Title:Current Progress on Neuroinflammation-mediated Postoperative
Cognitive Dysfunction: An Update
Volume: 23
Issue: 10
Author(s): Wenyong Peng*, Wei Lu, Xiaofeng Jiang, Chang Xiong, Hua Chai, Libin Cai and Zhijian Lan
Affiliation:
- Department of Anesthesiology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang 321000, China
Keywords:
Neuroinflammation, postoperative cognitive, dysfunction, biomarker, microglia, anesthesia.
Abstract: Postoperative cognitive dysfunction (POCD) is a common complication of
the central nervous system (CNS) in elderly patients after surgery, showing cognitive
changes such as decreased learning and memory ability, impaired concentration, and
even personality changes and decreased social behavior ability in severe cases.
POCD may appear days or weeks after surgery and persist or even evolve into Alzheimer's
disease (AD), exerting a significant impact on patients’ health. There are many
risk factors for the occurrence of POCD, including age, surgical trauma, anesthesia,
neurological diseases, etc. The level of circulating inflammatory markers increases
with age, and elderly patients often have more risk factors for cardiovascular diseases,
resulting in an increase in POCD incidence in elderly patients after stress responses
such as surgical trauma and anesthesia. The current diagnostic rate of POCD is relatively
low, which affects the prognosis and increases postoperative complications and
mortality. The pathophysiological mechanism of POCD is still unclear, however, central
nervous inflammation is thought to play a critical role in it. The current review
summarizes the related studies on neuroinflammation-mediated POCD, such as the
involvement of key central nervous cells such as microglia and astrocytes, proinflammatory
cytokines such as TNF-α and IL-1β, inflammatory signaling pathways
such as PI3K/Akt/mTOR and NF-κB. In addition, multiple predictive and diagnostic
biomarkers for POCD, the risk factors, and the positive effects of anti-inflammatory
therapy in the prevention and treatment of POCD have also been reviewed. The exploration
of POCD pathogenesis is helpful for its early diagnosis and long-term treatment,
and the intervention strategies targeting central nervous inflammation of POCD are of
great significance for the prevention and treatment of POCD.
