Because no preventative or curative treatments are known for SCAs, genetic testing for at risk individuals is not recommended for all cases, and is typically issued on an individual basis. Presymptomatic, prenatal, and preimplantation testing are typically requested through a genetic counsellor and require existing family history and documentation of informed consent of the consultand. Spinocerebellar ataxia type 1 was one of the first late onset diseases for which presymptomatic testing was demonstrated effective and predictive; prior to the development of testing for SCA1, Huntingtons disease was the only similar disease for which presymptomatic testing was available.Molecular genetic testing of SCAs must be able to differentiate samples with the pathogenic allele from those without and be able to accurately measure the number of repeats in repeat expansion disorders. Capillary electrophoresis (CE) is one method that has met these criteria and is recommended by the EMQN. Another method that is common is polyacrylamide gel electrophoresis (PAGE). Both methods require amplification of all loci of interest for a given test. Amplification is done using polymerase chain reactions or PCR. The choice of primers can allow either for a single gene to be amplified or for many genes to amplified for use in a multiplex assay which can save time in cases where a panel of many tests may be required. PAGE and CE both use timed cycles of electricity to draw pieces of DNA through a porous polymer, separating analytes by a combination of ionic mobility, size and mass.
This study found no causal relationship between cerebral hypoxia and low blood pressure and POCD. Age, duration of anaesthesia, introperative complications, and postoperative infections were found to be associated with POCD. POCD is just as likely to occur after operations under regional anesthesia as under general anesthesia. More likely after major operations than minor operations. More likely after heart operations than other types of surgery. More likely in aged than in younger patients. More likely in older patients with high alcohol intake. People with higher preoperative ASA physical status scores are more likely to develop POCD. People with lower educational level are more likely to develop POCD than those with a higher educational level. People with prior history of a stroke, even though there is complete functional recovery, are more likely to develop POCD. More likely in the elderly with pre-existing declining mental functions, termed mild cognitive impairment (MCI). MCI is a transitional zone between normal mental function and evident Alzheimers disease or other forms of dementia. It is insidious, and seldom recognized, except in retrospect after affected persons are evidently demented. Delirium and severe worsening of mental function is very likely in those with clinically evident Alzheimers disease or other forms of dementia, as well as those with a history of delirium after previous operations. Footnotes
Further reading
"Postoperative cognitive dysfunction" (PDF). {{cite journal}}: Cite journal requires |journal= (help)
Muñoz-Corsini L, Gómez-Arnau J, Porras MC, Galindo S, Jiménez R (May 1997). "Postoperative cognitive dysfunction". Rev Esp Anestesiol Reanim. 44 (5): 191–200. PMID 9280997. Crosby, Gregory; Culley, Deborah J.