• Cheshire Hardcastle, Hua Huang, Sam Crowley, Jared Tanner, Carlos Hernaiz, Mark Rice, Hari Parvataneni, Mingzhou Ding, and Catherine C Price.
• Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
• J. Alzheimers Dis. 2019 Jan 1; 69 (4): 1003-1018.

BackgroundResearch shows that older adults can have a decline in three key resting state networks (default mode network, central executive network, and salience network) after total knee arthroplasty and that patients' pre-surgery brain and cognitive integrity predicts decline.ObjectivesFirst, to assess resting state network connectivity decline from the perspective of nodal connectivity changes in a larger older adult surgery sample. Second, to compare pre-post functional connectivity changes in mild cognitive impairment (MCI) versus non-MCI.MethodsSurgery (n = 69) and non-surgery (n = 65) peers completed a comprehensive preoperative neuropsychological evaluation and pre- and acute (within 48 hours) post-surgery/pseudo-surgery functional brain magnetic resonance imaging scan. MCI was classified within both (MCI surgery, n = 13; MCI non-surgery, n = 10). Using standard coordinates, we defined default mode network, salience network, central executive network, and the visual network (serving as a control network). The functional connectivity of these networks and brain areas (nodes) that make up these networks were examined for pre-post-surgery changes through paired samples t-test and ANOVA.ResultsThere was a decline in RSN connectivity after surgery (p < 0.05) only in the three cognitive networks (not the visual network). The default mode and salience network showed nodal connectivity changes (p < 0.01). MCI surgery had greater functional connectivity decline in DMN and SN. Non-surgery participants showed no significant functional connectivity change.ConclusionSurgery with general anesthesia selectively alters functional connectivity in major cognitive resting state networks particularly in DMN and SN. Participants with MCI appear more vulnerable to these functional changes.

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