Neuroimaging Considerations for Studying Post-Operative Cognitive Decline - Abstract
The mechanisms and etiology of post-operative cognitive decline (POCD) are not well understood. POCD is common in older adults undergoing major surgery, particularly following cardiac and orthopedic procedures. Brain reserve, defined as the ability of individuals’ brains to cope with insults and pathology, might account
for differences in cognition following major surgery. Neuroimaging tools allow for the assessment of individual brain reserve and have the potential to provide insights into the etiology of POCD. Here we present a brief summary of standard clinical and more advanced neuroimaging sequences warranting consideration for clinical research studies addressing POCD. Standard brain MRI protocols useful for understanding
POCD include.
T1, T2, fluid-attenuated inversion recovery (FLAIR), and diffusion-weighted imaging (DWI). While two-dimension (2D) acquisitions are common clinically, three-dimension (3D) sequences are advised for research purposes in order to advance clinical science. In addition, the inclusion of advanced 3D MRI acquisitions such as DTI and resting state functional MRI is critical for the detection of more subtle and or functional disturbances causing POCD. Such advanced MRI techniques will facilitate the understanding of the
etiology of POCD, will be able to better predict and manage patient’s outcomes and ultimately improve patient’s care.