiliation: Geriatric Behavioral Health Division, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Welsh-Bohmer
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Newman
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Mathew
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D001921:Brain / Q000473:pathology*; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects*; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis; D012146:Rest
keywords: anesthesia; brain; cardiac surgical procedures; cognition; functional neuroimaging