A5018134087- Intensive Care Unit Cognitive Disorders
- Anesthesia and Sedative Agents
- Anesthesia and Neurotoxicity Research
- Cardiac, Anesthesia and Surgical Outcomes
- Sleep and related disorders
- EEG and Brain-Computer Interfaces
- Treatment of Major Depression
- Spatial Cognition and Navigation
- Sleep and Wakefulness Research
- Atomic and Subatomic Physics Research
- Frailty in Older Adults
- Electroconvulsive Therapy Studies
- Health and Wellbeing Research
- Cognitive Functions and Memory
- Balance, Gait, and Falls Prevention
- Medical Malpractice and Liability Issues
- Neuroscience and Neuropharmacology Research
- Patient Safety and Medication Errors
- Radiation Dose and Imaging
- Hemodynamic Monitoring and Therapy
- Functional Brain Connectivity Studies
- Circadian rhythm and melatonin
- Heart Rate Variability and Autonomic Control
- Memory and Neural Mechanisms
- Neural dynamics and brain function
Washington University in St. Louis
2014-2025
Institute of Aging
2017
<h3>Importance</h3> Intraoperative electroencephalogram (EEG) waveform suppression, often suggesting excessive general anesthesia, has been associated with postoperative delirium. <h3>Objective</h3> To assess whether EEG-guided anesthetic administration decreases the incidence of <h3>Design, Setting, and Participants</h3> Randomized clinical trial 1232 adults aged 60 years older undergoing major surgery receiving anesthesia at Barnes-Jewish Hospital in St Louis. Recruitment was from January...
In Brief BACKGROUND: Postoperative delirium is a common complication associated with increased morbidity and mortality, longer hospital stays, greater health care expenditures. Intraoperative electroencephalogram (EEG) slowing has been previously postoperative delirium, but the relationship between intraoperative EEG suppression not investigated. METHODS: this observational cohort study, 727 adult patients who received general anesthesia planned intensive unit admission were included....
General anesthesia-a pharmacologically induced reversible state of unconsciousness-enables millions life-saving procedures. Anesthetics induce unconsciousness in part by impinging upon sexually dimorphic and hormonally sensitive hypothalamic circuits regulating sleep wakefulness. Thus, we hypothesized that anesthetic sensitivity should be sex-dependent modulated sex hormones. Using distinct behavioral measures, show at identical brain concentrations, female mice are more resistant to...
Recent modeling and empirical studies support the hypothesis that large-scale brain networks function near a critical state. Similar functional connectivity patterns derived from resting state data network models at criticality provide further support. However, despite strong implication of relationship, there has been no principled explanation how shapes characteristic in networks. Here, we hypothesized science concept partial phase locking is underlying mechanism optimal We provides...
Understanding how the brain recovers from unconsciousness can inform neurobiological theories of consciousness and guide clinical investigation. To address this question, we conducted a multicenter study 60 healthy humans, half whom received general anesthesia for 3 hr served as awake controls. We administered battery neurocognitive tests recorded electroencephalography to assess cortical dynamics. hypothesized that recovery cognition is an extended process, with differential cognitive...
Ketamine is a general anaesthetic with anti-depressant effects at subanaesthetic doses. We hypothesised that intraoperative administration of ketamine would prevent or mitigate postoperative depressive symptoms in surgical patients.We conducted an international, randomised clinical trial testing the [0.5 mg kg-1 (Lo-K) 1.0 (Hi-K)] vs control [saline placebo (P)] patients ≥60 yr old undergoing major surgery anaesthesia. administered Patient Health Questionnaire-8 before operation, on day...
Postoperative delirium, arbitrarily defined as occurring within 5 days of surgery, affects up to 50% patients older than 60 after a major operation. This geriatric syndrome is associated with longer intensive care unit and hospital stay, readmission, persistent cognitive deterioration mortality. No effective preventive methods have been identified, but preliminary evidence suggests that EEG monitoring during general anaesthesia, by facilitating reduced anaesthetic exposure suppression, might...
Abstract Background Postoperative delirium is a common complication that hinders recovery after surgery. Intraoperative electroencephalogram suppression has been linked to postoperative delirium, but it unknown if this relationship causal or merely marker of underlying cognitive abnormalities. The hypothesis study was intraoperative mediates nonzero portion the effect between preoperative abnormal cognition and delirium. Methods This prespecified secondary analysis Electroencephalography...
<h3>Introduction</h3> Postoperative delirium is one of the most common complications major surgery, affecting 10–70% surgical patients 60 years and older. Delirium an acute change in cognition that manifests as poor attention illogical thinking associated with longer intensive care unit (ICU) hospital stay, long-lasting cognitive deterioration increased mortality. Ketamine has been used anaesthetic drug for over 50 established safety record. Recent research suggests that, addition to...
Introduction Delirium is a common, serious postoperative complication. For clinical studies to generate valid findings, delirium assessments must be standardised and administered accurately by independent researchers. The Confusion Assessment Method (CAM) widely used assessment tool. objective was determine whether implementing CAM training protocol for researchers at multiple international sites yields reliable inter-rater accurate diagnosis. Methods Patients consented video recordings of...
Route retracing (i.e., returning to your start location) is critical for successful navigation in everyday life. While age-related impairment traversing a route from location target destination has been well-established, age differences the ability reverse previously learned path less examined. Previous work found that studying map facilitates better older adults than an egocentric perspective during initial learning. However, mechanism this benefit unclear. This study examined whether...
Abstract Introduction Persistent pain is a prevalent consequence of traumatic brain injury (TBI), with an estimated 51.5% civilian populations experiencing chronic comorbidly. Sleep disturbance and are interrelated share cognitive-emotional contributors. Their relationship believed to be reciprocal, whereby disrupts sleep, disturbed sleep exacerbates clinical via impaired functioning endogenous modulatory systems. This cycle suggests that integrating management strategies into treatment...
Abstract Introduction Insomnia and sleep apnea (SA) are common disorders, with approximately 11-13% of the global population experiencing comorbid insomnia (COMISA). COMISA substantially increases risk for both medical psychiatric morbidity relative to having either disorder alone. Moreover, disorders notably in those a traumatic brain injury (TBI; rates 71% SA 25%). This study explored military civilian TBI populations. Methods Data came from two different randomized trials cognitive...
Abstract Introduction Disordered circadian rest/activity rhythms (RARs) and insomnia frequently co-occur. Aspects of cognitive behavioral therapy for (CBTI) aim at improving RARs by establishing regular sleep times consolidating periods. Timing periods has also been associated with insomnia, wherein evening chronotype linked to greater disturbance. However, there is limited research exploring whether CBTI improves via improved structure timing RARs. We examined reduces severity RAR or...
Postoperative delirium is an important public health concern without effective prevention strategies. This study tested the hypothesis that perioperative epidural use would be associated with decreased risk of through postoperative day 3.This was a secondary, observational, nonrandomized analysis data from The Prevention Delirium and Complications Associated With Surgical Treatments Trial (PODCAST; NCT01690988). primary outcome current incidence (ie, any positive screen, postanesthesia care...
(Abstracted from Anesth Analg, 122:234–242, 2016) Increased morbidity and mortality, longer hospital stays, greater healthcare expenditures are common complications associated with postoperative delirium. While intraoperative electroencephalogram (EEG) slowing has been delirium, the effects of EEG suppression on this condition not adequately studied.
Electroconvulsive therapy (ECT) employs the elective induction of generalizes seizures as a potent treatment for severe psychiatric illness. As such, ECT provides an opportunity to rigorously study recovery consciousness, reconstitution cognition, and electroencephalographic (EEG) activity following seizures. Fifteen patients with major depressive disorder refractory pharmacologic will be enrolled (Clinicaltrials.gov, NCT02761330). Adequate seizure duration confirmed right unilateral under...
Delirium is a common postoperative complication in older patients that often goes undetected and might lead to worse outcomes. The 3-Minute Diagnostic Confusion Assessment Method (3D-CAM) be practical tool for routine clinical diagnosis of delirium.To assess the 3D-CAM detecting delirium compared with long-form CAM used research purposes.This cohort study enrolled ongoing trials between 2015 2018 was conducted at single tertiary US hospital. Included participants were aged 60 years or...
BACKGROUND: Although the National Institutes of Health (NIH) invests $30 billion in research annually, many funded studies fail to generate results that can inform practice. The introduced a phased funding mechanism as one potential solution. Study-specific milestones are established for an initial pilot phase. We assess utility this approach through ongoing Electroencephalography (EEG) Guidance Anesthesia Alleviate Geriatric Syndromes (ENGAGES) pragmatic clinical trial. hypothesis trial is...
Delirium is a postoperative complication accompanied by disturbances in attention, cognition, arousal, and psychomotor activity. Wrist actigraphy has been advocated to study inactivity inferred sleep patterns during delirium. We hypothesized that altered of motor activity or immobility, reflective disordered wakefulness patterns, would serve as predictive markers hypoactive delirium.Eighty-four elderly surgical patients were classified into three groups based on the timing delirium following...