Impact of Preoperative Environmental Enrichment on Prevention of Development of Cognitive Impairment following Abdominal Surgery in a Rat Model

Abstract

PEE could prevent the development of neuroinflammation and related POCD in aged rats by reversion of a proinflammatory phenotype of hippocampal microglia.

The role of Perioperative Surgical Home on health and longevity in society: importance of the surgical prehabilitation program

“…Although clinical data are limited, there is an interesting experimental report regarding the effects of prehabilitation on cognitive function after surgery. Kawano et al [26] demonstrated that preoperative interventions with physical activity (a running wheel) and cognitive activity (a modified Hebb-Williams maze) for 14 days attenuated cognitive deficits and cytokine production in the brain after abdominal surgery in rats. Prehabilitation with exercise and cognitive intervention may be effective in preventing delirium and cognitive dysfunction.…”

Management of cognition as reported in Japanese historical documents and modern anesthesiology research papers

“…Five presenters presented their own most recent research outcomes and reviewed related publications. Takashi Kawano explained that postoperative delirium and POCD are closely related, and both are the result of an inflammatory reaction in the nervous system [28,29]. He also reported that postoperative pain management and intensive early rehabilitation seem to be important for the prevention of POCD in elderly patients.…”

Postoperative Cognitive Dysfunction: Preclinical Highlights and Perspectives on Preventive Strategies

“…In addition, animal models mimicking these interventions, in which rodents were exposed to voluntary wheel running and an enriched environment, showed improvement in cognitive performance (Figure 2) [48,90]. Although the mechanism of these beneits has been debated, both interventions are reported to have common positive efects on microglial number, proliferation and phenotype in the brain.…”

“…In fact, surgery induces peripheral immune challenges, leading to an exaggerated neuroinlammatory response. More recently, several studies have demo nstrated that neuroinlammation in the hippocampus is most likely to be involved in the pathogenesis of POCD [35,[44][45][46][47][48][49][50][51]. Neuroinlammation is a complex response to brain injury characterized by maladaptive microglial activation mainly involving the activation of glia and increased levels of pro-inlammatory cytokines, including interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α) [52][53][54].…”

“…In particular, the hippocampus is known to be a region important to cognition and highly vulnerable to ageing. Pro-inlammatory cytokines TNF-α and IL-1β released from microglia within the hippocampus are reported to inhibit the long-term potentiation that is important in the formation of memory, as well as inducing apoptosis, and thus play a pathogenic role in cognitive disorders in neurodegenerative diseases [48,[52][53][54][55][56][57][58]. Based on these indings, it can be hypothesized that age-related microglial priming in the hippocampus, and subsequent overproduction of inlammatory cytokines, plays a critical role in the development of POCD in the elderly population.…”