Intraoperative Diagnosis of Neurocognitive Complications Via Electroencephalographic Analysis

April 4, 2025 updated by: Valery Likhvantsev, Federal Research and Clinical Centre of Intensive Care Medicine and Rehabilitology

Intraoperative Diagnosis of Neurocognitive Complications Via Electroencephalographic (IDEA Network)

Postoperative neurocognitive disorders (PND) are serious and common complications after surgery, especially in elderly patients. These disorders can affect cognitive functions for years, deteriorating quality of life and increasing hospital stays and medical costs. Diagnosing PND is challenging due to their varied manifestations, such as memory and attention problems, and the lack of standardized criteria and biomarkers.

One well-studied form of PND is postoperative delirium (POD). According to the ICD-10, POD is an organic cerebral syndrome characterized by disturbances in consciousness, attention, perception, and other cognitive functions. Researchers suggest that POD development involves a combination of predisposing and precipitating factors.

Electroencephalography (EEG) has been used in anesthesiology to assess anesthesia depth and intraoperative awareness. Modern EEG analysis methods, like spectral analysis, offer new ways to evaluate patients' neurophysiological states. Studies show that EEG monitoring can predict complications such as intraoperative stroke and delirium, particularly in cardiothoracic and neurosurgical operations.

The relationship between EEG patterns and POD is not well understood. Specific EEG patterns may indicate the risk of POD, aiding in the identification of risk factors and prevention methods. This could help anesthesiologists and surgeons optimize their approaches, reducing the risk of cognitive complications.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Postoperative Neurocognitive Disorders (PND) are one of the most serious and common complications following surgery, especially in elderly patients. Postoperative neurocognitive disorders can impact cognitive functions for a prolonged period post-surgery, sometimes lasting several years. This not only deteriorates the quality of life but also increases hospitalization time and medical costs.

The difficulty in diagnosing postoperative neurocognitive disorders is that postoperative neurocognitive disorders can manifest in various forms, including memory, attention, and executive function problems. The lack of standardized diagnostic criteria and clear biomarkers complicates early identification and prognosis of postoperative neurocognitive disorders.

One of the most studied forms of postoperative neurocognitive disorders is postoperative delirium (POD). Currently, the concept of postoperative delirium development suggests a combination of predisposing and precipitating factors. Furthermore, according to the ICD-10, postoperative delirium is defined as an etiologically nonspecific organic cerebral syndrome characterized by disturbances in consciousness, attention, perception, thinking, memory, psychomotor behavior, emotions, and the sleep-wake cycle. The indication of an organic nature of the lesion prompts researchers to explore the possibility of diagnosing brain dysfunctions clinically manifesting as postoperative delirium.

Electroencephalography (EEG) has long been used in anesthesiology to assess the depth of anesthesia and the risk of awareness during surgery. With the use of modern analysis algorithms, such as spectral analysis and synchronization between different brain regions, electroencephalography opens new horizons for assessing the patient's neurophysiological state. Currently, the use of electroencephalography for monitoring cerebral perfusion and oxygenation is being studied, which is especially critical during cardiothoracic and neurosurgical operations. One study showed that a new interhemispheric similarity index in electroencephalography could serve as an indicator of the risk of complications such as intraoperative stroke and delirium after cardiac surgery. These data demonstrate the possibility of using electroencephalography monitoring as a tool for predicting adverse neurocognitive outcomes.

The relationship between electroencephalography and postoperative delirium has not been sufficiently studied. The hypothesis is that specific electroencephalography patterns may serve as indicators of the organic substrate development of postoperative delirium, which may lead to the study of risk factors and methods of their prevention. This, in turn, will allow anesthesiologists and surgeons to optimize approaches to anesthesia and surgical intervention, minimizing the risk of negative cognitive consequences.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
265

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Russian Federation
    • Moscow region
      • Moscow, Moscow region, Russian Federation, 115446
        • Recruiting
        • City clinical hospital named after SS Yudin
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

Patients scheduled for non-cardiac surgery of intermediate to high risk

Description

Inclusion Criteria:

  • Age ≥ 18 years
  • Scheduled non-cardiac surgery of intermediate or high risk
  • General anesthesia using inhalational anesthetics
  • Informed consent from the patient to participate in the study

Exclusion Criteria:

  • Preoperative MMSE score less than 20 points
  • History of any mental illness
  • Use of psychotropic drugs within 1 month prior to inclusion in the study
  • Presence of neuromuscular diseases
  • Neurosurgical procedures
  • Inability to undergo preoperative testing for any reason

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Non-cardiac surgery
Patients scheduled for non-cardiac surgery of intermediate to high risk
Device: Intraoperative electroencephalography
EEG recording will be performed using the standard 16-electrode configuration according to the international "10-20" system. During the recording, electrode impedances will be maintained at a level not exceeding 5 kilo-ohms.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Prognostic value of mean intraoperative alpha rhythm power for the development of postoperative delirium
Time Frame: Through study completion, an average of 3 year
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Through study completion, an average of 3 year
Prognostic value of mean intraoperative alpha rhythm power for the development of early postoperative neurocognitive disorders
Time Frame: Through study completion, an average of 3 year
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Through study completion, an average of 3 year
Prognostic value of mean intraoperative alpha rhythm power for the development of intraoperative silent brain infarction
Time Frame: Through study completion, an average of 3 year
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Through study completion, an average of 3 year

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
28-days mortality
Time Frame: 28 days
Number of deaths in period of 28 days after enrollment
28 days
Prognostic value of maximum intraoperative alpha rhythm power for the development of postoperative delirium
Time Frame: Through study completion, an average of 3 year
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Through study completion, an average of 3 year
Prognostic value of maximum intraoperative alpha rhythm power for the development of early postoperative neurocognitive disorders
Time Frame: Through study completion, an average of 3 year
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Through study completion, an average of 3 year
Prognostic value of maximum intraoperative alpha rhythm power for the development of silent brain infarction
Time Frame: Through study completion, an average of 3 year
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Through study completion, an average of 3 year
The prognostic capability of the "burst suppression" pattern for predicting the development of silent brain infarction
Time Frame: Through study completion, an average of 3 year
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Through study completion, an average of 3 year
The prognostic capability of the "burst suppression" pattern for predicting the development of postoperative delirium.
Time Frame: Through study completion, an average of 3 year
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Through study completion, an average of 3 year
The prognostic capability of the "burst suppression" pattern for predicting the development of early postoperative neurocognitive disorders.
Time Frame: Through study completion, an average of 3 year
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Through study completion, an average of 3 year
The prognostic value of early postoperative neurocognitive disorders for predicting the development of postoperative delirium.
Time Frame: Through study completion, an average of 3 year
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Through study completion, an average of 3 year
The prognostic value of postoperative delirium for predicting the development of silent brain infarction
Time Frame: Through study completion, an average of 3 year
The prognostic value assessment is performed using the area under the ROC curve (AUROC). The value ranges from 0.5 to 1.0. The closer the AUROC value is to one, the higher the prognostic capability of the electroencephalography.
Through study completion, an average of 3 year
1-year mortality
Time Frame: 1 year
Number of deaths in period of 1 year after enrollment
1 year

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Time Frame
Serum level of S100 beta protein
Time Frame: within 1 hour before surgery, 1 hour after surgery
within 1 hour before surgery, 1 hour after surgery
Serum level of Interleukin-6
Time Frame: within 1 hour before surgery, 1 hour after surgery
within 1 hour before surgery, 1 hour after surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Federal Research and Clinical Centre of Intensive Care Medicine and Rehabilitology

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Valery Likhvantsev, PhD, Federal Research and Clinical Centre of Intensive Care Medicine and Rehabilitology

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 25, 2024

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 20, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
August 20, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 6, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 6, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 9, 2024

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 8, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 4, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • IDEA Network

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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Conditions

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Drug Interventions

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