Cognitive Decline Clinical Trial
The incidence of cognitive decline related to CPB ranges from 20% to 80%, which may affect length of hospital stay, quality of life, the rehabilitation process, and work performance.However, there is no method to prevent the decline.Gastrodin,the active constituent of gastrodia elata, has been widely used for the treatment of paralysis, hemiplegia, headache, vertigo, and Alzheimer's disease. Gastrodin is safe. No severe side-effect has been observed in the treatment. We postulate that gastrodin would attenuate the causative parameters of cognitive dysfunction related to CPB and would be an effective drug to prevent the decline as a result.
Cardiac surgery with cardiopulmonary bypass (CPB) is one of the most frequently performed
operations. Neurobehavioral disorders, including neuropsychiatric and neuropsychological
deficits, are a very frequently reported sequela of valve replacement or coronary artery
bypass grafting (CABG) surgery. CPB is associated with significant cerebral morbidity. The
incidence of cognitive decline related to CPB ranges from 20% to 80%, which may affect
length of hospital stay, quality of life, the rehabilitation process, and work performance.
Neurocognitive decline can present days to weeks after surgery and may remain a permanent
disorder. Many pharmacologic strategies have been proposed or investigated for preventing
post-CPB cognitive decline, but to our knowledge, none of these drugs has been
systematically evaluated for efficacy in preventing post-CPB cognitive decline.
The causative parameters of cognitive dysfunction associated with CPB include cerebral
ischemia secondary to either microemboli or hypoperfusion, intraoperative cerebrovascular
risk factors such as the duration of CPB, inflammatory response, cerebral glutamine release,
free radicals, and NO release.
Gastrodia elata, a famous Chinese medical herb, has effects on preventing ischemic brain
injury, neuronal cell damage or apoptosis, suppressing inflammatory response, inhibiting
glutamine receptors and nNOS, and scavenging free radicals. Gastrodin
(4-[hydroxymethyl]phenyl-β-D-glucopyranoside), the primary active constituent of gastrodia
elata, has been widely used for the treatment of paralysis, hemiplegia, headache, vertigo,
and Alzheimer's disease. Based on its pharmacological effects, we postulated that gastrodin
would attenuate the causative parameters of cognitive dysfunction related to CPB and would
be an effective drug to prevent the decline as a result.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Prevention
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