Association of sleep and anaesthesia EEG biomarkers with preoperative MoCA score: A pilot study.

Introduction: Preoperative cognitive impairments increase the risk of postoperative complications. The electroencephalogram (EEG) could provide information on cognitive vulnerability. The feasibility and clinical relevance of sleep EEG (EEG ) compared to intraoperative EEG (EEG ) in cognitive risk stratification remains to be explored. We investigated similarities between EEG and EEG vis-a-vis preoperative cognitive impairments.

Methods: Pilot study including 27 patients (63 year old [53.5, 70.0]) to whom Montreal cognitive assessment (MoCA) and EEG were administered 1 day before a propofol-based general anaesthesia, in addition to EEG acquisition from depth-of-anaesthesia monitors. Sleep spindles on EEG and intraoperative alpha-band power on EEG were particularly explored.

Results: In total, 11 (41%) patients had a MoCA <25 points. These patients had a significantly lower sleep spindle power on EEG (25 vs. 40 μv /Hz, p = .035) and had a weaker intraoperative alpha-band power on EEG (85 vs. 150 μv /Hz, p = .001) compared to patients with normal MoCA. Correlation between sleep spindle and intraoperative alpha-band power was positive and significant (r = 0.544, p = .003).

Conclusion: Preoperative cognitive impairment appears to be detectable by both EEG and EEG . Preoperative sleep EEG to assess perioperative cognitive risk is feasible but more data are needed to demonstrate its benefit compared to intraoperative EEG.