%0 Journal Article
%T Cognitive Dysfunction after On-Pump Operations: Neuropsychological Characteristics and Optimal Core Battery of Tests
%A Anna G. Polunina
%A Elena Z. Golukhova
%A Alla B. Guekht
%A Natalia P. Lefterova
%A Leo A. Bokeria
%J Stroke Research and Treatment
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/302824
%X 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. 1. Introduction Postoperative cognitive dysfunction (POCD) is a mild form of perioperative ischemic brain injury, which emerges predominantly as memory decline during several months, or even years after surgery [1每5]. In addition, patients commonly report decreased concentration, attention span, and psychomotor speed. Both patients and spouses of patients notice postoperative memory decline after the first year after operation [3]. Negative effects on driving abilities during several months after uncomplicated cardiac surgeries were registered [6]. Some researchers include a broader spectrum of disorders around the term ※postoperative cognitive dysfunction§〞these disorders may include perioperative ischemic brain damage, brain death, delirium, stroke, and transitory ischemic attack [5]. Multiple neuropsychological studies confirm a decline in the performance of cognitive tests in the majority of patients during the first week after cardiac surgery and in about 30每40% of patients in 1每3 months after surgery in comparison with preoperative testing [review: [7]]. In young patients, cognitive function tends to be restored to its preoperative levels, in about 6每12 months after surgery [8每12], and there is no association between POCD and risk of dementia, in this young
%U http://www.hindawi.com/journals/srt/2014/302824/