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| Item Type: | Preprint |
|---|---|
| Title: | Dopaminergic sub-network connectivity alterations are associated with postoperative cognitive dysfunction: results from the BioCog cohort study |
| Creators Name: | Lammers-Lietz, Florian, Borchers, Friedrich, Feinkohl, Insa, Kanar, Cicek, Krampe, Henning, Lichtner, Gregor, Sreekanth, Jayanth, Wiebach, Janine, Weygandt, Martin, Spies, Claudia, Winterer, Georg and Paul, Friedemann |
| Abstract: | Postoperative cognitive dysfunction (POCD) is a detrimental complication after surgery with lasting impact on the patients’ daily life. It is most common after postoperative delirium. Dopaminergic dysfunction has been suggested to play a role in delirium, but little knowledge exists regarding its relevance for POCD. We hypothesized that POCD is associated with altered resting-state functional connectivity of the ventral tegmental area (VTA) and the substantia nigra pars compacta (SNc) in functional magnetic resonance imaging (fMRI) before surgery and at postoperative follow-up after three months. Patients ≥65 years old underwent resting-state fMRI and neuropsychological assessment before major elective surgery and at follow-up three months later. POCD was determined as the reliable change index. Connectivity between VTA or SNc and 132 regions were calculated. Principal component analysis (PCA) was used for sub-network construction, and components explaining >5% of variance were retained for analysis. To study postoperative changes in patients with POCD, we applied the same transformation to postoperative connectivity, and multi-factor analysis. Regression analyses were used to describe connectivity alterations while adjusting for age, sex, MMSE, surgery and anaesthesia. Of 214 patients, 26 (12%) developed POCD. Among 132 principal components, four components for VTA- and SNc-FC were selected for further analysis. For both VTA and SNc connectivity, one component was significantly associated with POCD. Postoperative alterations of dopaminergic networks were observed in an exploratory voxel-wise analysis in a left temporal cluster. Higher dopaminergic connectivity to regions associated with spatial perceptive processes and lower connectivity to cognitive control-related areas may predispose to POCD. |
| Keywords: | Dopamine, Ventral Tegmental Area, Substantia Nigra, Surgery, Anaesthesia, Cognition, Connectivity |
| Source: | medRxiv |
| Publisher: | Cold Spring Harbor Laboratory Press |
| Article Number: | 2025.01.02.25319918v2 |
| Date: | 15 September 2025 |
| Official Publication: | https://doi.org/10.1101/2025.01.02.25319918 |
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