Restoring Order to Postoperative Neurocognitive Disorders

Saxena, Sarah; Uchida, Yoshiyuki; Maze, Mervyn

doi:10.1001/jamaneurol.2017.4030

Cited by 4 publications

(4 citation statements)

References 14 publications

(27 reference statements)

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“…Исследования CAPACITY и ARCADIAN, проведенные с января 2014 г. по август 2015 г., показали на примере 30 пациентов, имеющих послеоперационное когнитивные расстройства, наличие двух важных биомаркеров нейронального повреждения: уровней tau-белка и легкой субъединицы нейрофиламентного белка (NfL) [17,18].…”

Section: результаты и обсужденияunclassified

“…Tau-протеин является неотъемлемым компонентом целостности аксонов, и повышенный его уровень свидетельствует о повреждении аксонов. Рост количественных значений данных маркеров в крови пропорционален степени повреждения нейронов [18,20].…”

Section: результаты и обсужденияunclassified

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Biological markers as predictors of postoperative neurocognitive disorders

Basenko

Astakhov

Синицкий

et al. 2021

jour

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Introduction. The literature review presents new definitions of the concepts of postoperative cognitive dysfunctions, taking into account the new nomenclature according to DSM-5 (Diagnostic and Statistical Manual of mental disorders, fifth edition — Diagnostic and statistical manual of mental disorders, 5th edition) and time of their manifestations, depending on the age of the surgical intervention performed. The main discussed tactical aspects of the anesthesiologist's management of patients at risk of cognitive impairment in the postoperative period are outlined. The main biological markers, predictors of the development of cognitive postoperative disorders, are emphasized.Aim of the study: to highlight the main discussed tactical points of anesthesiologist's management of patients, to outline more promising aspects of biochemical laboratory diagnosis of postoperative neurocognitive disorders.Materials and methods. The data were analyzed and systematized based on scientific publications in the general PubMed database for the period 2016-2020.Results and discussion. New research advances in the search for biological targets, markers and predictors of postoperative neurocognitive disorders at the molecular level are presented, allowing a more precise impact on the pathogenetic mechanisms of neuronal inflammation and assessment of the potential damage to the cognitive status of the patient. The paper outlines more promising aspects of biochemical laboratory diagnosis using markers of innate immunity response to surgical trauma and the resulting systemic inflammation. Conclusion. Problems requiring further study to find pathogenetic therapy for postoperative neurocognitive disorders have been identified.

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Section: результаты и обсужденияunclassified

Biological markers as predictors of postoperative neurocognitive disorders

Basenko

Astakhov

Синицкий

et al. 2021

jour

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“…Throughout the ages, general anesthesia has been recognized as an "instantly reversible condition" that leaves no sequalae after emergence, despite remarkable alterations in consciousness and similarly dramatic changes in other organ systems. 1 However, increasing amount of evidence has shown that general anesthesia is not simply an "instantly reversible condition," but has acute, even long-lasting influence on central nerve system (CNS). [2][3][4] Coexisting with general anesthesia, orthopedic or cardiac surgeries often lead to acute or long-term cognitive decline after surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

Neuroinflammation in perioperative neurocognitive disorders: From bench to the bedside

Liu

Wang

2022

CNS Neurosci Ther

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“…Postoperative neurocognitive dysfunction (PNCD) is a frequent postoperative complication in elderly patients and can lead to prolonged hospitalization and additional postoperative complications, and imposes a serious medical and economic burden on both families and society. Despite the continuous improvement of surgical and anesthesia techniques, the incidence of PNCD remains high, especially among elderly patients, and its pathogenesis is not yet fully understood (1)(2)(3)(4). Several pathogenic mechanisms have been proposed for PNCD, including oxidative and nitrosative stress, protein misfolding and aggregation, apoptosis, and glutamatergic excitotoxicity (5,6).…”

Section: Introductionmentioning

confidence: 99%

Mdivi-1 improves postoperative neurocognitive disorders in aged rats undergoing splenectomy by inhibiting dynamin-related protein-1

Lin¹,

Jin²,

Lai³

et al. 2022

Ann Transl Med

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Background: The regulatory role of mitochondria in the inflammatory response of the nervous system postoperatively remains unclear. This study explored the relationship between mitochondria and postoperative neurocognitive dysfunction (PNCD) by regulating mitochondrial function in aged rats undergoing splenectomy.Methods: A total of 120 aged rats were randomly divided into five groups (n=24) as follows: Control group (not subjected to any form of treatment), Sham group (subjected only to sham-splenectomized operation after anesthesia), Splenectomy group (only underwent splenectomy after anesthesia), Synonyms Mitochondrial division inhibitor 1 (Mdivi-1) group [treated with Mdivi-1, a dynamin-relatedprotein 1 (Drp1) inhibitor], and Dimethyl Sulfoxide (DMSO) group (treated with DMSO, a solvent). Inflammatory markers, namely interleukin-1β (IL-1β) and tumor necrosis factor α (TNF-α), were measured in the plasma and brains of the rats. Cognitive function was assessed using the Morris water maze test.Results: During the perioperative period, the physiological parameters did not differ among the five groups (P>0.05). The results of the Morris water maze experiments showed that the memory of the rats was significantly impaired after splenectomy, which was alleviated by Mdivi-1 administration (P=0.04).Postoperatively, the proinflammatory cytokine levels in the serum and hippocampus tissue were upregulated, while Mdivi-1 administration reduced this increase. The electron microscopy and hematoxylin-eosin (HE) staining results indicated that the structure of neurons and mitochondria was minimally impaired in the Mdivi-1 group.Conclusions: Aged rats that underwent splenectomy exhibited significant postoperative cognitive impairments. The selective inhibitor of Drp1, Mdivi-1, exerted protective effects against PNCD by ameliorating mitochondrial dysfunction and reducing the inflammatory response.

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Restoring Order to Postoperative Neurocognitive Disorders

Cited by 4 publications

References 14 publications

Biological markers as predictors of postoperative neurocognitive disorders

Biological markers as predictors of postoperative neurocognitive disorders

Neuroinflammation in perioperative neurocognitive disorders: From bench to the bedside

Mdivi-1 improves postoperative neurocognitive disorders in aged rats undergoing splenectomy by inhibiting dynamin-related protein-1

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