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Association between genetic variants of the cholinergic system and postoperative delirium and cognitive dysfunction in elderly patients

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Item Type:Article
Title:Association between genetic variants of the cholinergic system and postoperative delirium and cognitive dysfunction in elderly patients
Creators Name:Heinrich, M. and Sieg, M. and Kruppa, J. and Nürnberg, P. and Schreier, P.H. and Heilmann-Heimbach, S. and Hoffmann, P. and Nöthen, M.M. and Janke, J. and Pischon, T. and Slooter, A.J.C. and Winterer, G. and Spies, C.D.
Abstract:BACKGROUND: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are frequent and serious complications after surgery. We aim to investigate the association between genetic variants in cholinergic candidate genes according to the Kyoto encyclopedia of genes and genomes - pathway: cholinergic neurotransmission with the development of POD or POCD in elderly patients. METHODS: This analysis is part of the European BioCog project ( www.biocog.eu ), a prospective multicenter observational study with elderly surgical patients. Patients with a Mini-Mental-State-Examination score ≤ 23 points were excluded. POD was assessed up to seven days after surgery using the Nursing Delirium Screening Scale, Confusion Assessment Method and a patient chart review. POCD was assessed three months after surgery with a neuropsychological test battery. Genotyping was performed on the Illumina Infinium Global Screening Array. Associations with POD and POCD were analyzed using logistic regression analysis, adjusted for age, comorbidities and duration of anesthesia (for POCD analysis additionally for education). Odds ratios (OR) refer to minor allele counts (0, 1, 2). RESULTS: 745 patients could be included in the POD analysis, and 452 in the POCD analysis. The rate of POD within this group was 20.8% (155 patients), and the rate of POCD was 10.2% (46 patients). In a candidate gene approach three genetic variants of the cholinergic genes CHRM2 and CHRM4 were associated with POD (OR [95% confidence interval], rs8191992: 0.61[0.46; 0.80]; rs8191992: 1.60[1.22; 2.09]; rs2067482: 1.64[1.10; 2.44]). No associations were found for POCD. CONCLUSIONS: We found an association between genetic variants of CHRM2 and CHRM4 and POD. Further studies are needed to investigate whether disturbances in acetylcholine release and synaptic plasticity are involved in the development of POD.
Keywords:CHRM2, CHRM4, Genome-Wide Association Study, Neurocognitive Disorder
Source:BMC Medical Genomics
Publisher:BioMed Central
Page Range:248
Date:21 October 2021
Official Publication:https://doi.org/10.1186/s12920-021-01071-1
PubMed:View item in PubMed

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