Brain white matter lesions and postoperative cognitive dysfunction: a review

Nakao, Shinichi; Yamamoto, Tomohisa; Kimura, Satoshi; Mino, Takashi; Iwamoto, Tatsushige

doi:10.1007/s00540-019-02613-9

Cited by 31 publications

(28 citation statements)

References 54 publications

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“…However, there is no evidence to date that this is the case. Brain lesions within the white matter, which contains the majority of myelinated axons, have been identified as a risk factor for POCD [22]. This could also be transferred to MS patients with THA under general anesthesia.…”

Section: Role Of Anaesthesiamentioning

confidence: 99%

Total Hip Arthroplasty in Multiple Sclerosis

2019

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Systemic neurological disease represents a risk factor for complications after total hip arthroplasty (THA), especially for dislocation, infections, gait disorders and fall-related periprosthetic fractures. There is little specific literature on total hip arthroplasty in patients with multiple sclerosis. However, increased revision rates have been reported, which are in part due to dislocations. Implants with increased dislocation safety, e.g. tripolar acetabular systems, can represent a reasonable alternative. Due to gait disorders and a higher prevalence of osteoporosis, specific osteological evaluation and treatment should be considered to prevent periprosthetic fractures. This short review summarizes the current literature on total hip arthroplasty in patients with multiple sclerosis.

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Section: Role Of Anaesthesiamentioning

confidence: 99%

Total Hip Arthroplasty in Multiple Sclerosis

2019

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“…Accumulating evidence indicates that CCH might promote neurodegeneration through the production of reactive oxygen species and proinflammatory cytokines by activating glial, consequently leading to neuronal damage [3,4,5,6]. The main clinical feature of CCH is chronic neurodegeneration, which leads to cognitive impairment, mood disorder, impaired problem-solving ability, and loss of executive function because of impaired blood supply [7,8,9,10].…”

Section: Introductionmentioning

confidence: 99%

Mumefural Ameliorates Cognitive Impairment in Chronic Cerebral Hypoperfusion via Regulating the Septohippocampal Cholinergic System and Neuroinflammation

2019

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Chronic cerebral hypoperfusion (CCH) causes cognitive impairment and neurogenic inflammation by reducing blood flow. We previously showed that Fructus mume (F. mume) improves cognitive impairment and inhibits neuroinflammation in a CCH rat model. One of the components of F. mume, Mumefural (MF), is known to improve blood flow and inhibit platelet aggregation. Whether MF affects cerebral and cognitive function remains unclear. We investigated the effects of MF on cognitive impairment and neurological function-related protein expression in the rat CCH model, established by bilateral common carotid arterial occlusion (BCCAo). Three weeks after BCCAo, MF (20, 40, or 80 mg/kg) was orally administrated once a day for 42 days. Using Morris water maze assessment, MF treatment significantly improved cognitive impairment. MF treatment also inhibited cholinergic system dysfunction, attenuated choline acetyltransferase-positive cholinergic neuron loss, and regulated cholinergic system-related protein expressions in the basal forebrain and hippocampus. MF also inhibited myelin basic protein degradation and increased the hippocampal expression of synaptic markers and cognition-related proteins. Moreover, MF reduced neuroinflammation, inhibited gliosis, and attenuated the activation of P2X7 receptor, TLR4/MyD88, NLRP3, and NF-κB. This study indicates that MF ameliorates cognitive impairment in BCCAo rats by enhancing neurological function and inhibiting neuroinflammation.

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“…However, some scholars have put forward different opinions. Nakao et al continuously monitored rSO2 during the operation of 50 patients undergoing shoulder surgery on the beach chair position and analyzed the correlation with postoperative cognitive function changes [ 36 ]. In this study, each patient underwent neuropsychological status assessment on the day of surgery, the first day before discharge, and the third day after discharge.…”

Section: Discussionmentioning

confidence: 99%

The Association between Postoperative Cognitive Dysfunction and Cerebral Oximetry during Geriatric Orthopedic Surgery: A Randomized Controlled Study

Zhu

Wang

Shi

2021

BioMed Research International

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Background. Postoperative cognitive dysfunction (POCD) refers to disorders affecting orientation, attention, perception, consciousness, and judgment that develop after geriatric orthopedic surgery. Cerebral blood oxygen saturation detection is a way to diagnose cerebral oxygen supply during operation. At present, more and more applications are used for early diagnosis of postoperative cognitive function. Therefore, the present study is to analyze the relationship between postoperative cognitive dysfunction and cerebral blood oxygen saturation in elderly orthopedic patients. Methods. This study enrolled 90 elderly patients undergoing orthopedic surgery in our hospital. According to the postoperative cognitive dysfunction, they were divided into POCD group ( N = 45 ) and no-POCD ( N = 45 ) group. The cognitive and psychological function and cerebral blood oxygen saturation were analyzed before and 3 months after the operation. Finally, the indicators of cognitive psychological function and the indicators of cerebral blood oxygen saturation are correlated and analyzed. Results. Compared with the normal group, patients with cognitive dysfunction at 3 months after surgery time below preoperative rScO2, time below a 10% decrease from preoperative rScO2, CDL preoperative, minimum rScO2 value, and maximum rScO2 value have significant changes. The results of the correlation analysis found that there is also a significant correlation between the postoperative cognitive and psychological function of the patient and the cerebral blood oxygen saturation at 3 weeks after the operation. Conclusion. In elderly orthopedic patients, there is a significant relationship between cerebral blood oxygen saturation detection and cognitive function 3 months after surgery.

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Brain white matter lesions and postoperative cognitive dysfunction: a review

Cited by 31 publications

References 54 publications

Total Hip Arthroplasty in Multiple Sclerosis

Total Hip Arthroplasty in Multiple Sclerosis

Mumefural Ameliorates Cognitive Impairment in Chronic Cerebral Hypoperfusion via Regulating the Septohippocampal Cholinergic System and Neuroinflammation

The Association between Postoperative Cognitive Dysfunction and Cerebral Oximetry during Geriatric Orthopedic Surgery: A Randomized Controlled Study

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