Inflammation: A bridge between postoperative cognitive dysfunction and Alzheimer’s disease

Hu, Zhonghua; Ou, Yangwen; Duan, Kai-Ming; Jiang, Xianzhen

doi:10.1016/j.mehy.2009.10.040

Cited by 58 publications

(42 citation statements)

References 19 publications

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“…Inflammation is the bridge between POCD and AD; therefore, surgery and anesthesia may lead to brain inflammation, which may be one of the mechanisms of the increased incidence of POCD (Hu et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein

Shao

Wang³

et al. 2014

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To investigate the relationship between post-operative cognitive dysfunction (POCD) and regional cerebral oxygen saturation (rSO 2 ) and β-amyloid protein (Aβ) in patients undergoing laparoscopic pancreaticoduodenectomy. Methods: Fifty patients undergoing elective laparoscopic pancreaticoduodenectomy received five groups of neuropsychological tests 1 d pre-operatively and 7 d post-operatively, with continuous monitoring of rSO 2 intra-operatively. Before anesthesia induction (t 0 ), at the beginning of laparoscopy (t 1 ), and at the time of pneumoperitoneum 120 min (t 2 ), pneumoperitoneum 240 min (t 3 ), pneumoperitoneum 480 min (t 4 ), the end of pneumoperitoneum (t 5 ), and 24 h after surgery, jugular venous blood was drawn respectively for the measurement of Aβ by enzyme-linked immunosorbent assay (ELISA). Results: Twenty-one cases of the fifty patients suffered from POCD after operation. We found that the maximum percentage drop in rSO 2 (rSO 2, %max ) was significantly higher in the POCD group than in the non-POCD group. The rSO 2, %max value of over 10.2% might be a potential predictor of neurocognitive injury for those patients. In the POCD group, the plasma Aβ levels after 24 h were significantly higher than those of pre-operative values (P<0.01). After 24 h, levels of plasma Aβ in the POCD group were significantly higher than those in the non-POCD group (P<0.01). Conclusions: The development of POCD in patients undergoing laparoscopic pancreaticoduodenectomy is associated with alterations of rSO 2 and Aβ. Monitoring of rSO 2 might be useful in the prediction of POCD, and Aβ might be used as a sensitive biochemical marker to predict the occurrence of POCD.

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Section: Discussionmentioning

confidence: 99%

Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein

Shao

Wang³

et al. 2014

J. Zhejiang Univ. Sci. B

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“…Minocycline 41,42 , memantine 43 and a TNF-a synthesis inhibitor 44 have all demonstrated anti-inflammatory based improvements in cognition, by major indicators of neuroinflammation 20,21 and proteins associated with Alzheimer's disease (AD) 22 . This inflammatory phenotype is hypothesized to eventually result in neuronal loss 23 . A similar inflammatory paradigm has also been postulated for the learning impairment seen in young children who have had multiple anaesthetic exposures 24 .…”

Section: Discussionmentioning

confidence: 99%

Microglia provide unexplored avenues to attenuate cognitive decline following isoflurane exposure in susceptible young and elderly patients: A critical review of TREM2-DAP12 function and therapeutic potential

Niesman¹,

Carter²

2013

OA Anaesthetics

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“…[4] Despite its lack of formal definition, the clinical presentation of POCD has been described in similar ways in recent literature; symptoms generally include: decline in language comprehension, comorbidity with major depressive disorder, impaired executive functioning, memory loss, psychomotor agitation, loss of fine-motor coordination, reduced ability to concentrate, and impaired visual memory and abstraction. [6,7] Cognitive status changes are typically temporary, however mental decline can become permanent in some patients (persistent POCD). [8] POCD is generally identified either via a discrepancy between pre and postoperative neurocognitive inventories such as the widely used Mini Mental Status Exam (MMSE), or in the absence of a preoperative baseline score, unexpectedly poor scores accompanied by persistent change in mental status.…”

Section: Prevalence and Diagnosismentioning

confidence: 99%

Postoperative cognitive dysfunction: A case report and literature review

Singh

Cinicola

Parva

et al. 2017

CRIM

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Background: Postoperative cognitive dysfunction (POCD) is loss of cognition especially in memory and executive function that can extend from a few days to a few weeks after surgery. It is more common in older adult patients. We present a case featuring a typical progression of POCD along with its associated preoperative risk factors. Case report: A 65-year-old male patient with an extensive past medical history including generalized anxiety disorder, hypertension and hyperlipidemia initially presented to the emergency department for chest pain. Coronary artery bypass graft (CABG) was performed under general anesthesia with Propofol, Fentanyl, Rocuronium and Midazolam. The patient tolerated the procedure well. After the procedure, his stay was complicated by delirium and altered mental status. All reversible causes were investigated and eliminated as likely causes. Later, the patient was sent home after a prolonged hospital stay. Following discharge, he had multiple admissions to the hospital for altered mental status, and his mental status has not reached baseline again. Family has been confident that the patient's psychological and cognitive symptoms began following the CABG. Conclusion: We present this case to highlight the heightened incidence of postoperative cognitive decline in patients over sixty undergoing major surgery. We also present a comprehensive review of the current literature on the risk factors, clinical manifestations, and pathogenesis of POCD.

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Inflammation: A bridge between postoperative cognitive dysfunction and Alzheimer’s disease

Cited by 58 publications

References 19 publications

Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein

Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein

Microglia provide unexplored avenues to attenuate cognitive decline following isoflurane exposure in susceptible young and elderly patients: A critical review of TREM2-DAP12 function and therapeutic potential

Postoperative cognitive dysfunction: A case report and literature review

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