Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.06.025
Brazilian Journal of Anesthesiology
Original Investigation

Assessment of a digital game as a neuropsychological test for postoperative cognitive dysfunction

Avaliação de um jogo digital como teste neuropsicológico para disfunção cognitiva pós-operatória

André Lucatelli; Ananaira Alves Goulart; Paulo Sergio Panse Silveira; José de Oliveira Siqueira; Maria José Carvalho Carmona; Livia Stocco Sanches Valentin; Joaquim Edson Vieira; Valéria Fontenelle Angelim Pereira

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Abstract

Objective
Postoperative cognitive dysfunction may result from worsening in a condition of previous impairment. It causes greater difficulty in recovery, longer hospital stays, and consequent delay in returning to work activities. Digital games have a potential neuromodulatory and rehabilitation effect. In this study, a digital game was used as a neuropsychological test to assess postoperative cognitive dysfunction, with preoperative patient performance as control.

Methods
It was an non-controlled study, with patients selected among candidates for elective non-cardiac surgery, evaluated in the pre- and postoperative periods. The digital game used has six phases developed to evaluate selective attention, alternating attention, visuoperception, inhibitory control, short-term memory, and long-term memory. The digital game takes about 25 minutes. Scores are the sum of correct answers in each cognitive domain. Statistical analysis compared these cognitive functions pre- and post-surgery using a generalized linear mixed model (ANCOVA).

Results
Sixty patients were evaluated, 40% male and 60% female with a mean age of 52.7 ± 13.5 years. Except for visuoperception, a reduction in post-surgery scores was found in all phases of the digital game.

Conclusion
The digital game was able to detect decline in several cognitive functions postoperatively. As its completion is faster than in conventional tests on paper, this digital game may be a potentially recommended tool for assessing patients, especially the elderly and in the early postoperative period.

Keywords

Cognitive dysfunction;  Postoperative period;  Computers;  Diagnostic self evaluation;  Anesthesia

Resumo

Objetivo: A disfunção cognitiva pós-operatória pode ser o resultado de piora em um quadro de comprometimento anterior. Acarreta maior dificuldade na recuperação, maior permanência no hospital e consequente atraso no retorno às atividades laborais. Jogos digitais têm potencial efeito neuromodulador e de reabilitação. Neste estudo, foi utilizado um jogo digital como teste neuropsicológico para avaliação de disfunção cognitiva pós-operatória, tendo como controle o desempenho dos pacientes no momento pré-operatório.

Métodos: Trata-se de estudo não controlado com pacientes selecionados entre os candidatos a cirurgias eletivas não cardíacas, avaliados nos períodos pré e pós-operatório. O jogo digital aplicado tem seis etapas, desenvolvidas para avaliar atenção seletiva, atenção alternada, visuopercepção, controle inibitório, memória de curto prazo e memória de longo prazo. Sua aplicação leva cerca de 25 minutos. Os resultados são a soma de acertos em cada domínio cognitivo. Análise estatística comparou essas funções cognitivas antes e após a intervenção cirúrgica por meio de modelo linear misto generalizado, e utilizou-se uma ANCOVA mista para avaliar se há influência do tempo de cirurgia.

Resultados: Foram avaliados 60 pacientes, 40% do sexo masculino e 60% do sexo feminino, com média de idade de 52,7 ± 13,5 anos. Com exceção de visuopercepção, encontrou-se redução dos escores nas etapas do jogo digital.
 

Palavras-chave

Disfunção cognitiva, Período Pós-operatório, Computadores, Autoavaliação Diagnóstica, Anestesia

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Submitted date:
01/06/2020

Accepted date:
06/20/2021

6107f3bda953953f0154f074 rba Articles

Braz J Anesthesiol

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