Evaluation of cognitive function and P300 in patients undergoing cardiac surgery.

R Agarwal, J Kalita, S Pandey, S K Agarwal, U K Misra
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Abstract

Objective: This study reports cognitive, P300 and MRI changes in the patients undergoing open heart surgery.

Design: 18 patients undergoing open heart surgery were included who were aged > or = 18 years of age and educated at least up to 5th standard. Patients with preoperative neuropsychiatric, and metabolic illnesses were excluded. The operative and post operative events wer recorded Cognitive tests included Mini Mental State examination (MMSE), forward and backward digit span, trail making test (TMT), motor speed and precision test (MSPT), Luria's 3 step, Benton visual retention test (BVRT) and hospital anxiety and depression (HAD). P300 study was carried out using auditory oddball paradigm and recording from Cz, Fz and Pz referred to mastoids. Clinical psychometry, MRI and P300 studies were repeated after 6 weeks.

Results: The median age of the patients was 51 years and 7 were females. Coronary artery bypass graft (15) was done off pump and valve replacement (7) and atrial septal defect (2) were done on pump. Clinical psychometric tests did not change significantly after surgery except BVRT and MSPT were improved significantly after the surgery. The pre and post surgical P300 latency and amplitude were also not different. Follow up MRI in 10 patients also did not reveal any additional findings.

Conclusion: Cognitive decline was not observed after open heart surgery as assessed by clinical psychometry and P300 studies.

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心脏手术患者认知功能和P300的评价。
目的:本研究报道心脏直视手术患者的认知、P300和MRI变化。设计:纳入18例接受心脏直视手术的患者,年龄>或= 18岁,受教育程度至少达到5级标准。排除术前有神经精神疾病和代谢性疾病的患者。记录患者术中及术后发生的事件。认知测试包括迷你精神状态检查(MMSE)、前后手指跨距、轨迹测验(TMT)、运动速度及精度测验(MSPT)、Luria三步法、Benton视觉保持测验(BVRT)和住院焦虑抑郁(HAD)。P300研究采用听觉古怪范式,从乳突Cz、Fz和Pz进行记录。6周后再次进行临床心理测量、MRI和P300检查。结果:患者中位年龄51岁,女性7例。冠状动脉旁路移植术15例,瓣膜置换术7例,房间隔缺损术2例。除BVRT和MSPT术后显著改善外,临床心理测量指标术后无明显变化。术前、术后P300潜伏期和振幅差异无统计学意义。10名患者的后续MRI也未发现任何其他发现。结论:经临床心理测量和P300研究评估,心内直视手术后未观察到认知能力下降。
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