Introduction
postoperative cognitive dysfunction, cognitive impairment, POCD, neurocognitive disorders, amnestic, thalamic volume reduction
SECONDARY, PATHOGENESIS
Depending on risk factors and study type, postoperative cognitive dysfunction (POCD) can be observed in 8.9% to 46.1% of surgical patientsThe thalamus is an important pharmacological target for most anesthetic agents which cause a reduction of thalamic blood flow and metabolismWhile the crucial function of the thalamus as gatekeeper to consciousness, for instance during anesthesia, has been known for decades, its probable impact on cognition is receiving growing attentionSome epidemiological evidence suggests the thalamic function plays a role in age-related cognitive impairment. For instance, one study found that thalamic volume reduction was an early sign of amnestic mild cognitive impairmentA synopsis of prior research suggests that the thalamus might be a region of interest in the field of perioperative neurocognitive disorders. This secondary analysis was conducted as a longitudinal observational cohort study. We focused on preoperative brain health by measuring the preoperative thalamus volume in older patients scheduled for surgery by using structural magnetic resonance imaging. Our study objective was to investigate the possible association of presurgical thalamic volume with the presence of preoperative cognitive impairment (preCI) and its potential as a predictor for postoperative cognitive dysfunction at a 3-month follow-up (POCD). Furthermore, we aimed to clarify the role of the thalamus as a potential biomarker for perioperative neurocognitive disorders. Related findings may also help to understand the pathogenesis of cognitive impairment linked to surgical interventions. Our hypothesis suggests that a lower preoperative thalamus volume might be associated with preCI and it additionally predicts the onset of POCD.