Postoperative Neuroinflammation and Cognitive Dysfunction After Abdominal Surgery

Karolinska University Hospital8 enrolled

Overview

The main purpose of this study is to assess the induction of neuroinflammation in brain regions of interest for learning and memory in adult patients undergoing urological surgery under general anesthesia

The investigators aim to study immune cell activation as a biomarker for neuroinflammation using the cell specific \[11C\]PBR28 probe as detected by PET imaging techniques.

Study Type

INTERVENTIONAL

Allocation

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

Conditions

Anesthesia Surgery Neurogenic Inflammation Cognitive Disorders

Interventions

Positron emission tomography (PET) using [11C]PBR28RADIATION

Eligibility

Sex: ALLMin age: 60 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patients 60-75 years of age. American Society for Anesthesiologist' criteria (ASA) physical status I-III 2. Lower abdominal surgery (hysterectomy/prostatectomy) under general anaesthesia 3. Obtained consent within 3 months before execution of the study. Exclusion Criteria: 1. Patient's refusal to participate in the trial 2. Ongoing smoking, snuff or other nicotine compound treatment 3. Disabling neuropsychiatrical disorder (a Mini mental State Examination (MMSE) score ≤ 24, diagnosis of dementia, Mb Alzheimer, Mb Parkinson, schizophrenia, or mental depression) or other signs of significant cognitive decline. 4. History of stroke with neurological sequelae 5. Surgical procedure scheduled for regional anaesthesia. 6. Severe cardia and/or renal and/or hepatic impairment. 7. Coagulopathy. 8. Terminal phase of a chronic disease. 9. Patient on steroidal or non-steroidal anti-inflammatory drugs. 10. Admission B-Glucose \> 15 mmol/litre or poorly controlled diabetes mellitus. 11. Presumed uncooperativeness or legal incapacity. 12. Preoperative or later postoperative B-hemoglobin \< 90 g/L.

Outcomes

Primary Outcomes

Binding of the PET probe [11C]PBR28

PET imaging of brain regions of relevance for memory and learning will be compared between the pre- and postoperative states.

Time frame: Preoperatively, once at postoperative day 2-5 and after 3 month

Secondary Outcomes

Cognitive testing

Postoperative cognitive test battery according to the ISPOCD protocol, see Moller JT et al, Lancet 1998.

Time frame: Preoperatively and after 3 month

Inflammatory biomarkers

Inflammatory biomarkers and genetic analysis of inflammatory biomarkers in blood.

Time frame: Preoperatively, once at postoperative day 2-5 and after 3 month, i.e. at the same time as the PET investigation

Data from ClinicalTrials.gov

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