Influences of pre-operative anxiety on delirium in the Post Anesthesia Care Unit.

• Applicant: Dr. Sebastian Zinn
• Subject Area: Anaesthesiology
• Term: since 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 525566280

The purpose of the proposed observational study is to examine the influence of anxiety on postoperative Delirium in the Post Anaesthesia Care Unit (PACU) in 250 patients. The project will be conducted at Columbia University Irving Medical Center in New York, USA under the guidance of Paul Garcia, MD, PhD, Division Chief of Neuroanesthesiology. Delirium is a burden for patients, their families, as well as society. Understandably, patients commonly experience mental distress related to anxiety about undergoing surgery and experiencing its unwelcome consequences. Unfortunately, the influence of anxiety on PACU Delirium is not well investigated. At the same time, it is important to capture anxiety in all its facets to accurately determine the influences of anxiety on PACU Delirium with a mechanistic neurophysiological understanding. Functional changes in cortical networks are known to be influenced by anxiety as well as Delirium. In addition to the main hypothesis that anxiety can influence PACU Delirium, the influence of anxiety traits on perioperative EEG trajectories and the influence of personality traits on delirium frequency, will be investigated. Global long-range network instability as well as local patterns (e.g., frontal alpha activity) measured in the EEG has been shown to influence both delirium risk and different anxiety dimensions. Modern perioperative biomarkers in electroencephalography (EEG) provide a window into the functioning of cortical processes and allow the prediction of recovery of neurological functions after surgery. In addition to the main hypothesis that anxiety influences the occurrence of PACU delirium, the influence of personality traits on delirium frequency (a) and the influence of anxiety traits on perioperative EEG trajectories (b) will be investigated. The protocol includes sophisticated measures of anxiety levels during the perioperative period, in-depth testing of preoperative neurocognitive functions, and EEG recordings during routine clinical and recovery periods. The host institution has a well-established track record in neurocognitive recovery studies and this cooperation project is expected to yield joint international publications. Conducting the study represents the opportunity to acquire advanced methodological training in modern EEG analysis, artifact rejection, connectivity analyses and quantitative data analysis, broaden the expertise in perioperative neurocognitive studies, and intensify scientific collaboration with Columbia University’s Department of Anesthesiology.

• DFG Programme: WBP Fellowship
• International Connection: USA
• Host: Professor Paul Garcia, Ph.D.