Tang Xuemiao, Zhang Xinxin, Dong Hailong, Zhao Guangchao
Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Brain Sci. 2022 Aug 13;12(8):1073. doi: 10.3390/brainsci12081073.
Postoperative neurocognitive disorder (PND) is a common postoperative complication, particularly in older patients. Electroencephalogram (EEG) monitoring, a non-invasive technique with a high spatial-temporal resolution, can accurately characterize the dynamic changes in brain function during the perioperative period. Current clinical studies have confirmed that the power density of alpha oscillation during general anesthesia decreased with age, which was considered to be associated with increased susceptibility to PND in the elderly. However, evidence on whether general anesthesia under EEG guidance results in a lower morbidity of PND is still contradictory. This is one of the reasons that common indicators of the depth of anesthesia were limitedly derived from EEG signals in the frontal lobe. The variation of multi-channel EEG features during the perioperative period has the potential to highlight the occult structural and functional abnormalities of the subcortical-cortical neurocircuit. Therefore, we present a review of the application of multi-channel EEG monitoring to predict the incidence of PND in older patients. The data confirmed that the abnormal variation in EEG power and functional connectivity between distant brain regions was closely related to the incidence and long-term poor outcomes of PND in older adults.
术后神经认知障碍（PND）是一种常见的术后并发症，在老年患者中尤为常见。脑电图（EEG）监测是一种具有高时空分辨率的非侵入性技术，能够准确地表征围手术期脑功能的动态变化。目前的临床研究证实，全身麻醉期间α波振荡的功率密度随年龄增长而降低，这被认为与老年人对PND易感性增加有关。然而，关于EEG引导下的全身麻醉是否会降低PND发病率的证据仍然相互矛盾。这是麻醉深度的常用指标有限地源自额叶EEG信号的原因之一。围手术期多通道EEG特征的变化有可能凸显皮质下-皮质神经回路隐匿的结构和功能异常。因此，我们对多通道EEG监测在预测老年患者PND发生率方面的应用进行综述。数据证实，EEG功率异常变化以及远距离脑区之间的功能连接与老年人PND的发生率和长期不良预后密切相关。
