Top

22-09-2023 | Review

The Thalamus in Perioperative Neurocognitive Disorders

Authors: Marinus Fislage, Norman Zacharias, Insa Feinkohl

Abstract

Thalamus function and structure are known predictors of individual differences in the risk of age-related neurocognitive disorders (NCD), such as dementia. However, to date, little is known about their role in the perioperative setting. Here, we provide a narrative review of brain-imaging studies of preoperative and postoperative thalamus scanning parameters associated with risks of developing perioperative NCD, such as postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) during the postoperative phase. These findings are discussed in light of the concept of reserve capacity.

Alkire, M. T., Hudetz, A. G., & Tononi, G. (2008). Consciousness and anesthesia. Science, 322(5903), 876–880. CrossRefPubMedPubMedCentral

Bagarinao, E., Watanabe, H., Maesawa, S., Kawabata, K., Hara, K., Ohdake, R., et al. (2022). Reserve and maintenance in the aging brain: A longitudinal study of healthy older adults. eNeuro, 9(1), 1–10. CrossRef

Biessels, G. J., Deary, I. J., & Ryan, C. M. (2008). Cognition and diabetes: A lifespan perspective. Lancet Neurology, 7(2), 184–190. CrossRefPubMed

Bocchetta, M., Malpetti, M., Todd, E. G., Rowe, J. B, & Rohrer, J. D. (2021). Looking beneath the surface: the importance of subcortical structures in frontotemporal dementia. Brain Communications, 3(3).

Borchers, F., Spies, C. D., Feinkohl, I., Brockhaus, W. R., Kraft, A., Kozma, P., et al. (2021). Methodology of measuring postoperative cognitive dysfunction: A systematic review. British Journal of Anaesthesia, 126(6), 1119–1127. CrossRefPubMed

Braak, H., & Braak, E. (1991). Neuropathological stageing of Alzheimer-related changes. Acta Neuropathologica, 82(4), 239–259. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1759558

Cavallari, M., Dai, W., Guttmann, C. R. G., Meier, D. S., Ngo, L. H., Hshieh, T. T., et al. (2016). Neural substrates of vulnerability to postsurgical delirium as revealed by presurgical diffusion MRI. Brain, 139(4), 1282–1294. CrossRefPubMedPubMedCentral

Davis, D. H. J., Skelly, D. T., Murray, C., Hennessy, E., Bowen, J., Norton, S., et al. (2015). Worsening cognitive impairment and neurodegenerative pathology progressively increase risk for delirium. The American Journal of Geriatric Psychiatry, 23(4), 403–415. CrossRefPubMedPubMedCentral

Evered, L. A., & Silbert, B. S. (2018). Postoperative cognitive dysfunction and noncardiac surgery. Anesthesia and Analgesia, 127(2), 496–505. CrossRefPubMed

Feinkohl, I., Winterer, G., Spies, C. D., & Pischon, T. (2017). Cognitive reserve and the risk of postoperative cognitive dysfunction - A systematic review and meta-analysis. Deutsches Ärzteblatt International, 114(7), 110–117. PubMedPubMedCentral

Fislage, M., Feinkohl, I., Borchers, F., et al. (2023). Preoperative thalamus volume is not associated with preoperative cognitive impairment (preCI) or postoperative cognitive dysfunction (POCD). Science and Reports, 13, 11732. https://doi.org/10.1038/s41598-023-38673-x CrossRef

Fislage, M., Feinkohl, I., Pischon, T., Spies, C. D., Borchers, F., Winterer, G., et al. (2022a). Presurgical thalamus volume in postoperative delirium: A longitudinal observational cohort study in older patients. Anesthesia and Analgesia, 135(1), 136–142. CrossRefPubMed

Fislage, M., Winzeck, S., Stamatakis, E., Correia, M. M., Preller, J., Feinkohl, I., et al. (2022b). Presurgical diffusion metrics of the thalamus and thalamic nuclei in postoperative delirium: A prospective two-centre cohort study in older patients. NeuroImage: Clinical, 36.

Halassa, M. M., & Kastner, S. (2017). Thalamic functions in distributed cognitive control. Natural Neuroscience, 20(12), 1669–1679. https://doi.org/10.1038/s41593-017-0020-1 CrossRef

Herrero, M. T., Barcia, C., & Navarro, J. M. (2002). Functional anatomy of thalamus and basal ganglia. Child’s Nervous System, 18(8), 386–404. CrossRefPubMed

Hilal, S., Amin, S. M., Venketasubramanian, N., Niessen, W. J., Vrooman, H., Wong, T. Y., et al. (2015). Subcortical atrophy in cognitive impairment and dementia. Journal of Alzheimer’s Disease, 48(3), 813–823. CrossRefPubMed

Hshieh, T. T., Yang, T., Gartaganis, S. L., Yue, J., & Inouye, S. K. (2018). Hospital elder life program: Systematic review and meta-analysis of effectiveness. The American Journal of Geriatric Psychiatry, 26(10), 1015–1033. CrossRefPubMedPubMedCentral

Huang, C., Mårtensson, J., Gögenur, I., & Asghar, M. S. (2018). Exploring postoperative cognitive dysfunction and delirium in noncardiac surgery using MRI: A systematic review. Neural Plasticity, 2018, 1–12. Available from: https://www.hindawi.com/journals/np/2018/1281657/

Hudetz, A. G. (2012). General anesthesia and human brain connectivity. Brain Connectivity, 2(6), 291–302. CrossRefPubMedPubMedCentral

Hudetz, A. G., & Mashour, G. A. (2016). Disconnecting consciousness: Is there a common anesthetic end point? Anesthesia and Analgesia, 123(5), 1228–1240. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27331780

Johnson, M. D., & Ojemann, G. A. (2000). The role of the human thalamus in language and memory: Evidence from electrophysiological studies. Brain and Cognition, 42(2), 218–230. CrossRefPubMed

Kalaria, R. N., Kenny, R. A., Ballard, C. G., Perry, R., Ince, P., & Polvikoski, T. (2004). Towards defining the neuropathological substrates of vascular dementia. Journal of the Neurological Sciences, 226(1–2), 75–80. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15537525

Kantonen, O., Laaksonen, L., Alkire, M., et al. (2023). Decreased thalamic activity is a correlate for disconnectedness during anesthesia with propofol, dexmedetomidine and sevoflurane but not S-ketamine. Journal of Neuroscience, 43(26), 4884–4895. CrossRefPubMed

Koch, S., Windmann, V., Chakravarty, S., Kruppa, J., Yürek, F., Brown, E. N., et al. (2021). Perioperative electroencephalogram spectral dynamics related to postoperative delirium in older patients. Anesthesia and Analgesia, 133(6), 1598–1607. CrossRefPubMed

Leslie, D. L., Marcantonio, E. R., Zhang, Y., Leo-Summers, L., & Inouye, S. K. (2008). One-year health care costs associated with delirium in the elderly population. Archives of Internal Medicine, 168(1), 27–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18195192

MacLullich, A. M. J., Ferguson, K. J., Deary, I. J., Seckl, J. R., Starr, J. M., & Wardlaw, J. M. (2002). Intracranial capacity and brain volumes are associated with cognition in healthy elderly men. Neurology, 59(2), 169–174. CrossRefPubMed

Mahanna-Gabrielli, E., Schenning, K. J., Eriksson, L. I., Browndyke, J. N., Wright, C. B., Evered, L., et al. (2019). State of the clinical science of perioperative brain health: Report from the American Society of Anesthesiologists Brain Health Initiative Summit 2018. British Journal of Anaesthesia, 123(4), 464–478. https://doi.org/10.1016/j.bja.2019.07.004 CrossRefPubMedPubMedCentral

Mcmanus, J., Pathansali, R., Stewart, R., Macdonald, A., & Jackson, S. (2007). Delirium post-stroke. Age and Ageing, 36(6), 613–618. CrossRefPubMed

Neuropathology Group of the Medical Research Council Cognitive Function and Aging Study. (2001). Pathological correlates of late-onset dementia in a multicentre, community-based population in England and Wales. Neuropathology Group of the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS). Lancet (London, England), 357(9251), 169–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11213093

Newman, M. F., Grocott, H. P., Mathew, J. P., White, W. D., Landolfo, K., Reves, J. G., et al. (2001). Report of the substudy assessing the impact of neurocognitive function on quality of life 5 years after cardiac surgery. Stroke, 32(12), 2874–2879. CrossRefPubMed

Nitchingham, A., Pereira, J. V., Wegner, E. A., Oxenham, V., Close, J., & Caplan, G. A. (2023). Regional cerebral hypometabolism on 18F-FDG PET/CT scan in delirium is independent of acute illness and dementia. Alzheimer’s & Dementia, 19(1), 97–106. CrossRef

Oh, J., Shin, J. E., Yang, K. H., Kyeong, S., Lee, W. S., Chung, T., et al. (2019). Cortical and subcortical changes in resting-state functional connectivity before and during an episode of postoperative delirium. Australian & New Zealand Journal of Psychiatry, 53(8), 794–806. Available from: http://journals.sagepub.com/doi/10.1177/0004867419848826

Orhun, G., Esen, F., Özcan, P. E., et al. (2019). Neuroimaging findings in sepsis-induced brain dysfunction: Association with clinical and laboratory findings. Neurocritical Care, 30, 106–117. CrossRefPubMed

Pang, J. C., Aquino, K. M., Oldehinkel, M., et al. (2023). Geometric constraints on human brain function. Nature, 618(7965), 566–574. CrossRefPubMedPubMedCentral

Power, B. D., & Looi, J. C. L. (2015). The thalamus as a putative biomarker in neurodegenerative disorders. Australian and New Zealand Journal of Psychiatry, 49(6), 502–518. CrossRefPubMed

Rasmussen, L. S., Larsen, K., Houx, P., et al. (2001). The assessment of postoperative cognitive function. Acta Anaesthesiologica Scandinavica, 45(3), 275–289. https://doi.org/10.1034/j.1399-6576.2001.045003275.x CrossRefPubMed

Rikhye, R. V., Gilra, A., & Halassa, M. M. (2018). Thalamic regulation of switching between cortical representations enables cognitive flexibility. Nature Neuroscience, 21(12), 1753–1763. https://doi.org/10.1038/s41593-018-0269-z CrossRefPubMedPubMedCentral

Sato, C., Sekiguchi, A., Kawai, M., Kotozaki, Y., Nouchi, R., Tada, H., et al. (2015). Postoperative structural brain changes and cognitive dysfunction in patients with breast cancer. PLoS ONE, 10(11), 1–16. CrossRef

Satz, P., Cole, M. A., Hardy, D. J., & Rassovsky, Y. (2011). Brain and cognitive reserve: Mediator(s) and construct validity, a critique. Journal of Clinical and Experimental Neuropsychology, 33(1), 121–130. CrossRefPubMed

Schmahmann, J. D. (2003). Vascular syndromes of the thalamus. Stroke, 34(9), 2264–2278. CrossRefPubMed

Schmitt, L. I., Wimmer, R. D, Nakajima, M., Happ, M., Mofakham, S., & Halassa, M. M. (2017). Thalamic amplification of cortical connectivity sustains attentional control. Nature, 545(7653), 219–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28467827

Schreckenberger, M., Lange-Asschenfeldt, C., Lochmann, M., Mann, K., Siessmeier, T., & Buchholz, H.-G., et al. (2004). The thalamus as the generator and modulator of EEG alpha rhythm: A combined PET/EEG study with lorazepam challenge in humans. Neuroimage, 22(2), 637–644. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15193592

Sele, S., Liem, F., Mérillat, S., & Jäncke, L. (2020). Decline variability of cortical and subcortical regions in aging: A longitudinal study. Frontiers in Human Neuroscience, 14, 363. CrossRefPubMedPubMedCentral

Shine, J. M., Lewis, L. D., Garrett, D. D., et al. (2023). The impact of the human thalamus on brain-wide information processing. Nature Reviews Neuroscience, 24, 416–430. CrossRefPubMed

Shioiri, A., Kurumaji, A., Takeuchi, T., Matsuda, H., Arai, H., & Nishikawa, T. (2010). White matter abnormalities as a risk factor for postoperative delirium revealed by diffusion tensor imaging. The American Journal of Geriatric Psychiatry, 18(8), 743–753. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20220599

Staff, R. T. (2012). Reserve, brain changes, and decline. Neuroimaging Clinics of North America, 22(1), 99–105. CrossRefPubMed

Stamatakis, E. A, Adapa, R. M., Absalom, A. R., & Menon, D. K. (2010). Changes in resting neural connectivity during propofol sedation. PLoS ONE, 5(12).

Steinmetz, J., Christensen, K. B., Lund, T., Lohse, N., & Rasmussen, L. S. (2009). Long-term consequences of postoperative cognitive dysfunction. Anesthesiology, 110(3), 548–555. CrossRefPubMed

Stern, Y. (2009). Cognitive reserve. Neuropsychologia, 47(10), 2015–2028. CrossRefPubMedPubMedCentral

Tate, D. F., Neeley, E. S., Norton, M. C., Tschanz, J. T., Miller, M. J., Wolfson, L., et al. (2011). Intracranial volume and dementia: Some evidence in support of the cerebral reserve hypothesis. Brain Research, 1385(1), 151–162. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3624763/pdf/nihms412728.pdf

Taylor, J., Parker, M., Casey, C. P., Tanabe, S., Kunkel, D., Rivera, C., et al. (2022). Postoperative delirium and changes in the blood-brain barrier, neuroinflammation, and cerebrospinal fluid lactate: A prospective cohort study. British Journal of Anaesthesia, 129(2), 219–230. Available from: http://www.ncbi.nlm.nih.gov/pubmed/35144802

Teipel, S., Drzezga, A., Grothe, M. J., et al. (2015). Multimodal imaging in Alzheimer’s disease: Validity and usefulness for early detection. Lancet Neurology, 14(10), 1037–1053. CrossRefPubMed

van der Velpen, I. F., Vlasov, V., Evans, T. E., Ikram, M. K., Gutman, B. A., Roshchupkin, G. V., et al. (2022). Subcortical brain structures and the risk of dementia in the Rotterdam Study. Alzheimer’s & Dementia, 1–12.

Vonk, J. M. J., Ghaznawi, R., Zwartbol, M. H. T., Stern, Y., Geerlings, M. I., UCC-SMART-Study Group. (2022). The role of cognitive and brain reserve in memory decline and atrophy rate in mid and late-life: The SMART-MR study. Cortex, 148, 204–214. CrossRefPubMed

White, N. S., & Alkire, M. T. (2003). Impaired thalamocortical connectivity in humans during general-anesthetic-induced unconsciousness. NeuroImage, 19(2), 402–411. CrossRefPubMed

Winterer, G., Androsova, G., Bender, O., Boraschi, D., Borchers, F., Dschietzig, T. B., et al. (2018). Personalized risk prediction of postoperative cognitive impairment - Rationale for the EU-funded BioCog project. European Psychiatry, 50, 34–39. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29398565

Witlox, J., Eurelings, L. S. M., De Jonghe, J. F. M., Kalisvaart, K. J., Eikelenboom, P., & Van Gool, W. A. (2010). Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: A meta-analysis. JAMA, 304(4), 443–451. CrossRefPubMed

Xie, G., Deschamps, A., Backman, S. B., Fiset, P., Chartrand, D., Dagher, A., et al. (2011). Critical involvement of the thalamus and precuneus during restoration of consciousness with physostigmine in humans during propofol anaesthesia: A positron emission tomography study. British Journal of Anaesthesia, 106(4), 548–557. https://doi.org/10.1093/bja/aeq415 CrossRefPubMed

Yokota, H., Ogawa, S., Kurokawa, A., & Yamamoto, Y. (2003). Regional cerebral blood flow in delirium patients. Psychiatry and Clinical Neurosciences, 57(3), 337–339. CrossRefPubMed

Zidan, M., Boban, J., Bjelan, M., Todorović, A., Stankov Vujanić, T., Semnic, M., et al. (2019). Thalamic volume loss as an early sign of amnestic mild cognitive impairment. Journal of Clinical Neuroscience, 68, 168–173. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31324472

Title: The Thalamus in Perioperative Neurocognitive Disorders
Authors: Marinus Fislage
Norman Zacharias
Insa Feinkohl
Publication date: 22-09-2023
Publisher: Springer US
Published in: Neuropsychology Review
Print ISSN: 1040-7308
Electronic ISSN: 1573-6660
DOI: https://doi.org/10.1007/s11065-023-09615-1

Keynote Webinar | Spotlight on Diet and Diabetes

Springer Medicine

The Thalamus in Perioperative Neurocognitive Disorders

Abstract

Keynote Webinar | Spotlight on Diet and Diabetes

Springer Medicine

Abstract

Please log in to get access to this content