神經認知功能病人之先進腦波即時監測

Advanced EEG Anesthetic Monitoring for Patients with Neurocognitive Disorders

隨著人口老化，神經認知功能障礙如阿茲海默症及腦血管疾病日益普遍，但「老化腦部」不等於「脆弱腦部」。脆弱腦部指，在急性壓力下因韌性機制不足，無法維持正常功能增加譫妄風險。其特徵性腦波表現為慢波（delta、theta波）增加、快波（alpha、beta波）減少及腦區連結性下降。研究顯示，麻醉中前額葉α波減弱，及爆發－抑制腦波的持續時間延長，與術後譫妄風險相關。腦波監測可用於麻醉深度調控及譫妄風險預測，特別是在高風險病人的辨識與個別化照護上有潛力。雖針對減少爆發－抑制，是否能降低譫妄的證據尚不一致，但其重要性已被確認。未來應加強術前認知篩檢及跨學科合作，改善圍手術期腦部健康管理。

With global population aging, neurocognitive disorders such as Alzheimer’s disease and cerebrovascular diseases are becoming increasingly prevalent. However, an“aging brain”is not equivalent to a“vulnerable brain.”A vulnerable brain refers to one that lacks sufficient resilience mechanisms to maintain normal functions under acute stress, leading to an increased risk of delirium. Characteristic EEG features of a vulnerable brain include increased slow waves (delta and theta), decreased fast waves (alpha and beta), and reduced interregional connectivity. Studies have shown that diminished frontal alpha power and prolonged burst suppression during anesthesia are strongly associated with postoperative delirium (POD). EEG monitoring can help regulate anesthetic depth and predict POD risk, with potential for identifying high-risk patients and guiding personalized care. Although evidence remains inconsistent regarding whether reducing burst suppression can lower POD incidence, its role as a predictive marker is well-established. Future efforts should focus on preoperative cognitive screening and interdisciplinary collaboration to enhance perioperative brain health management and reduce the occurrence of POD and long-term cognitive decline.