Director’s Blog An understanding of how memory works has been the Holy Grail of psychology for the past century. Over the past fifty years, neuroscientists have joined that quest, searching for how and where the brain forms new memories and retrieves old ones.

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Abstract: Objective: To examine whether preoperative psychological dysfunctions rather than intraoperative factors may differentially predict short- and long-term postoperative cognitive decline (POCD) in patients after cardiac surgery.Method: Forty-two patients completed a psychological evaluation, including the Trail Making Test Part A and B (TMT-A/B), the memory with 10/30-s interference, the phonemic verbal fluency and the Center for Epidemiological Studies of Depression (CES-D) scale for cognitive functions and depressive symptoms, respectively, before surgery, at discharge and at 18-month follow-up.Results: Ten (24%) and 11 (26%) patients showed POCD at discharge and at 18-month follow-up, respectively. The duration of cardiopulmonary bypass significantly predicted short-term POCD [odds ratio (OR)=1.04, P .23).Conclusions: Our findings showed that preexisting depressive symptoms rather than perioperative risk factors are associated with cognitive decline 18 months after cardiac surgery. This study suggests that a preoperative psychological evaluation of depressive symptoms is essential to anticipate which patients are likely to show long-term cognitive decline after cardiac surgery.

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Abstract: Objective: The objective was to examine whether preexisting cognitive function rather than cognitive decline associated with intraoperative procedures may predict change in behavioral functional capacity in patients 1 year after cardiac surgery.Method: Forty-five patients completed a cognitive evaluation, including the Trail Making Test part B (TMT-B) for attention and psychomotor speed, the Memory with 10-s interference for working memory, the Digit Span test for short-term memory and the Instrumental Activities of Daily Living (IADLs) questionnaire for behavioral functional capacity, before surgery and 1 year after cardiac surgery.Results: Sixteen patients (36%) exhibited cognitive decline after cardiac surgery. Preoperative scores on TMT-B significantly predicted change in behavioral functional capacity as measured by IADLs (beta=0.371, P .08).Conclusions: Preexisting cognitive dysfunctions as assessed by TMT-B can be a marker of preoperative brain dysfunction, which, in turn, in addition to brain damage caused by cardiac surgery procedures, may further predispose patients to poor behavioral functional capacity and outcome 1 year after surgery.

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