Summary

for people ages 40-75 (full criteria)
at UCLA
study started
estimated completion
Susana Vacas, MD, PhD(ucla)

Description

Summary

The purpose of this study is to examine the mechanisms of brain injury contributing to postoperative neurocognitive disorders (PNCD) in an at-risk population (obstructive sleep apnea (OSA)) undergoing surgery. The investigators will enroll 50 OSA patients scheduled for surgery. All patients will have a brain scan (fMRI) within five days before surgery and two days and six months after surgery. During this visit cognitive function will be assessed using the Wide Range Assessment of Memory and Learning (WRAML2) and Montreal Cognitive Assessment (MoCA) tests. Patients will also be asked to participate in a blood draw during the first 2 visits for fMRI (within five days of surgery and two days after surgery). The Confusion Assessment Method (CAM-S) test, will be used to examine postoperative delirium.

Official Title

Mechanisms Mediating Postoperative Neurocognitive Disorders

Details

The investigators will examine the potential mechanisms of brain injury contributing to postoperative neurocognitive disorders (PNCD) in an at-risk population (obstructive sleep apnea (OSA)). This study proposes that neuro-inflammation is associated with measurable tissue changes that can be examined with MD measures and blood biomarkers.

On the day of surgery, standard of care procedures will take place. Hemodynamic vitals will be continuously monitored. As per the latest guidelines and recommendations from the ASA, mean arterial pressure (MAP) will be targeted to > 60 mmHg or within 20% of baseline values, and processed EEG-guided anesthesia will be monitored to maintain a patient state index between 20-50. Electronic medical records and intraoperative integrated physiologic waveform will be collected.

In summary, the investigators will examine the potential mechanisms of brain injury contributing to postoperative delirium (POD) and acute and long-lasting neurocognitive deficits in an at-risk population (OSA).

Keywords

Obstructive Sleep Apnea Neurocognitive Disorders brain imaging neurocognitive testing Sleep Apnea, Obstructive Cognitive testing Blood Biomarkers

Eligibility

For people ages 40-75

Inclusion Criteria:

Subjects with a diagnosis of moderate-to-severe OSA (apnea hypopnea index [AHI]>15 events/hour confirmed by overnight polysomnography), scheduled for open or robotic surgery (abdominal, gynecologic, or urologic), and upper or lower extremity orthopedic procedures

Location

  • Ronald Reagan UCLA Medical Center, Department of Anesthesiology & Perioperative Medicine accepting new patients
    Los Angeles California 90095 United States

Lead Scientist

  • Susana Vacas, MD, PhD (ucla)
    Assistant Professor-in-Residence, Anesthesiology. Authored (or co-authored) 12 research publications.

Details

Status
accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
University of California, Los Angeles
ID
NCT04244162
Study Type
Observational
Last Updated