The Role of Astrocytes in the Mechanism of Perioperative Neurocognitive Disorders

Cao, Ying; Lin, Xiaowan; Liu, Xiao; Yu, Kang; Miao, Huihui; Li, Tianzuo

doi:10.3390/brainsci12111435

Cited by 5 publications

(2 citation statements)

References 102 publications

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“…Postpartum depression is more likely in women who have a history of sleep disorders, who drink to excess, who take multiple medications or psychotropic drugs, and who have certain medical conditions like diabetes, severe vascular disease, frailty, or neuronal damage from a stroke or traumatic brain injury (Figure 1) [15,16]. Reproduced under the terms and conditions of the Creative Commons Attribution (CC BY) license from ref [17].…”

Section: Review Risk Factors For Pnds In Perioperative Settingsmentioning

confidence: 99%

Advancing Perioperative Neurocognitive Health: A Critical Review of Predictive Tools, Diagnostic Methods, and Interventional Strategies

Lakshminarayanan,

Aboobacker,

Brar

et al. 2024

Cureus

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Perioperative neurocognitive disorders (PNDs) affect a large percentage of people who undergo surgeries that need general anesthesia. There is an increased risk of death and a major disruption to postoperative self-care as a result of this. This study compiles all the relevant materials that the authors have found to investigate postnatal depression and its causes, as well as the methods used to determine the probability and severity of PNDs and how to reduce their risk before surgery. Postnatal depression can have many causes, and this text explores some of them. These include a history of alcohol or opiate use, immunological dysregulation, advanced age, educational background, infections, neurocognitive impairment, and preexisting chronic inflammatory disorders. It also delves into various methods used to gauge the likelihood and severity of postpartum depression. The following assessment tools were covered: the Clock Drawing Test, Domain-Specific Tests, the Mini-Mental State Examination, and the Montreal Cognitive Assessment. In addition to biochemical markers, neuroimaging techniques play an important role in diagnosis. The Frailty Fried assessment, which measures inertia, sluggishness, lack of physical activity, fatigue, and unintentional weight loss, is a key prognostic sign that is highlighted. There is strong evidence that the index, which is derived from these five characteristics, may accurately predict the likelihood of PNDs. Risk mitigation strategies are also covered in this research. Preoperative brain plasticity-based therapies, such as physical exercise and intensive cognitive training, can significantly reduce the incidence and severity of postoperative neurocognitive disorders. A peripheral nerve block, monitoring cerebral oxygen saturation, dexmedetomidine, and a reduction in anesthesia depth are all ways to improve anesthetic procedures. Methods that lower blood pressure should be avoided, the body temperature should be kept down during surgery, or the time without liquids should be lengthened; all of these raise the risk of postoperative nausea and vomiting and make it worse. Potential approaches include a Mediterranean diet, physical activity, cognitive stimulation, smoking cessation, alcohol reduction, avoidance of anticholinergic medications, and non-steroidal anti-inflammatory drug stewardship, although there is no definitive evidence for successful postoperative neurocognitive rehabilitation procedures. More standardized diagnostic criteria, evaluation methods, and PND classification are urgently needed, according to this study. Different cases of PNDs are characterized by different combinations of tests, cutoff values, and methods because there is a broad variety of diagnostic tests used to make the diagnosis. Until now, PNDs and pre-existing neurocognitive disorders have been diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). With an aging population comes an increase in the occurrence and prevalence of PNDs, which calls for a specific way to classify an...

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Section: Review Risk Factors For Pnds In Perioperative Settingsmentioning

confidence: 99%

Advancing Perioperative Neurocognitive Health: A Critical Review of Predictive Tools, Diagnostic Methods, and Interventional Strategies

Lakshminarayanan,

Aboobacker,

Brar

et al. 2024

Cureus

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“…Astrocytes are important regulators of neuroin ammation [14] . Surgical trauma and pain trigger a systemic in ammatory response, leading to the release of systemic in ammatory mediators that can breach the relatively permeable blood-brain barrier.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of the P38 MAPK/NLRP3 Pathway Mitigates Cognitive Dysfunction and Mood Alterations in Aged Mice after Abdominal Surgery Plus Sevoflurane

Lv,

Wang,

et al. 2024

Preprint

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Background Cognitive dysfunction, encompassing perioperative psychological distress and cognitive impairment, is a prevalent postoperative complication within the elderly population, and in severe cases, it may lead to dementia. Building upon our prior research that unveiled a connection between postoperative mood fluctuations and cognitive dysfunction with the phosphorylation of P38, this present investigation aims to delve deeper into the involvement of the P38 MAPK/NLRP3 pathway in perioperative neurocognitive disorders (PND) in an abdominal exploratory laparotomy (AEL) aged mice model. Methods C57BL/6 mice (male, 18-month-old) underwent AEL with 3% anesthesia. Then, inhibitors targeting P38 MAPK (SB202190, 1 mg/kg) and GSK3β (TWS119, 10 mg/kg) were administered multiple times daily for 7 days post-surgery. The NLRP3-cKO AEL and WT AEL groups only underwent the AEL procedure. Behavioral assessments, including the open field test (OFT), novel object recognition (NOR), force swimming test (FST) and fear conditioning (FC), were initiated on postoperative day 14. Additionally, mice designated for neuroelectrophysiological monitoring had electrodes implanted on day 14 before surgery and underwent novel object recognition while their local field potential (LFP) was concurrently recorded on postoperative day 14. Lastly, after they were euthanasized, pathological analysis and western blot were performed. Results SB202190, TWS119, and astrocyte-conditional knockout NLRP3 all ameliorated the cognitive impairment behaviors induced by AEL in mice and increased mean theta power during novel location exploration. However, it is worth noting that SB202190 may exacerbate postoperative depressive and anxiety-like behaviors in mice, while TWS119 may induce impulsive behaviors. Conclusions Our study suggests that anesthesia and surgical procedures induce alterations in mood and cognition, which may be intricately linked to the P38 MAPK/NLRP3 pathway.

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Inhibition of the P38 MAPK/NLRP3 pathway mitigates cognitive dysfunction and mood alterations in aged mice after abdominal surgery plus sevoflurane

Lv,

Gao,

Wang

et al. 2024

Brain Research Bulletin

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The Role of Astrocytes in the Mechanism of Perioperative Neurocognitive Disorders

Cited by 5 publications

References 102 publications

Advancing Perioperative Neurocognitive Health: A Critical Review of Predictive Tools, Diagnostic Methods, and Interventional Strategies

Advancing Perioperative Neurocognitive Health: A Critical Review of Predictive Tools, Diagnostic Methods, and Interventional Strategies

Inhibition of the P38 MAPK/NLRP3 Pathway Mitigates Cognitive Dysfunction and Mood Alterations in Aged Mice after Abdominal Surgery Plus Sevoflurane

Inhibition of the P38 MAPK/NLRP3 pathway mitigates cognitive dysfunction and mood alterations in aged mice after abdominal surgery plus sevoflurane

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