Neuroprotective Strategies in the Perioperative Period: A Systematic Review
Journal of Cellular & Molecular Anesthesia,
Vol. 6 No. 1 (2021),
17 March 2021
,
Page 50-65
https://doi.org/10.22037/jcma.v6i1.33072
Abstract
Surgery and anesthetics may cause brain damage, and the resulting neurological defect can impair the patient's cognitive function. This disorder is one of the most common complications after surgery and causes disorders in several cognitive areas of the patient. The mechanism of this disorder is not fully understood, but Neuronal inflammation is one of the main causes of this disorder. The purpose of this systematic review study was to evaluate neuroprotective drug strategies for the treatment or prevention of surgical disorders associated with anesthesia. We searched the keywords "neuroprotective", "neuroprotection", "postoperative" and "perioperative" in the databases of web of science, Scopus, PubMed, science direct and Google Scholar with a 5-year time limit. At first, 492 articles were obtained and finally, after detailed survey based on exclusion and inclusion criteria, 31 studies were selected to extract data. Findings from studies show that medication and treatment strategies used in group of mice and rats under surgery with treatment can improve Neuronal inflammation and brain damage compared to mice and rats with surgery only and reduce the side effects of surgery and anesthetics.
- Perioperative Period
- brain injury
- Neuroprotection
How to Cite
References
2. Kotekar N, Shenkar A, Nagaraj R. Postoperative cognitive dysfunction–current preventive strategies. Clin. Interv. Aging. 2018;13:2267.
3. Steinmetz J, Christensen KB, Lund T, Lohse N, Rasmussen LS, ISPOCD Group. Long-term consequences of postoperative cognitive dysfunction. Anesthesiology. 2009; 110:548–555.
4. Hovens IB, Schoemaker RG, van der Zee EA, Absalom AR, Heineman E, van Leeuwen BL. Postoperative cognitive dysfunction: involvement of neuroinflammation and neuronal functioning. Brain Behav Immun. 2014; 38:202–210.
5. Papaioannou A, Fraidakis O, Michaloudis D, Balalis C, Askitopoulou H. The impact of the type of anaesthesia on cognitive status and delirium during the first postoperative days in elderly patients. Eur. J. Anaesthesiol. 2005; 22(7): 492–499.
6. Silverstein JH. Cognition, anesthesia, and surgery. Int. Anesthesiol. Clin.2014; 52(4): 42–57.
7. Vutskits L, Xie Z. Lasting impact of general anaesthesia on the brain: mechanisms and relevance. Nat. Rev. Neurosci. 2016; 17(11): 705–717.
8. Li YC, Xi CH, An YF, Dong WH, Zhou M. Perioperative inflammatory response and protein S-100beta concentrations—relationship with post-operative cognitive dysfunction in elderly patients. Acta Anaesthesiol Scand. 2012; 56:595–600.
9. Peng L, Xu L, Ouyang W. Role of peripheral inflammatory markers in postoperative cognitive dysfunction (POCD): a meta-analysis. PLoS One. 2013; 8:e79624.
10. Degos V, Vacas S, Han Z, et al. Depletion of bone marrow-derived macrophages perturbs the innate immune response to surgery and reduces postoperative memory dysfunction. Anesthesiology. 2013;118:527–536.
11. Feng X, Valdearcos M, Uchida Y, Lutrin D, Maze M, Koliwad SK. Microglia mediate postoperative hippocampal inflammation and cognitive decline in mice. JCI Insight. 2017; 2:e91229.
12. Cao XZ, Ma H, Wang JK, et al. Postoperative cognitive deficits and neuroinflammation in the hippocampus triggered by surgical trauma are exacerbated in aged rats. Prog Neuropsychopharmacol Biol Psychiatry. 2010; 34:1426–1432.
13. Vacas S, Degos V, Feng X, Maze M. The neuroinflammatory response of postoperative cognitive decline. Br Med Bull.2013; 106:161–178.
14. Fodale V, Santamaria LB, Schifilliti D, Mandal PK. Anaesthetics and postoperative cognitive dysfunction: a pathological mechanism mimicking Alzheimer’s disease.2010; 65(4):388-95.
15. Hu Z, Ou Y, Duan K, Jiang X. Inflammation: a bridge between postoperative cognitive dysfunction and Alzheimer’s disease. Med Hypotheses. 2010; 74:722–724.
16. Xu Z, Dong Y, Wang H, et al. Age-dependent postoperative cognitive impairment and Alzheimer-related neuropathology in mice. Sci Rep. 2014; 4:3766.
17. Zhang Y, Meng Q, Yin J, Zhang Z, Bao H, Wang X. Anthocyanins attenuate neuroinflammation through the suppression of MLK3 activation in a mouse model of perioperative neurocognitive disorders. Brain Research. 2020; 1726:146504.
18. Ye JS, Chen L, Lu YY, Lei SQ, Peng M, Xia ZY. SIRT3 activator honokiol ameliorates surgery/anesthesia‐induced cognitive decline in mice through anti‐oxidative stress and anti‐inflammatory in hippocampus. CNS neuroscience & therapeutics. 2019; 25(3):355-66.
19. Zhang Z, Ji M, Liao Y, Yang J, Gao J. Endotoxin tolerance induced by lipopolysaccharide preconditioning protects against surgery‑induced cognitive impairment in aging mice. Molecular medicine reports. 201; 17(3):3845-52.
20. Kilkenny C, Browne WJ, Cuthill IC, Emerson M, Altman DG. Improving bioscience research reporting: the ARRIVE guidelines for reporting animal research. PLoS Biol. 2010; 8(6):e1000412.
21. Zhang J, Xiao B, Li CX, Wang Y. Fingolimod (FTY720) improves postoperative cognitive dysfunction in mice subjected to D-galactose-induced aging. Neural regeneration research. 2020; 15(7):1308.
22. Zhang D, Li N, Wang Y, et al. Methane ameliorates post-operative cognitive dysfunction by inhibiting microglia NF-κB/MAPKs pathway and promoting IL-10 expression in aged mice. International Immunopharmacology. 2019; 71:52-60.
23. Ye JS, Chen L, Lu YY, Lei SQ, Peng M, Xia ZY. Honokiol-mediated mitophagy ameliorates postoperative cognitive impairment induced by surgery/sevoflurane via inhibiting the activation of NLRP3 inflammasome in the hippocampus. Oxidative Medicine and Cellular Longevity. 2019.
24. Miao HH, Wang M, Wang HX, Tian M, Xue FS. Ginsenoside Rg1 attenuates isoflurane/surgery-induced cognitive disorders and sirtuin 3 dysfunction. Bioscience reports. 2019 ;39(10).
25. Chu JM, Xiong W, Linghu KG, et al. Siegesbeckia Orientalis L. extract attenuates postoperative cognitive dysfunction, systemic inflammation, and neuroinflammation. Experimental neurobiology. 2018; 27(6):564.
26. Zheng B, Lai R, Li J, Zuo Z. Critical role of P2X7 receptors in the neuroinflammation and cognitive dysfunction after surgery. Brain, behavior, and immunity. 2017; 61:365-74.
27. Tian Y, Guo S, Zhang Y, Xu Y, Zhao P, Zhao X. Effects of hydrogen-rich saline on hepatectomy-induced postoperative cognitive dysfunction in old mice. Molecular neurobiology. 2017; 54(4):2579-84.
28. Tian A, Ma H, Zhang R, Cui Y, Wan C. Edaravone improves spatial memory and modulates endoplasmic reticulum stress-mediated apoptosis after abdominal surgery in mice. Experimental and Therapeutic Medicine. 2017; 14(1):355-60.
29. Chen X, Hua HP, Liang L, Liu LJ. The oral pretreatment of glycyrrhizin prevents surgery-induced cognitive impairment in aged mice by reducing neuroinflammation and Alzheimer’s-related pathology via HMGB1 inhibition. Journal of Molecular Neuroscience. 2017; 63(3-4):385-95.
30. Wang HL, Liu H, Xue ZG, Liao QW, Fang H. Minocycline attenuates post‐operative cognitive impairment in aged mice by inhibiting microglia activation. Journal of cellular and molecular medicine. 2016; 20(9):1632-9.
31. Li Y, Pan K, Chen L,et al. Deferoxamine regulates neuroinflammation and iron homeostasis in a mouse model of postoperative cognitive dysfunction. Journal of neuroinflammation. 2016; 13(1):1-2.
32. Zakhary G, Sherchan P, Li Q, Tang J, Zhang JH. Modification of kynurenine pathway via inhibition of kynurenine hydroxylase attenuates surgical brain injury complications in a male rat model. Journal of neuroscience research. 2020; 98(1):155-67.
33. Gao Z, Li Z, Deng R, Liu Q, Xiao Q, Han J, Pu C, Zhang Y. Dexmedetomidine improves postoperative neurocognitive disorder after cardiopulmonary bypass in rats. Neurological Research. 2020; 1-9.
34. Zuo Y, Hu X, Yang Q, et al. Preoperative vitamin-rich carbohydrate loading alleviates postoperative cognitive dysfunction in aged rats. Behavioural brain research. 2019; 373:112107.
35. Zhu YS, Xiong YF, Luo FQ, Min J. Dexmedetomidine protects rats from postoperative cognitive dysfunction via regulating the GABABR‐mediated cAMP‐PKA‐CREB signaling pathway. Neuropathology. 2019; 39(1):30-8.
36. Zhou Y, Li Z, Cao X, et al. Exendin-4 improves behaviorial deficits via GLP-1/GLP-1R signaling following partial hepatectomy. Brain research. 2019; 1706:116-24.
37. Li PJ, Guo YQ, Ding PY, et al. Neuroprotective effects of a Smoothened receptor agonist against postoperative cognitive dysfunction by promoting autophagy in the dentate gyrus of aged rats. Neurological Research. 2019; 41(10):867-74.
38. Fonken LK, Frank MG, D'Angelo HM, et al. Mycobacterium vaccae immunization protects aged rats from surgery-elicited neuroinflammation and cognitive dysfunction. Neurobiology of aging. 2018; 71:105-14.
39. Locatelli FM, Kawano T, Iwata H, et al. Resveratrol-loaded nanoemulsion prevents cognitive decline after abdominal surgery in aged rats. Journal of Pharmacological Sciences. 2018; 137(4):395-402.
40. Wang WX, Wu Q, Liang SS, et al. Dexmedetomidine promotes the recovery of neurogenesis in aged mouse with postoperative cognitive dysfunction. Neuroscience letters. 2018; 677:110-6.
41. Wei P, Zheng Q, Liu H,et al. Nicotine-induced neuroprotection against cognitive dysfunction after partial hepatectomy involves activation of BDNF/TrkB signaling pathway and inhibition of NF-κB signaling pathway in aged rats. Nicotine and Tobacco Research. 2018; 20(4):515-22.
42. Zhang Q, Li Y, Bao Y, et al. Pretreatment with nimodipine reduces incidence of POCD by decreasing calcineurin mediated hippocampal neuroapoptosis in aged rats. BMC anesthesiology. 201; 18(1):1-7.
43. Xin Y, Liu H, Zhang P, Chang L, Xie K. Molecular hydrogen inhalation attenuates postoperative cognitive impairment in rats. Neuroreport. 2017; 28(11):694-700.
44. Sun Y, Song D, Wang M, Chen K, Zhang T. α7 nicotinic acetylcholine receptor agonist attenuates the cerebral injury in a rat model of cardiopulmonary bypass by activating the Akt/GSK3β pathway. Molecular Medicine Reports. 2017; 16(6):7979-86.
45. Qi Z, Tianbao Y, Yanan L, Xi X, Jinhua H, Qiujun W. Pre-treatment with nimodipine and 7.5% hypertonic saline protects aged rats against postoperative cognitive dysfunction via inhibiting hippocampal neuronal apoptosis. Behavioural brain research. 2017; 321:1-7.
46. Gui L, Lei X, Zuo Z. Decrease of glial cell-derived neurotrophic factor contributes to anesthesia-and surgery-induced learning and memory dysfunction in neonatal rats. Journal of Molecular Medicine. 2017; 95(4):369-79.
47. Chen Y, Zhang X, Zhang B, He G, Zhou L, Xie Y. Dexmedetomidine reduces the neuronal apoptosis related to cardiopulmonary bypass by inhibiting activation of the JAK2–STAT3 pathway. Drug design, development and therapy. 2017;11:2787.
48. Pan K, Li X, Chen Y, et al. Deferoxamine pre-treatment protects against postoperative cognitive dysfunction of aged rats by depressing microglial activation via ameliorating iron accumulation in hippocampus. Neuropharmacology. 2016; 111:180-94.
49. Silverstein JH, Timberger M, Reich DL, Uysal S, Warltier DC. Central nervous system dysfunction after noncardiac surgery and anesthesia in the elderly. The Journal of the American Society of Anesthesiologists. 2007; 106(3):622-8.
50. Carrascal Y, Guerrero AL. Neurological damage related to cardiac surgery: pathophysiology, diagnostic tools and prevention strategies. Using actual knowledge for planning the future. The neurologist. 2010; 16(3):152-64.
51. McKhann GM, Goldsborough MA, Borowicz LM, et al. Cognitive outcome after coronary artery bypass: a one-year prospective study. The Annals of thoracic surgery. 1997; 63(2):510-5.
52. Moller JT, Cluitmans P, Rasmussen LS, et al. Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study. The Lancet. 1998; 351(9106):857-61.
- Abstract Viewed: 381 times
- PDF Downloaded: 338 times