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ID
Source
Brief title
Health condition
cerebral glucose metabolism; polyol pathway; postoperative cognitive dysfunction (POCD); hyperglycemia; neurocognitive; Cerebrospinal fluid (CSF); sorbitol; fructose; Montreal Cognitive Assessment (MoCA)
Sponsors and support
Intervention
Outcome measures
Primary outcome
The association between cerebral glucose concentration and cerebral sorbitol and fructose concentration.
Secondary outcome
The correlation between plasma glucose levels with CSF glucose levels
The correlation between cognitive function and cerebral glucose, sorbitol and fructose
Differences in the above mentioned objectives between patients with low plasma glucose, high plasma glucose and DM-patients
Background summary
Background:
Hyperglycaemia can lead to increased activity of the polyol pathway. In this pathway, glucose is metabolized to sorbitol and fructose. These metabolites are believed to be neurotoxic, however evidence on activation of the polyol pathway in the brain is scarce. Furthermore, activation of the polyol pathway could contribute to postoperative cognitive dysfunction (POCD). Both POCD as anaesthetic drugs (and surgical stress) are associated with hyperglycaemia.
Rationale:
We hypothesize that cerebral hyperglycaemia leads to activation of the neurotoxic polyol pathway and that increased activation of this pathway is associated with cognitive dysfunction
Study design:
Secondary analysis of data from a prospective cohort study
Methods:
Analysis of glucose, sorbitol and fructose will be performed on cerebrospinal fluid (CSF) of participants of the Anaesthetic Biobank of Cerebrospinal Fluid (ABC). Plasma glucose will also be analysed. In the ABC study, blood, CSF and clinical data are collected from patients undergoing spinal anaesthesia for elective surgery.
Study objective
We hypothesize that cerebral hyperglycaemia leads to activation of the neurotoxic polyol pathway and that increased activation of this pathway is associated with cognitive dysfunction.
Study design
Time point 1: A neurological examination and Montreal Cognitive Assessment (MoCA) are performed pre-operatively.
Time point 2: CSF and blood are collected from adult patients undergoing spinal anaesthesia for elective surgery and stored.
Relevant clinical, surgical and anaesthetic data are registered.
Intervention
None.
Inclusion criteria
• Spinal anaesthesia for elective surgery
• 18 years and older
Exclusion criteria
• Neurometabolic disorder
Design
Recruitment
IPD sharing statement
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL9356 |
| Other | METc UMCG : 2016/174 |