Polunina Anna G, Golukhova Elena Z, Guekht Alla B, Lefterova Natalia P, Bokeria Leo A
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.
A. N. Bakulev Research Center for Cardiovascular Surgery, Russian Academy of Medical Sciences, Rublevskoe shosse 135, Moscow 121552, Russia.
Stroke Res Treat. 2014;2014:302824. doi: 10.1155/2014/302824. Epub 2014 Apr 30.
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.
术后认知功能障碍（POCD）是围手术期缺血性脑损伤的一种轻度形式，表现为术后数月甚至数年出现记忆力减退、注意力下降和注意力不集中。在此，我们展示了三项神经心理学研究的结果，这些研究总共纳入了145例接受体外循环手术的患者。我们发现，与单词列表学习和故事学习测试相比，听觉记忆广度测试（数字广度）作为POCD登记工具更有效。非言语记忆或视觉构建测试对术中打开心腔且脑空气栓塞增加的患者的POCD敏感。心理运动速度测试（数字符号或TMT A）记录了POCD，这是老年动脉粥样硬化患者的特征。最后，我们观察到测试顺序对该测试的表现有显著影响。例如，当在测试开始时进行核心测试（数字广度和数字符号）中的任何一项时，术后表现显示出最小的损害。总体而言，我们的数据表明，测试的选择以及这些测试的实施顺序可能会极大地影响POCD研究的结果。
