PMID- 28854532
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20220330
IS  - 1471-6771 (Electronic)
IS  - 0007-0912 (Print)
IS  - 0007-0912 (Linking)
VI  - 119
IP  - 2
DP  - 2017 Aug 1
TI  - Association of intraoperative changes in brain-derived neurotrophic factor and 
      postoperative delirium in older adults.
PG  - 324-332
LID - 10.1093/bja/aex103 [doi]
AB  - BACKGROUND: Delirium is common after surgery, although the aetiology is poorly 
      defined. Brain-derived neurotrophic factor (BDNF) is a neurotrophin important in 
      neurotransmission and neuroplasticity. Decreased levels of BDNF have been 
      associated with poor cognitive outcomes, but few studies have characterized the 
      role of BDNF perioperatively. We hypothesized that intraoperative decreases in 
      BDNF levels are associated with postoperative delirium. METHODS: Patients 
      undergoing spine surgery were enrolled in a prospective cohort study. Plasma BDNF 
      was collected at baseline and at least hourly intraoperatively. Delirium was 
      assessed using rigorous methods, including the Confusion Assessment Method (CAM) 
      and CAM for the intensive care unit. Associations of changes in BDNF and delirium 
      were examined using regression models. RESULTS: Postoperative delirium developed 
      in 32 of 77 (42%) patients. The median baseline BDNF level was 7.6 ng ml -1 
      [interquartile range (IQR) 3.0-11.2] and generally declined intraoperatively 
      [median decline 61% (IQR 31-80)]. There was no difference in baseline BDNF levels 
      by delirium status. However, the percent decline in BDNF was greater in patients 
      who developed delirium [median 74% (IQR 51-82)] vs in those who did not develop 
      delirium [median 50% (IQR 14-79); P =0.03]. Each 1% decline in BDNF was 
      associated with increased odds of delirium in unadjusted odds ratio [OR] 1.02 
      [95% confidence interval (CI) 1.00-1.04]; P =0.01, multivariable-adjusted [OR 
      1.02 (95% CI 1.00-1.03); P =0.03], and propensity score-adjusted models [OR 1.02 
      (95% CI 1.00-1.04); P =0.03]. CONCLUSIONS: We observed an association between 
      intraoperative decline in plasma BDNF and delirium. These preliminary results 
      need to be confirmed but suggest that plasma BDNF levels may be a biomarker for 
      postoperative delirium.
CI  - (c) The Author 2017. Published by Oxford University Press on behalf of the British 
      Journal of Anaesthesia. All rights reserved. For Permissions, please email: 
      journals.permissions@oup.com
FAU - Wyrobek, J
AU  - Wyrobek J
AD  - Department of Anesthesiology and Critical Care, Brigham and Women's Hospital, 
      Boston, MA, USA.
FAU - LaFlam, A
AU  - LaFlam A
AD  - Tufts University School of Medicine, Boston, MA, USA.
FAU - Max, L
AU  - Max L
AD  - Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University 
      School of Medicine, Baltimore, MD 21287, USA.
FAU - Tian, J
AU  - Tian J
AD  - Department of Biostatistics, Johns Hopkins University Bloomberg School of Public 
      Health, Baltimore, MD, USA.
FAU - Neufeld, K J
AU  - Neufeld KJ
AD  - Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School 
      of Medicine, Baltimore, MD, USA.
FAU - Kebaish, K M
AU  - Kebaish KM
AD  - Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Walston, J D
AU  - Walston JD
AD  - Department of Geriatric Medicine and Gerontology, Johns Hopkins University School 
      of Medicine, Baltimore, MD, USA.
FAU - Hogue, C W
AU  - Hogue CW
AD  - Department of Anesthesiology and Critical Care Medicine, Northwestern Feinberg 
      School of Medicine, Chicago, IL, USA.
FAU - Riley, L H
AU  - Riley LH
AD  - Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Everett, A D
AU  - Everett AD
AD  - Department of Pediatrics, Cardiology, Johns Hopkins University School of 
      Medicine, Baltimore, MD, USA.
FAU - Brown, C H 4th
AU  - Brown CH 4th
AD  - Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University 
      School of Medicine, Baltimore, MD 21287, USA.
LA  - eng
GR  - K23 AG051783/AG/NIA NIH HHS/United States
GR  - P30 AG021334/AG/NIA NIH HHS/United States
GR  - P50 AG005146/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Br J Anaesth
JT  - British journal of anaesthesia
JID - 0372541
RN  - 0 (Brain-Derived Neurotrophic Factor)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Brain-Derived Neurotrophic Factor/*blood
MH  - Delirium/blood/*etiology
MH  - Female
MH  - Humans
MH  - Intraoperative Period
MH  - Male
MH  - Postoperative Complications/blood/*etiology
MH  - Prospective Studies
PMC - PMC6172970
OTO - NOTNLM
OT  - BDNF
OT  - biological
OT  - delirium of mixed origin
OT  - marker
EDAT- 2017/09/01 06:00
MHDA- 2018/12/12 06:00
PMCR- 2017/08/24
CRDT- 2017/09/01 06:00
PHST- 2017/03/23 00:00 [accepted]
PHST- 2017/09/01 06:00 [entrez]
PHST- 2017/09/01 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2017/08/24 00:00 [pmc-release]
AID - S0007-0912(17)33302-0 [pii]
AID - 10.1093/bja/aex103 [doi]
PST - ppublish
SO  - Br J Anaesth. 2017 Aug 1;119(2):324-332. doi: 10.1093/bja/aex103.