PT  - JOURNAL ARTICLE
AU  - Sunwoo, Mun Kyung
AU  - Hong, Jin Yong
AU  - Choi, Junjeong
AU  - Park, Hyun Jung
AU  - Kim, Se Hoon
AU  - Lee, Phil Hyu
TI  - α-Synuclein pathology is related to postoperative delirium in patients undergoing gastrectomy
AID  - 10.1212/WNL.0b013e3182840782
DP  - 2013 Feb 26
TA  - Neurology
PG  - 810--813
VI  - 80
IP  - 9
4099  - http://n.neurology.org/content/80/9/810.short
4100  - http://n.neurology.org/content/80/9/810.full
SO  - Neurology2013 Feb 26; 80
AB  - Objective: The clinical characteristics of postoperative delirium are similar to core features of α-synuclein–related cognitive disorders, such as dementia with Lewy bodies or Parkinson disease dementia. We therefore investigated the α-synuclein pathology in patients who experienced postoperative delirium after gastrectomy for stomach cancer.Method: Patients with and without postoperative delirium were selected among patients undergoing total gastrectomy for primary gastric cancer from 2007 to 2011 (each n = 16) at the university hospital. Immunohistochemical staining for α-synuclein of both normal and phosphorylated form was performed in the myenteric plexus. A logistic regression analysis was applied to identify independent predictors of postoperative delirium.Results: No significant differences were observed for age, sex, operation time, or onset of delirium after total gastrectomy between patients with and without postoperative delirium. Patients with postoperative delirium had a higher frequency of intensive care unit admissions (43.8 vs 6.3%, p = 0.037) and α-synuclein–positive pathologies of normal (56.3 vs 12.5%, p = 0.023) and phosphorylated form (43.8 vs 6.3%, p = 0.037) compared with those without postoperative delirium. A logistic regression analysis revealed that immunoreactivity for normal α-synuclein (odds ratio [OR] 9.20) and intensive care unit admission (OR 11.97) were independently associated with postoperative delirium.Conclusion: These results suggest that underlying α-synuclein pathologies in the stomach are associated with postoperative delirium, implying that postoperative delirium represents a preclinical stage of α-synuclein related to cognitive disorders.CI=confidence interval; ICU=intensive care unit; OR=odds ratio