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Oh TK, Park HY, Song IA. Incidence of psychiatric disorders after total knee or hip arthroplasty by anesthesia type: A nationwide cohort study. J Affect Disord 2024; 367:696-700. [PMID: 39260579 DOI: 10.1016/j.jad.2024.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 08/31/2024] [Accepted: 09/08/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Evidence is lacking of an association between anesthetic choice and the risk of psychiatric disorders. Therefore, this study aimed to examine the impact of regional anesthesia (R/A) versus general anesthesia (G/A) on the occurrence of psychiatric disorders in patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA). METHODS Data for this population-based cohort study were sourced from the National Health Insurance Service of South Korea. The study included adult patients who underwent TKA or THA between January 1, 2016, and December 31, 2021. The endpoint was the diagnosis of postoperative psychiatric disorders within 1 year postoperative. RESULTS This study included 411,967 patients who underwent THA or TKA. Among them, 290,476 (70.5 %) underwent THA or TKA under R/A (R/A group), while 121,491 (29.5 %) underwent THA or TKA under G/A (G/A group). In multivariate logistic regression, the R/A group had an 8 % lower incidence of postoperative psychiatric disorders (odds ratio [OR], 0.92; 95 % confidence interval [CI], 0.90-0.94; P < 0.001) than the G/A group. Specifically, a lower incidence of postoperative psychiatric disorder for depression (OR, 0.89; 95 % CI, 0.86-0.92; P < 0.001), bipolar disorder (OR, 0.88; 95 % CI, 0.83-0.94; P < 0.001), anxiety disorder (OR, 0.95; 95 % CI, 0.92-0.98; P = 0.001), and insomnia disorder (OR, 0.95; 95 % CI, 0.80-1.11; P = 0.496) was observed in the R/A versus G/A group. CONCLUSIONS Among these South Korean patients who underwent TKA or THA, the R/A group had a lower incidence of postoperative psychiatric disorders than the G/A group.
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Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea
| | - Hye Yoon Park
- Department of Psychiatry, Seoul National University Hospital, Seoul, South Korea
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
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Shen J, Ma H, Yang X, Hu M, Tian J. Perioperative impact of ultrasound-guided ilioinguinal and iliohypogastric nerve blocks in patients undergoing pelvic fracture surgery. Medicine (Baltimore) 2024; 103:e38634. [PMID: 38941385 DOI: 10.1097/md.0000000000038634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
Pelvic fractures present a severe and complex clinical challenge. This study aimed to compare ultrasound-guided ilioinguinal (IIN) and iliohypogastric nerve (IHN) blocks with conventional general anesthesia (GA) in patients undergoing internal fixation surgery for pelvic fractures. A retrospective analysis was conducted on 100 patients equally divided into ultrasound-guided and control groups. The study monitored hemodynamics, intraoperative anesthesia drug usage, postoperative pain levels, and the incidence of adverse reactions between the 2 groups. The ultrasound-guided group underwent ultrasound-guided IHN and IIN blocks combined with GA. The ultrasound-guided group exhibited significant advantages for hemodynamic measurements at specific time points, lower consumption of Propofol and Remifentanil, and reduced pain intensity across all evaluated time intervals (P < .05). The incidence rate of adverse reactions was significantly lower in the ultrasound group (P = .016). Ultrasound-guided anesthesia is a superior alternative to conventional GA for managing pelvic fractures through internal fixation surgery. It offers advantages in terms of hemodynamic stability, drug consumption, postoperative pain management, and adverse reaction reduction.
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Affiliation(s)
- Jie Shen
- Department of Anesthesiology, Handan First Hospital, Handan, Hebei Province, China
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Fan G, Zhong M, Su W, An Z, Zhu Y, Chen C, Dong L, Wu L, Zhang X. Effect of different anesthetic modalities on postoperative delirium in elderly hip fractures: A meta-analysis. Medicine (Baltimore) 2024; 103:e38418. [PMID: 38847680 PMCID: PMC11155603 DOI: 10.1097/md.0000000000038418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/09/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Previous findings on the effect of general versus spinal anesthesia on postoperative delirium in elderly people with hip fractures are somewhat controversial. This article included the latest randomized controlled study for meta-analysis to evaluate the effect of general anesthesia (GA) and spinal anesthesia (SA) on delirium after hip fracture surgery in the elderly, so as to guide the clinical. METHODS Cochrane Library, PubMed, Web Of Science, and Embase were searched from inception up to January 16, 2024. Randomized controlled trial (RCT) was included to evaluate the postoperative results of GA and SA in elderly patients (≥50 years old) undergoing hip fracture surgery. Two researchers independently screened for inclusion in the study and extracted data. Heterogeneity was assessed by the I²and Chi-square tests, and P < .1 or I² ≥ 50% indicated marked heterogeneity among studies. The Mantel-Haenszel method was used to estimate the combined relative risk ratio (RR) and the corresponding 95% confidence interval (CI) for the binary variables. RESULTS Nine randomized controlled trials were included. There was no significant difference (RR = 0.93, 95% CI = 0.774-1.111, P > .05) in the incidence of postoperative delirium between the GA group and the SA group. In intraoperative blood transfusion (RR = 1.0, 95% CI = 0.77-1.28, Z = 0.04, P = .971), pulmonary embolism (RR = 0.795, 95% CI = 0.332-1.904, Z = 0.59, P = .606), pneumonia (RR = 1.47, 95% CI = 0.75-2.87, P = .675), myocardial infarction (RR = 0.97, 95% CI = 0.24-3.86, Z = 0.05, P = .961), heart failure (RR = 0.80, 95% CI = 0.26-2.42, Z = 0.40, P = .961), urinary retention (RR = 1.42, 95% CI = 0.77-2.61, Z = 1.11, P = .267) were similar between the 2 anesthetic techniques. CONCLUSION There is no significant difference in the effect of GA and SA on postoperative delirium in elderly patients with hip fracture, and their effects on postoperative complications are similar.
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Affiliation(s)
- Guangya Fan
- Department of Orthopedics,The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Musen Zhong
- Department of Orthopedics,The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Wenshuo Su
- Department of Orthopedics,The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Zhongcheng An
- Department of Orthopedics,The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Yuchen Zhu
- Department of Orthopedics,The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Chen Chen
- Department of Orthopedics,The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Liqiang Dong
- Department of Orthopedics,The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Lianguo Wu
- Department of Orthopedics,The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Xiaoping Zhang
- Department of Geriatrics, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
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Semyachkina-Glushkovskaya O, Sergeev K, Semenova N, Slepnev A, Karavaev A, Hramkov A, Prokhorov M, Borovkova E, Blokhina I, Fedosov I, Shirokov A, Dubrovsky A, Terskov A, Manzhaeva M, Krupnova V, Dmitrenko A, Zlatogorskaya D, Adushkina V, Evsukova A, Tuzhilkin M, Elizarova I, Ilyukov E, Myagkov D, Tuktarov D, Kurths J. Machine Learning Technology for EEG-Forecast of the Blood-Brain Barrier Leakage and the Activation of the Brain's Drainage System during Isoflurane Anesthesia. Biomolecules 2023; 13:1605. [PMID: 38002287 PMCID: PMC10669477 DOI: 10.3390/biom13111605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 11/26/2023] Open
Abstract
Anesthesia enables the painless performance of complex surgical procedures. However, the effects of anesthesia on the brain may not be limited only by its duration. Also, anesthetic agents may cause long-lasting changes in the brain. There is growing evidence that anesthesia can disrupt the integrity of the blood-brain barrier (BBB), leading to neuroinflammation and neurotoxicity. However, there are no widely used methods for real-time BBB monitoring during surgery. The development of technologies for an express diagnosis of the opening of the BBB (OBBB) is a challenge for reducing post-surgical/anesthesia consequences. In this study on male rats, we demonstrate a successful application of machine learning technology, such as artificial neural networks (ANNs), to recognize the OBBB induced by isoflurane, which is widely used in surgery. The ANNs were trained on our previously presented data obtained on the sound-induced OBBB with an 85% testing accuracy. Using an optical and nonlinear analysis of the OBBB, we found that 1% isoflurane does not induce any changes in the BBB, while 4% isoflurane caused significant BBB leakage in all tested rats. Both 1% and 4% isoflurane stimulate the brain's drainage system (BDS) in a dose-related manner. We show that ANNs can recognize the OBBB induced by 4% isoflurane in 57% of rats and BDS activation induced by 1% isoflurane in 81% of rats. These results open new perspectives for the development of clinically significant bedside technologies for EEG-monitoring of OBBB and BDS.
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Affiliation(s)
- Oxana Semyachkina-Glushkovskaya
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
| | - Konstantin Sergeev
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
| | - Nadezhda Semenova
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
| | - Andrey Slepnev
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
| | - Anatoly Karavaev
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
- Institute of Radio Engineering and Electronics of RAS, Zelenaya Str. 38, 410019 Saratov, Russia
- Research Institute of Cardiology, Saratov State Medical University, B. Kazachaya Str. 112, 410012 Saratov, Russia
| | - Alexey Hramkov
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
- Institute of Radio Engineering and Electronics of RAS, Zelenaya Str. 38, 410019 Saratov, Russia
| | - Mikhail Prokhorov
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
- Institute of Radio Engineering and Electronics of RAS, Zelenaya Str. 38, 410019 Saratov, Russia
| | - Ekaterina Borovkova
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
- Institute of Radio Engineering and Electronics of RAS, Zelenaya Str. 38, 410019 Saratov, Russia
- Research Institute of Cardiology, Saratov State Medical University, B. Kazachaya Str. 112, 410012 Saratov, Russia
| | - Inna Blokhina
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
| | - Ivan Fedosov
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
| | - Alexander Shirokov
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
- Institute of Biochemistry and Physiology of Plants and Microorganisms, Russian Academy of Sciences, Prospekt Entuziastov 13, 410049 Saratov, Russia
| | - Alexander Dubrovsky
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
| | - Andrey Terskov
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
| | - Maria Manzhaeva
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
| | - Valeria Krupnova
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
| | - Alexander Dmitrenko
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
| | - Daria Zlatogorskaya
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
| | - Viktoria Adushkina
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
| | - Arina Evsukova
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
| | - Matvey Tuzhilkin
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
| | - Inna Elizarova
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
| | - Egor Ilyukov
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
| | - Dmitry Myagkov
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
| | - Dmitry Tuktarov
- Institute of Physics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (K.S.); (N.S.); (A.S.); (A.K.); (M.P.); (E.B.); (I.F.); (A.D.); (E.I.); (D.T.)
| | - Jürgen Kurths
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.S.); (A.T.); (M.M.); (V.K.); (A.D.); (D.Z.); (V.A.); (A.E.); (M.T.); (I.E.); (J.K.)
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
- Centre for Analysis of Complex Systems, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya 2, Building 4, 119435 Moscow, Russia
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
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The Crosstalk between the Blood–Brain Barrier Dysfunction and Neuroinflammation after General Anaesthesia. Curr Issues Mol Biol 2022; 44:5700-5717. [PMID: 36421670 PMCID: PMC9689502 DOI: 10.3390/cimb44110386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
As we know, with continuous medical progress, the treatment of many diseases can be conducted via surgery, which often relies on general anaesthesia for its satisfactory performance. With the widespread use of general anaesthetics, people are beginning to question the safety of general anaesthesia and there is a growing interest in central nervous system (CNS) complications associated with anaesthetics. Recently, abundant evidence has suggested that both blood–brain barrier (BBB) dysfunction and neuroinflammation play roles in the development of CNS complications after anaesthesia. Whether there is a crosstalk between BBB dysfunction and neuroinflammation after general anaesthesia, and whether this possible crosstalk could be a therapeutic target for CNS complications after general anaesthesia needs to be clarified by further studies.
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Affiliation(s)
- Michael S. Avidan
- Department of Anesthesiology, Washington University School
of Medicine
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Yin Y, Li H, Wang J, Kong Y, Chang J, Chu G. Implication of microglia in ketamine-induced long-term cognitive impairment in murine pups. Hum Exp Toxicol 2022; 41:9603271221128739. [PMID: 36172893 DOI: 10.1177/09603271221128739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Ketamine, a non-competitive N-methyl-D-aspartate receptor (NMDAR) antagonist, is widely applicable to anesthesia, analgesia, and sedation. However, the function and mechanisms of ketamine in the long-term learning and memory function of neonatal mice are unclear. OBJECTIVE The present study aims to investigate whether long-term learning and memory function will be affected by multiple ketamine exposures in the early development period. METHODS The mRNA and protein levels were measured by RT-qPCR and western blot, respectively. The Morris Water Maze test was performed to assess spatial learning and memory. RESULTS We identified that neonatal exposure to ketamine downsized the positive neurons for microtubule-associated protein doublecortin (DCX) and Ki67 in hippocampal dentate gyrus at the juvenile and late adolescence stages. Double-labeling tests demonstrated that the counts of Iba1+ cells and Ki67+ cells were pronouncedly diminished with exposure to ketamine. Further, qPCR assays to screen the key factors predisposing the populations and maturation of microglia exhibited remarkable decline of CX3CR1 mRNA levels in ketamine group versus the control group. The close relation of microglia to synaptic plasticity was depicted by the significantly downregulated synaptic plasticity-related proteins NR2B and PSD-95 subsequent to multiple exposures to ketamine. Finally, we found that both the protein and mRNA levels of BDNF were markedly decreased in ketamine group versus the control group. CONCLUSION We found that multiple exposures to ketamine in neonatal mice lead to spatial learning and memory dysfunction. The alterations of microglial development and function are the possible mechanisms of long-term learning and memory impairment.
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Affiliation(s)
- Y Yin
- Department of Anesthesiology, 117851Changzhou Maternity and Child Health Care Hospital, Changzhou, China
| | - H Li
- Department of Anesthesiology, 66322Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - J Wang
- Department of Anesthesiology, 56695Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y Kong
- Department of Anesthesiology, 117851Changzhou Maternity and Child Health Care Hospital, Changzhou, China
| | - J Chang
- Department of Anesthesiology, 117851Changzhou Maternity and Child Health Care Hospital, Changzhou, China
| | - G Chu
- Department of Anesthesiology, 117851Changzhou Maternity and Child Health Care Hospital, Changzhou, China
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8
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Affiliation(s)
- James P Rathmell
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston (J.P.R.); and the Department of Anesthesiology, Washington University School of Medicine, St. Louis (M.S.A.)
| | - Michael S Avidan
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston (J.P.R.); and the Department of Anesthesiology, Washington University School of Medicine, St. Louis (M.S.A.)
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Pant T, DiStefano JK, Logan S, Bosnjak ZJ. Emerging Role of Long Noncoding RNAs in Perioperative Neurocognitive Disorders and Anesthetic-Induced Developmental Neurotoxicity. Anesth Analg 2021; 132:1614-1625. [PMID: 33332892 DOI: 10.1213/ane.0000000000005317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Preclinical investigations in animal models have consistently demonstrated neurobiological changes and life-long cognitive deficits following exposure to widely used anesthetics early in life. However, the mechanisms by which these exposures affect brain function remain poorly understood, therefore, limiting the efficacy of current diagnostic and therapeutic options in human studies. The human brain exhibits an abundant expression of long noncoding RNAs (lncRNAs). These biologically active transcripts play critical roles in a diverse array of functions, including epigenetic regulation. Changes in lncRNA expression have been linked with brain development, normal CNS processes, brain injuries, and the development of neurodegenerative diseases, and many lncRNAs are known to have brain-specific expression. Aberrant lncRNA expression has also been implicated in areas of growing importance in anesthesia-related research, including anesthetic-induced developmental neurotoxicity (AIDN), a condition defined by neurological changes occurring in patients repeatedly exposed to anesthesia, and the related condition of perioperative neurocognitive disorder (PND). In this review, we detail recent advances in PND and AIDN research and summarize the evidence supporting roles for lncRNAs in the brain under both normal and pathologic conditions. We also discuss lncRNAs that have been linked with PND and AIDN, and conclude with a discussion of the clinical potential for lncRNAs to serve as diagnostic and therapeutic targets for the prevention of these neurocognitive disorders and the challenges facing the identification and characterization of associated lncRNAs.
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Affiliation(s)
- Tarun Pant
- Department of Diabetes and Fibrotic Disease Unit, Translational Genomic Research Institute, Phoenix, Arizona
| | | | - Sara Logan
- Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Zeljko J Bosnjak
- From the Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.,Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin
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Shen Y, Li X, Yao J. Develop a Clinical Prediction Model for Postoperative Cognitive Dysfunction after Major Noncardiac Surgery in Elderly Patients: A Protocol for a Prospective Observational Study. Gerontology 2021; 68:538-545. [PMID: 34315154 DOI: 10.1159/000517511] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/31/2021] [Indexed: 11/19/2022] Open
Abstract
Perioperative neurocognitive disorders (PNDs) refer to cognitive decline identified in the preoperative or postoperative period. It has been reported that the incidence of postoperative neurocognitive impairment after noncardiac surgery in patients older than 65 at 1 week was 25.8∼41.4%, and at 3 months 9.9∼12.7%. PNDs will last months or even develop to permanent dementia, leading to prolonged hospital stays, reduced quality of life, and increased mortality within 1 year. Despite the high incidence and poor prognosis of PNDs in the aged population, no effective clinical prediction model has been established to predict postoperative cognitive decline preoperatively. To develop a clinical prediction model for postoperative neurocognitive dysfunction, a prospective observational study (Clinical trial registration number: ChiCTR2000036304) will be performed in the Shanghai General Hospital during January 2021 to October 2022. A sample size of 675 patients aged >65 years old, male or female, and scheduled for elective major noncardiac surgery will be recruited. A battery of neuropsychological tests will be used to test the cognitive function of patients at 1 week, 1 month, and 3 months postoperatively. We will evaluate the associations of PNDs with a bunch of candidate predictors including general characteristics of patients, blood biomarkers, indices associated with anesthesia and surgery, retinal nerve-fiber layer thickness, and frailty index to develop the clinical prediction model by using multiple logistic regression analysis and least absolute shrinkage and the selection operator (LASSO) method. The k-fold cross-validation method will be utilized to validate the clinical prediction model. In conclusion, this study was aimed to develop a clinical prediction model for postoperative cognitive dysfunction of old patients. It is anticipated that the knowledge gained from this study will facilitate clinical decision-making for anesthetists and surgeons managing the aged patients undergoing noncardiac surgery.
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Affiliation(s)
- Yang Shen
- Department of Anesthesia, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,
| | - Xianchen Li
- Clinical Research Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junyan Yao
- Department of Anesthesia, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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11
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Wu Q, Shang Y, Shen T, Liu F, Zhang W. Biochanin A protects SH-SY5Y cells against isoflurane-induced neurotoxicity by suppressing oxidative stress and apoptosis. Neurotoxicology 2021; 86:10-18. [PMID: 34216683 DOI: 10.1016/j.neuro.2021.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/14/2021] [Accepted: 06/28/2021] [Indexed: 12/28/2022]
Abstract
Biochanin A (BCA) is a natural organic O-methylated isoflavone with a variety of pharmacological effects, and has been reported to have neuroprotective properties. Here, we explored whether BCA protects neurocytes against isoflurane-induced neurotoxicity and investigated the underlying mechanism. Cell viability was tested by cell counting kit-8 and lactate dehydrogenase release assays. Apoptosis was evaluated by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and caspase-3/7 activity assays. Superoxide dismutase (SOD) and catalase (CAT) activities and levels of glutathione (GSH) and malondialdehyde (MDA) were measured to assess oxidative stress. Expression of nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1) and NAD(P)H quinone oxidoreductase (NQO1) was determined by western blotting. Treatment with BCA significantly attenuated the reduction of cell viability induced by isoflurane in SH-SY5Y cells. In addition, BCA treatment reversed isoflurane-induced SOD and CAT activity reduction, GSH level decline and MDA level increase. Isoflurane-induced apoptosis was also attenuated by treatment with BCA. The increase in nuclear Nrf2, HO-1 and NQO1 expression induced by isoflurane was amplified by treatment with BCA. These inhibitory effects of BCA on isoflurane-induced oxidative stress, viability reduction and cell apoptosis were attenuated in Nrf2 knockdown SH-SY5Y cells. Our findings indicate that BCA protects SH-SY5Y cells against isoflurane-induced neurotoxicity via inducing the Nrf2/ARE pathway.
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Affiliation(s)
- Qiaoling Wu
- Department of Anesthesiology, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China
| | - You Shang
- Department of Anesthesiology, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China
| | - Tu Shen
- Department of Anesthesiology, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China.
| | - Feifei Liu
- Department of Anesthesiology, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China
| | - Wei Zhang
- Department of Anesthesiology, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China
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12
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Mei X, Zheng HL, Li C, Ma X, Zheng H, Marcantonio E, Xie Z, Shen Y. The Effects of Propofol and Sevoflurane on Postoperative Delirium in Older Patients: A Randomized Clinical Trial Study. J Alzheimers Dis 2021; 76:1627-1636. [PMID: 32651322 DOI: 10.3233/jad-200322] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Postoperative delirium is associated with adverse postoperative outcomes. However, whether intravenous and inhalation anesthetics are associated with different risks of postoperative delirium remains unknown. OBJECTIVE We set up to determine the incidence and duration of postoperative delirium in older patients who had surgery under the intravenous anesthetic propofol or the inhalational anesthetic sevoflurane. METHODS Participants were patients who had total hip/knee replacements and were randomized to propofol (N = 106) or sevoflurane (N = 103) anesthesia group. The Confusion Assessment Method was employed by investigators who were blinded to the anesthesia regimen to assess the incidence and duration (days of postoperative delirium per person) of postoperative delirium on postoperative days 1, 2, and 3. RESULTS A total of 209 participants (71.2±6.7 years old, 29.2% male) were included in the final data analysis. The incidence of postoperative delirium was 33.0% with propofol anesthesia and 23.3% with sevoflurane anesthesia (p = 0.119, Chi-square test), and we estimated that we would need 316 participants in each arm to detect a potential statistically significant difference. Days of postoperative delirium per person were higher in the propofol (0.5±0.8) anesthesia group compared to the sevoflurane anesthesia group (0.3±0.5, p = 0.049, Student's t-test). CONCLUSION This pilot study established a system to compare effects of different anesthetics and generated a hypothesis that propofol trended to have a higher incidence and had longer duration of postoperative delirium than sevoflurane. Additional studies with a larger sample size are needed to test this hypothesis.
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Affiliation(s)
- Xinchun Mei
- Department of Psychiatry, Shanghai Tenth People's Hospital, Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, P. R. China
| | - Hai-Lin Zheng
- Department of Psychiatry, Shanghai Tenth People's Hospital, Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, P. R. China
| | - Cheng Li
- Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, P. R. China
| | - Xin Ma
- Tongji University School of Medicine, Shanghai, P. R. China
| | - Hui Zheng
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Edward Marcantonio
- Divisions of General Medicine and Primary Care and Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Zhongcong Xie
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Yuan Shen
- Department of Psychiatry, Shanghai Tenth People's Hospital, Anesthesia and Brain Research Institute, Tongji University School of Medicine, Shanghai, P. R. China
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13
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Li H, Du M, Xu W, Wang Z. MiR-191 downregulation protects against isoflurane-induced neurotoxicity through targeting BDNF. Toxicol Mech Methods 2021; 31:367-373. [PMID: 33586613 DOI: 10.1080/15376516.2021.1886211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Isoflurane inhalation can cause nerve damage, and miR-191 is abnormally expressed in nerve crush injuries. This study aimed to explore the effect of miR-191 on isoflurane-induced cognition impairment and neurotoxicity in vivo and in vitro, as well as its potential mechanism. METHODS Sprague-Dawley male rats and primary hippocampal neurons were applied and exposed to 2% isoflurane. The level of miR-191 was regulated both in vitro and in vivo to investigate the role of miR-191 in isoflurane-induced neurotoxicity. Morris water maze assay was used to evaluate the neurological function of rats. The level of miR-191 was measured by qRT-PCR. CCK-8 assay and Flow cytometry were applied to detect the cell viability and apoptosis. Dual luciferase reporter gene detection was used for the target gene analysis. RESULTS miR-191 was up-regulated in the hippocampal tissues of rats exposed to isoflurane. Downregulation of miR-191 ameliorated isoflurane-induced cognition impairment, including the increase of the neurological score and the escape latency, and the decrease of the time spent in the original quadrant for the rats exposed to isoflurane. Isoflurane exposure inhibited hippocampal neuron viability and promoted cell apoptosis, which was reversed by down-regulation of miR-191. BDNF is a target gene of miR-191. CONCLUSIONS Isoflurane causes some neurotoxic effect which is mediated through miR-191 abnormal expression targeting BDNF. Downregulation of miR-191 has a protective role against isoflurane-induced neurotoxicity, regulates the vitality and slows down neuronal cell apoptosis.
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Affiliation(s)
- Hongxia Li
- Department of Anesthesiology, Shengli Oilfield Central Hospital, Dongying, China
| | - Meiqing Du
- Department of Anesthesiology, Shengli Oilfield Central Hospital, Dongying, China
| | - Weimin Xu
- Department of Anesthesiology, Shengli Oilfield Central Hospital, Dongying, China
| | - Zengfu Wang
- Department of Anesthesiology, Shengli Oilfield Central Hospital, Dongying, China
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14
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Predictors of swallowing outcomes in patients with combat-injury related dysphagia. J Trauma Acute Care Surg 2021; 89:S192-S199. [PMID: 32068719 DOI: 10.1097/ta.0000000000002623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Traumatic injuries, such as those from combat-related activities, can lead to complicated clinical presentations that may include dysphagia. METHODS This retrospective observational database study captured dysphagia-related information for 215 US military service members admitted to the first stateside military treatment facility after sustaining combat-related or combat-like traumatic injuries. A multidimensional relational database was developed to document the nature, course, and management for dysphagia in this unique population and to explore variables predictive of swallowing recovery using Bayesian statistical modeling and inferential statistical methods. RESULTS Bayesian statistical modeling revealed the importance of maxillofacial fractures and soft tissue loss as primary predictors of poor swallowing outcomes. The presence of traumatic brain injury (TBI), though common, did not further complicate dysphagia outcomes. A more detailed examination and rating of videofluoroscopic swallow studies from a subset of 161 participants supported greater impairment for participants with maxillofacial trauma and no apparent relationship between having sustained a TBI and swallow functioning. CONCLUSION These analyses revealed that maxillofacial trauma is a stronger indicator than TBI of dysphagia severity and slower or incomplete recovery following combat-related injuries. LEVEL OF EVIDENCE Therapeutic/Care Management study, level IV.
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15
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Yang F, Zhao H, Zhang K, Wu X, Liu H. Research progress and treatment strategies for anesthetic neurotoxicity. Brain Res Bull 2020; 164:37-44. [PMID: 32798600 DOI: 10.1016/j.brainresbull.2020.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/20/2020] [Accepted: 08/05/2020] [Indexed: 12/23/2022]
Abstract
Every year, a large number of infants and young children worldwide are administered general anesthesia. Whether general anesthesia adversely affects the intellectual development and cognitive function of children at a later date remains controversial. Many animal experiments have shown that general anesthetics can cause nerve damage during development, affect synaptic plasticity, and induce apoptosis, and finally affect learning and memory function in adulthood. The neurotoxicity of pediatric anesthetics (PAN) has received extensive attention in the field of anesthesia, which has been listed as a potential problem affecting public health by NFDA of the United States. Previous studies on rodents and non-human primates indicate that inhalation of anesthetics early after birth can induce long-term and sustained impairment of learning and memory function, as well as changes in brain function. Many anti-oxidant drugs, dexmedetomidine, as well as a rich living environment and exercise have been proven to reduce the neurotoxicity of anesthetics. In this paper, we summarize the research progress, molecular mechanisms and current intervention measures of anesthetic neurotoxicity.
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Affiliation(s)
- Fan Yang
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Sanhao Street 36, Shenyang, 110004, China.
| | - Hai Zhao
- Clinical Skills Center, Shenyang Medical College, Huanghe Street 146, Shenyang, 110034, China.
| | - Kaiyuan Zhang
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Sanhao Street 36, Shenyang, 110004, China.
| | - Xiuying Wu
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Sanhao Street 36, Shenyang, 110004, China.
| | - Hongtao Liu
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Sanhao Street 36, Shenyang, 110004, China.
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16
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SUBSTANTIATION OF A SAFE PERIOD OF TIME FOR THE ORAL CAVITY SANITATION UNDER GENERAL ANESTHESIA IN CHILDREN AGED 12-18 YEARS. WORLD OF MEDICINE AND BIOLOGY 2020. [DOI: 10.26724/2079-8334-2020-3-73-57-61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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17
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Qi J, Jia Y, Wang W, Lu H, Wang Y, Li Z. The role of Bag2 in neurotoxicity induced by the anesthetic sevoflurane. J Cell Biochem 2019; 120:7551-7559. [PMID: 30548665 DOI: 10.1002/jcb.28029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 10/15/2018] [Indexed: 01/24/2023]
Abstract
Sevoflurane is the most commonly used general anesthetic in pediatric patients. But preclinical studies indicate that sevoflurane could have neurotoxicity in newborn and old animals, and this raises concern regarding its safety. In this study, we explored the potential mechanisms of sevoflurane-induced neurotoxicity in human SH-SY5Y neuronal cells. We showed that prolonged exposure to 2% sevoflurane caused a significant increase in the Bag family protein Bag2 in a time- and dose-dependent manner. We investigated the possible role of Bag2 upon exposure to sevoflurane by silencing Bag2 in neuronal cells. Knockdown of Bag2 caused increased overall reactive oxygen species (ROS) and generation of lipid peroxidation products 4-hydroxynonenal (4-HNE). Upon sevoflurane exposure, Bag2-silent cells have reduced glutathione (GSH) and glutathione peroxidase activity. Under the sevoflurane treatment, Bag2-deficient cells have reduced mitochondrial membrane potential (MMP) and adenosine triphosphate (ATP) production, while knockdown cells have less viability and higher lactic dehydrogenase (LDH) release as well as a higher percentage of apoptotic cells. The knockdown cells also had higher levels of mitochondrial cytochrome C release, a higher ratio of Bax/Bcl-2 and increased caspase cleavage by sevoflurane. Overall, our data support an important role of Bag2 in sevoflurane-induced neurotoxicity.
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Affiliation(s)
- Jinlian Qi
- Department of anesthesiology, Henan Children's Hospital.,Department of anesthesiology, Zhengzhou Children's Hospital.,Department of Anesthesiology, Childern's Hospital Affiliated of Zhengzhou University, Zhengzhou, China
| | - Yingping Jia
- Department of anesthesiology, Henan Children's Hospital.,Department of anesthesiology, Zhengzhou Children's Hospital.,Department of Anesthesiology, Childern's Hospital Affiliated of Zhengzhou University, Zhengzhou, China
| | - Wenhua Wang
- Department of anesthesiology, Henan Children's Hospital.,Department of anesthesiology, Zhengzhou Children's Hospital.,Department of Anesthesiology, Childern's Hospital Affiliated of Zhengzhou University, Zhengzhou, China
| | - Haibing Lu
- Department of anesthesiology, Henan Children's Hospital.,Department of anesthesiology, Zhengzhou Children's Hospital.,Department of Anesthesiology, Childern's Hospital Affiliated of Zhengzhou University, Zhengzhou, China
| | - Yuan Wang
- Department of anesthesiology, Henan Children's Hospital.,Department of anesthesiology, Zhengzhou Children's Hospital.,Department of Anesthesiology, Childern's Hospital Affiliated of Zhengzhou University, Zhengzhou, China
| | - Zhengchen Li
- Department of anesthesiology, Henan Children's Hospital.,Department of anesthesiology, Zhengzhou Children's Hospital.,Department of Anesthesiology, Childern's Hospital Affiliated of Zhengzhou University, Zhengzhou, China
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18
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Anoxia-Hypoxia in Forensic Neuropsychological Assessment: Cognitive Impact of Pulmonary Injuries, Respiratory Distress, Cerebral Blood Hypoperfusion, and Major Surgeries. PSYCHOLOGICAL INJURY & LAW 2018. [DOI: 10.1007/s12207-018-9319-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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19
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Wu Z, Li X, Zhang Y, Tong D, Wang L, Zhao P. Effects of Sevoflurane Exposure During Mid-Pregnancy on Learning and Memory in Offspring Rats: Beneficial Effects of Maternal Exercise. Front Cell Neurosci 2018; 12:122. [PMID: 29773978 PMCID: PMC5943573 DOI: 10.3389/fncel.2018.00122] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/16/2018] [Indexed: 12/18/2022] Open
Abstract
Fetal exposure to general anesthetics may pose significant neurocognitive risks but methods to mitigate against these detrimental effects are still to be determined. We set out, therefore, to assess whether single or repeated in utero exposure to sevoflurane triggers long-term cognitive impairments in rat offspring. Since maternal exercise during pregnancy has been shown to improve cognition in offspring, we hypothesized that maternal treadmill exercise during pregnancy would protect against sevoflurane-induced neurotoxicity. In the first experiment, pregnant rats were exposed to 3% sevoflurane for 2 h on gestational (G) day 14, or to sequential exposure for 2 h on G13, G14 and G15. In the second experiment, pregnant rats in the exercise group were forced to run on a treadmill for 60 min/day during the whole pregnancy. The TrkB antagonist ANA-12 was used to investigate whether the brain-derived neurotrophic factor (BDNF)/TrkB/Akt signaling pathway is involved in the neuroprotection afforded by maternal exercise. Our data suggest that repeated, but not single, exposure to sevoflurane caused a reduction in both histone acetylation and BDNF expression in fetal brain tissues and postnatal hippocampus. This was accompanied by decreased numbers of dendritic spines, impaired spatial-dependent learning and memory dysfunction. These effects were mitigated by maternal exercise but the TrkB antagonist ANA-12 abolished the beneficial effects of maternal exercise. Our findings suggest that repeated, but not single, exposure to sevoflurane in pregnant rats during the second trimester caused long-lasting learning and memory dysfunction in the offspring. Maternal exercise ameliorated the postnatal neurocognitive impairment by enhancing histone acetylation and activating downstream BDNF/TrkB/Akt signaling.
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Affiliation(s)
- Ziyi Wu
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Xingyue Li
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Yi Zhang
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Dongyi Tong
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Lili Wang
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Ping Zhao
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang, China
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20
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Affiliation(s)
- Ferenc Zsila
- Biomolecular Self-Assembly Group; Institute of Materials and Environmental Chemistry; Research Centre for Natural Sciences; Hungarian Academy of Sciences; 1117 Budapest Hungary
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21
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Powell J, Powell S. Obstructive Sleep Apnea in the Very Young. CURRENT OTORHINOLARYNGOLOGY REPORTS 2018. [DOI: 10.1007/s40136-018-0184-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Imam SZ, He Z, Cuevas E, Rosas-Hernandez H, Lantz SM, Sarkar S, Raymick J, Robinson B, Hanig JP, Herr D, MacMillan D, Smith A, Liachenko S, Ferguson S, O'Callaghan J, Miller D, Somps C, Pardo ID, Slikker W, B Pierson J, Roberts R, Gong B, Tong W, Aschner M, J Kallman M, Calligaro D, Paule MG. Changes in the metabolome and microRNA levels in biological fluids might represent biomarkers of neurotoxicity: A trimethyltin study. Exp Biol Med (Maywood) 2017; 243:228-236. [PMID: 29105512 DOI: 10.1177/1535370217739859] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Neurotoxicity has been linked with exposure to a number of common drugs and chemicals, yet efficient, accurate, and minimally invasive methods to detect it are lacking. Fluid-based biomarkers such as those found in serum, plasma, urine, and cerebrospinal fluid have great potential due to the relative ease of sampling but at present, data on their expression and translation are lacking or inconsistent. In this pilot study using a trimethyl tin rat model of central nervous system toxicity, we have applied state-of-the-art assessment techniques to identify potential individual biomarkers and patterns of biomarkers in serum, plasma, urine or cerebral spinal fluid that may be indicative of nerve cell damage and degeneration. Overall changes in metabolites and microRNAs were observed in biological fluids that were associated with neurotoxic damage induced by trimethyl tin. Behavioral changes and magnetic resonance imaging T2 relaxation and ventricle volume changes served to identify animals that responded to the adverse effects of trimethyl tin. Impact statement These data will help design follow-on studies with other known neurotoxicants to be used to assess the broad applicability of the present findings. Together this approach represents an effort to begin to develop and qualify a set of translational biochemical markers of neurotoxicity that will be readily accessible in humans. Such biomarkers could prove invaluable for drug development research ranging from preclinical studies to clinical trials and may prove to assist with monitoring of the severity and life cycle of brain lesions.
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Affiliation(s)
- Syed Z Imam
- 1 Division of Neurotoxicology, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | - Zhen He
- 1 Division of Neurotoxicology, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | - Elvis Cuevas
- 1 Division of Neurotoxicology, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | | | - Susan M Lantz
- 1 Division of Neurotoxicology, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | - Sumit Sarkar
- 1 Division of Neurotoxicology, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | - James Raymick
- 1 Division of Neurotoxicology, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | - Bonnie Robinson
- 1 Division of Neurotoxicology, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | | | - David Herr
- 3 US EPA, 96653 NHEERL , Research Triangle Park, North Carolina, NC 27711, USA
| | - Denise MacMillan
- 3 US EPA, 96653 NHEERL , Research Triangle Park, North Carolina, NC 27711, USA
| | - Aaron Smith
- 4 Lilly, Lilly Corporate Center, Indianapolis, Indiana, IN 46285, USA
| | - Serguei Liachenko
- 1 Division of Neurotoxicology, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | - Sherry Ferguson
- 1 Division of Neurotoxicology, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | | | | | | | | | - William Slikker
- 1 Division of Neurotoxicology, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | | | - Ruth Roberts
- 8 Department of Biosciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Binsheng Gong
- 9 Division of Bioinformatics, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | - Weida Tong
- 9 Division of Bioinformatics, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
| | - Michael Aschner
- 10 Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Mary J Kallman
- 11 Kallman Preclinical Consulting, Greenfield, IN 46140, USA
| | - David Calligaro
- 3 US EPA, 96653 NHEERL , Research Triangle Park, North Carolina, NC 27711, USA
| | - Merle G Paule
- 1 Division of Neurotoxicology, US FDA, 4136 NCTR , Jefferson, AR 72079, USA
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Cascella M, Bimonte S. The role of general anesthetics and the mechanisms of hippocampal and extra-hippocampal dysfunctions in the genesis of postoperative cognitive dysfunction. Neural Regen Res 2017; 12:1780-1785. [PMID: 29239315 PMCID: PMC5745823 DOI: 10.4103/1673-5374.219032] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Postoperative cognitive dysfunction (POCD) is a multifactorial process with a huge number of predisposing, causal, and precipitating factors. In this scenario, the neuroinflammation and the microglial activation play a pivotal role by triggering and amplifying a complex cascade involving the immuno-hormonal activation, the micro circle alterations, the hippocampal oxidative stress activation and, finally, an increased blood-brain barrier's permeability. While the role of anesthetics in the POCD's genesis in humans is debated, a huge number of preclinical studies have been conducted on the topic and many mechanisms have been proposed to explain the potential neurodegenerative effects of general anesthetics. Probably, the problem concerns on what we are searching for and how we are searching and, surprisingly, preclinical studies showed that anesthetics may also manifest neuroprotective properties. The aim of this paper is to offer an overview on the potential impact of general anesthetics on POCD. Mechanisms of hippocampal and extra-hippocampal dysfunction due to neuroinflammation are discussed, whereas further research perspectives are also given.
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Affiliation(s)
- Marco Cascella
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Via Mariano Semmola, Naples, Italy
| | - Sabrina Bimonte
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Via Mariano Semmola, Naples, Italy
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