Hereditary vulnerabilities to post-operative cognitive dysfunction and dementia

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• 作者：Kirk J. Hogan
• 关键词：POCD ; post-operative cognitive dysfunction ; POD ; post-operative dementia ; aMCI ; amnestic minimal cognitive impairment ; MH ; malignant hyperthermia ; RCT ; randomized clinical trial ; MMSE ; Minnesota Mental Status Exam ; CAM ; Confusion Assessment Method
• 刊名：Progress in Neuro-Psychopharmacology and Biological Psychiatry
• 出版年：2 December, 2013
• 年：2013
• 卷：47
• 期：Complete
• 页码：128-134
• 全文大小：246 K

文摘

In view of multiple prospective investigations reporting an incidence of 10% or greater in elderly patients after cardiac and non-cardiac procedures, it is surprising that no families, twins or even individual cases have been reported with persistent post-operative cognitive dysfunction (POCD) or post-operative dementia (POD) that is otherwise unexplained. As POCD and POD research has shifted in recent years from surgical and anesthetic variables to predictors of intrinsic, patient-specific susceptibility, a number of markers based on DNA sequence variation have been investigated. Nevertheless, no heritable, genomic indices of persistent POCD or post-operative dementia lasting 3 months or longer after surgery have been identified to date. The present manuscript surveys challenges confronting the search for markers of heritable vulnerability to POCD and POD, and proposes steps forward to be taken now, including the addition of surgical and anesthetic descriptors to ongoing longitudinal dementia protocols and randomized clinical trials (RCTs) comprising serial psychometric testing, and a fresh focus on phenotypes and genotypes shared between outliers with 鈥渆xtreme鈥?POCD and POD traits.