Effects of stage I hypertension on the recovery of early postoperative attention network function in elderly patients undergoing elective hip or knee arthroplasty surgery

Background/aim: Hypertension is an important risk factor for cognitive impairment. This study explored whether elderly patients with stage I hypertension HPs and normotensive patients NPs showed differences in the recovery of postoperative attention network function according to the attentional network test ANT performance.Materials and methods: Of 110 patients screened, 25 HPs and 25 NPs completed this study. The Mini-Mental State Examination MMSE was applied to all participants before the operation and the ANT on days 2 and 7 after the operation. All participants completed 1 day preoperatively and the ANT on postoperative days PODs 2 and 7.Results: Compared with NPs, HPs had significantly lower alerting network effect scores and more difficulty resolving conflict on POD 7. However, no significant difference was observed between the groups on POD 2. Orienting network performance was similar between the groups at all time points. Significant differences in alerting and executive control network performances were observed between PODs 2 and 7 in each group.Conclusion: HPs showed selective cognitive impairment at different time points following elective hip or knee arthroplasty. Compared with NPs, during the first postoperative week, HPs were more likely to experience delayed recovery of alerting and executive control network function, but not orienting network function.

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  • 1. Qiu C, Winblad B, Fratiglioni L. The age-dependent relation of blood pressure to cognitive function and dementia. The Lancet Neurology 2005; 4 (8): 487-499. doi: 10.1016/s1474- 4422(05)70141-1
  • 2. Hughes TM, Sink KM. Hypertension and its role in cognitive function: current evidence and challenges for the future. American Journal of Hypertension 2016; 29 (2): 149-157. doi: 10.1093/ajh/hpv180
  • 3. McGuinness B, Todd S, Passmore AP, Bullock R. Systematic review: Blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia. Journal of Neurology, Neurosurgery & Psychiatry 2008; 79 (1): 4-5. doi: 10.1136/jnnp.2007.118505
  • 4. Lande MB, Adams H, Falkner B, Waldstein SR, Schwartz GJ et al. Parental assessment of executive function and internalizing and externalizing behavior in primary hypertension after antihypertensive therapy. The Journal of Pediatrics 2010; 157 (1): 114-119. doi: 10.1016/j.jpeds.2009.12.053
  • 5. van der Veen PH, Geerlings MI, Visseren FL, Nathoe HM, Mali WP et al. Hypertensive target organ damage and longitudinal changes in brain structure and function: the second manifestations of arterial disease-magnetic resonance study. Hypertension 2015; 66 (6): 1152-1158. doi: 10.1161/ hypertensionaha.115.06268
  • 6. Monk TG, Weldon BC, Garvan CW, Dede DE, van der Aa MT et al. Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology 2008; 108 (1): 18-30. doi: 10.1097/01.anes.0000296071.19434.1e
  • 7. Raksamani K, Lertakyamanee J, Toomtong P, Pattanittum P. General versus regional anaesthesia for cognitive dysfunction after procedures other than cardiac or neurosurgery. Cochrane Database of Systematic Reviews 2010; 303 (7868): 1224-1225. doi: 10.1002/14651858.CD008737
  • 8. Krenk L, Rasmussen LS, Kehlet H. New insights into the pathophysiology of postoperative cognitive dysfunction. Acta Anaesthesiologica Scandinavica 2010; 54 (8): 951-956. doi: 10.1111/j.1399-6576.2010.02268.x
  • 9. Rasmussen LS. Postoperative cognitive dysfunction: incidence and prevention. Best Practice & Research Clinical Anaesthesiology 2006; 20 (2): 315-330. doi: 10.1016/j. bpa.2005.10.011
  • 10. Garmezy N. The psychology and psychopathology of attention. Schizophrenia Bulletin 1977; 3 (3): 360-369. doi: 10.1093/ schbul/3.3.360
  • 11. Wang K, Fan J, Dong Y, Wang CQ, Lee TM et al. Selective impairment of attentional networks of orienting and executive control in schizophrenia. Schizophrenia Research 2005; 78 (2- 3): 235-241. doi: 10.1016/j.schres.2005.01.019
  • 12. Gu X, Liu X, Guise KG, Fossella J, Wang K et al. Alexithymic trait and voluntary control in healthy adults. PLoS ONE 2008; 3 (11): e3702. doi: 10.1371/journal.pone.0003702
  • 13. Roh GU, Kim WO, Rha KH, Lee BH, Jeong HW et al. Prevalence and impact of incompetence of internal jugular valve on postoperative cognitive dysfunction in elderly patients undergoing robot-assisted laparoscopic radical prostatectomy. Archives of Gerontology Geriatrics 2016; 64: 167-171. doi: 10.1016/j.archger.2016.01.013
  • 14. Son YG, Byun SH, Kim JH. The anhepatic phase extended by temporary portocaval shunt does not affect anesthetic sensitivity and postoperative cognitive function: a case-control study. Medicine (Baltimore) 2016; 95 (49): e5654. doi: 10.1097/ md.0000000000005654
  • 15. Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ et al. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension 2006; 47 (2): 296-308. doi: 10.1161/01. hyp.0000202568.01167.b6
  • 16. Fan J, McCandliss BD, Sommer T, Raz A, Posner MI. Testing the efficiency and independence of attentional networks. Journal of Cognitive Neuroscience 2002; 14 (3): 340-347. doi: 10.1162/089892902317361886
  • 17. Posner MI, Petersen SE. The attention system of the human brain. Annual Review of Neuroscience 1990; 13: 25-42. doi: 10.1146/annurev.ne.13.030190.000325
  • 18. Liu G, Ma HJ, Hu PP, Tian YH, Hu S et al. Effects of painful stimulation and acupuncture on attention networks in healthy subjects. Behavioral and Brain Function 2013; 9: 23. doi: 10.1186/1744-9081-9-23
  • 19. Gasecki D, Kwarciany M, Nyka W, Narkiewicz K. Hypertension, brain damage and cognitive decline. Current Hypertension Reports 2013; 15 (6): 547-558. doi: 10.1007/s11906-013-0398-4
  • 20. Coull JT, Nobre AC, Frith CD. The noradrenergic α2 agonist clonidine modulates behavioural and neuroanatomical correlates of human attentional orienting and alerting. Cerebral Cortex 2001; 11 (1): 73-84. doi: 10.1093/cercor/11.1.73
  • 21. Brozoski TJ, Brown RM, Rosvold HE, Goldman PS. Cognitive deficit caused by regional depletion of dopamine in prefrontal cortex of rhesus monkey. Science 1979; 205 (4409): 929-932. doi: 10.1126/science.112679
  • 22. Li X, Liang Y, Chen Y, Zhang J, Wei D et al. Disrupted frontoparietal network mediates white matter structure dysfunction associated with cognitive decline in hypertension patients. The Journal of Neuroscience 2015; 35 (27): 10015- 10024. doi: 10.1523/jneurosci.5113-14.2015
  • 23. Leech R, Kamourieh S, Beckmann CF, Sharp DJ. Fractionating the default mode network: distinct contributions of the ventral and dorsal posterior cingulate cortex to cognitive control. The Journal of Neuroscience 2011; 31 (9): 3217-3224. doi: 10.1523/ jneurosci.5626-10.2011
  • 24. Li X, Ma C, Sun X, Zhang J, Chen Y et al. Disrupted white matter structure underlies cognitive deficit in hypertensive patients. European Radiology 2016; 26 (9): 2899-2907. doi: 10.1007/s00330-015-4116-2
  • 25. Hajjar I, Zhao P, Alsop D, Novak V. Hypertension and cerebral vasoreactivity: a continuous arterial spin labeling magnetic resonance imaging study. Hypertension 2010; 56 (5): 859-864. doi: 10.1161/hypertensionaha.110.160002
  • 26. Oveisgharan S, Hachinski V. Hypertension, executive dysfunction, and progression to dementia: the Canadian study of health and aging. Archives of Neurology 2010; 67 (2): 187- 192. doi: 10.1001/archneurol.2009.312
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK