Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction

Physiologic signals such as the electroencephalogram (EEG) demonstrate irregular behaviors due to the interaction of multiple control processes operating over different time scales. The complexity of this behavior can be quantified using multi-scale entropy (MSE). High physiologic complexity denotes...

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Autores principales:	Leah Acker, Christine Ha, Junhong Zhou, Brad Manor, Charles M. Giattino, Ken Roberts, Miles Berger, Mary Cooter Wright, Cathleen Colon-Emeric, Michael Devinney, Sandra Au, Marty G. Woldorff, Lewis A. Lipsitz, Heather E. Whitson
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	electroencephalogram (EEG) complexity resilience cognition attention anesthesia Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/2e548e744be94fd4a5878c2569c3ea0b
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spelling	oai:doaj.org-article:2e548e744be94fd4a5878c2569c3ea0b2021-11-10T08:24:29ZElectroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction1662-513710.3389/fnsys.2021.718769https://doaj.org/article/2e548e744be94fd4a5878c2569c3ea0b2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fnsys.2021.718769/fullhttps://doaj.org/toc/1662-5137Physiologic signals such as the electroencephalogram (EEG) demonstrate irregular behaviors due to the interaction of multiple control processes operating over different time scales. The complexity of this behavior can be quantified using multi-scale entropy (MSE). High physiologic complexity denotes health, and a loss of complexity can predict adverse outcomes. Since postoperative delirium is particularly hard to predict, we investigated whether the complexity of preoperative and intraoperative frontal EEG signals could predict postoperative delirium and its endophenotype, inattention. To calculate MSE, the sample entropy of EEG recordings was computed at different time scales, then plotted against scale; complexity is the total area under the curve. MSE of frontal EEG recordings was computed in 50 patients ≥ age 60 before and during surgery. Average MSE was higher intra-operatively than pre-operatively (p = 0.0003). However, intraoperative EEG MSE was lower than preoperative MSE at smaller scales, but higher at larger scales (interaction p < 0.001), creating a crossover point where, by definition, preoperative, and intraoperative MSE curves met. Overall, EEG complexity was not associated with delirium or attention. In 42/50 patients with single crossover points, the scale at which the intraoperative and preoperative entropy curves crossed showed an inverse relationship with delirium-severity score change (Spearman ρ = −0.31, p = 0.054). Thus, average EEG complexity increases intra-operatively in older adults, but is scale dependent. The scale at which preoperative and intraoperative complexity is equal (i.e., the crossover point) may predict delirium. Future studies should assess whether the crossover point represents changes in neural control mechanisms that predispose patients to postoperative delirium.Leah AckerLeah AckerChristine HaJunhong ZhouJunhong ZhouBrad ManorBrad ManorCharles M. GiattinoKen RobertsMiles BergerMiles BergerMiles BergerMary Cooter WrightCathleen Colon-EmericCathleen Colon-EmericMichael DevinneySandra AuMarty G. WoldorffMarty G. WoldorffMarty G. WoldorffLewis A. LipsitzLewis A. LipsitzHeather E. WhitsonHeather E. WhitsonHeather E. WhitsonFrontiers Media S.A.articleelectroencephalogram (EEG)complexityresiliencecognitionattentionanesthesiaNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENFrontiers in Systems Neuroscience, Vol 15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	electroencephalogram (EEG) complexity resilience cognition attention anesthesia Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	electroencephalogram (EEG) complexity resilience cognition attention anesthesia Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Leah Acker Leah Acker Christine Ha Junhong Zhou Junhong Zhou Brad Manor Brad Manor Charles M. Giattino Ken Roberts Miles Berger Miles Berger Miles Berger Mary Cooter Wright Cathleen Colon-Emeric Cathleen Colon-Emeric Michael Devinney Sandra Au Marty G. Woldorff Marty G. Woldorff Marty G. Woldorff Lewis A. Lipsitz Lewis A. Lipsitz Heather E. Whitson Heather E. Whitson Heather E. Whitson Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction
description	Physiologic signals such as the electroencephalogram (EEG) demonstrate irregular behaviors due to the interaction of multiple control processes operating over different time scales. The complexity of this behavior can be quantified using multi-scale entropy (MSE). High physiologic complexity denotes health, and a loss of complexity can predict adverse outcomes. Since postoperative delirium is particularly hard to predict, we investigated whether the complexity of preoperative and intraoperative frontal EEG signals could predict postoperative delirium and its endophenotype, inattention. To calculate MSE, the sample entropy of EEG recordings was computed at different time scales, then plotted against scale; complexity is the total area under the curve. MSE of frontal EEG recordings was computed in 50 patients ≥ age 60 before and during surgery. Average MSE was higher intra-operatively than pre-operatively (p = 0.0003). However, intraoperative EEG MSE was lower than preoperative MSE at smaller scales, but higher at larger scales (interaction p < 0.001), creating a crossover point where, by definition, preoperative, and intraoperative MSE curves met. Overall, EEG complexity was not associated with delirium or attention. In 42/50 patients with single crossover points, the scale at which the intraoperative and preoperative entropy curves crossed showed an inverse relationship with delirium-severity score change (Spearman ρ = −0.31, p = 0.054). Thus, average EEG complexity increases intra-operatively in older adults, but is scale dependent. The scale at which preoperative and intraoperative complexity is equal (i.e., the crossover point) may predict delirium. Future studies should assess whether the crossover point represents changes in neural control mechanisms that predispose patients to postoperative delirium.
format	article
author	Leah Acker Leah Acker Christine Ha Junhong Zhou Junhong Zhou Brad Manor Brad Manor Charles M. Giattino Ken Roberts Miles Berger Miles Berger Miles Berger Mary Cooter Wright Cathleen Colon-Emeric Cathleen Colon-Emeric Michael Devinney Sandra Au Marty G. Woldorff Marty G. Woldorff Marty G. Woldorff Lewis A. Lipsitz Lewis A. Lipsitz Heather E. Whitson Heather E. Whitson Heather E. Whitson
author_facet	Leah Acker Leah Acker Christine Ha Junhong Zhou Junhong Zhou Brad Manor Brad Manor Charles M. Giattino Ken Roberts Miles Berger Miles Berger Miles Berger Mary Cooter Wright Cathleen Colon-Emeric Cathleen Colon-Emeric Michael Devinney Sandra Au Marty G. Woldorff Marty G. Woldorff Marty G. Woldorff Lewis A. Lipsitz Lewis A. Lipsitz Heather E. Whitson Heather E. Whitson Heather E. Whitson
author_sort	Leah Acker
title	Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction
title_short	Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction
title_full	Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction
title_fullStr	Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction
title_full_unstemmed	Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction
title_sort	electroencephalogram-based complexity measures as predictors of post-operative neurocognitive dysfunction
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/2e548e744be94fd4a5878c2569c3ea0b
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Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction

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