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评估一款数字游戏作为术后认知功能障碍的神经心理学测试。

Assessment of a digital game as a neuropsychological test for postoperative cognitive dysfunction.

机构信息

Universidade de São Paulo, Faculdade de Medicina, Programa de Pós-Graduação em Anestesiologia, Ciências Cirúrgicas e Medicina Perioperatória, São Paulo, SP, Brazil.

Universidade de São Paulo, Faculdade de Medicina, Programa de Pós-Graduação em Anestesiologia, Ciências Cirúrgicas e Medicina Perioperatória, São Paulo, SP, Brazil.

出版信息

Braz J Anesthesiol. 2022 Jan-Feb;72(1):7-12. doi: 10.1016/j.bjane.2021.06.025. Epub 2021 Jul 29.

Abstract

OBJECTIVE

Postoperative cognitive dysfunction may result from worsening in a condition of previous impairment. It causes greater difficulty in recovery, longer hospital stays, and consequent delay in returning to work activities. Digital games have a potential neuromodulatory and rehabilitation effect. In this study, a digital game was used as a neuropsychological test to assess postoperative cognitive dysfunction, with preoperative patient performance as control.

METHODS

It was a non-controlled study, with patients selected among candidates for elective non-cardiac surgery, evaluated in the pre- and postoperative periods. The digital game used has six phases developed to evaluate selective attention, alternating attention, visuoperception, inhibitory control, short-term memory, and long-term memory. The digital game takes about 25 minutes. Scores are the sum of correct answers in each cognitive domain. Statistical analysis compared these cognitive functions pre- and post-surgery using a generalized linear mixed model (ANCOVA).

RESULTS

Sixty patients were evaluated, 40% male and 60% female, with a mean age of 52.7 ± 13.5 years. Except for visuoperception, a reduction in post-surgery scores was found in all phases of the digital game.

CONCLUSION

The digital game was able to detect decline in several cognitive functions postoperatively. As its completion is faster than in conventional tests on paper, this digital game may be a potentially recommended tool for assessing patients, especially the elderly and in the early postoperative period.

摘要

目的

术后认知功能障碍可能源于先前受损状况的恶化。它导致恢复更加困难,住院时间延长,并因此延迟恢复工作活动。数字游戏具有潜在的神经调节和康复作用。在这项研究中,数字游戏被用作神经心理学测试来评估术后认知功能障碍,以术前患者表现作为对照。

方法

这是一项非对照研究,选择择期非心脏手术患者作为研究对象,在术前和术后进行评估。所使用的数字游戏有六个阶段,用于评估选择性注意、交替注意、视知觉、抑制控制、短期记忆和长期记忆。数字游戏大约需要 25 分钟。分数是每个认知领域正确答案的总和。使用广义线性混合模型(ANCOVA)对术前和术后这些认知功能进行统计学分析。

结果

共评估了 60 名患者,40%为男性,60%为女性,平均年龄为 52.7±13.5 岁。除了视知觉外,数字游戏的所有阶段术后得分均下降。

结论

数字游戏能够检测到术后认知功能的下降。由于其完成速度比纸质常规测试快,因此该数字游戏可能是评估患者,特别是老年人和术后早期患者的一种潜在推荐工具。

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