Recent Advances in the Mechanisms of Postoperative Neurocognitive Dysfunction: A Narrative Review

Biomedicines, Journal Year: 2025, Volume and Issue: 13(1), P. 115 - 115

Published: Jan. 7, 2025

Postoperative neurocognitive dysfunction (PND) is a prevalent and debilitating complication in elderly surgical patients, characterized by persistent cognitive decline that negatively affects recovery quality of life. As the aging population grows, rising number patients has made PND an urgent clinical challenge. Despite increasing research efforts, pathophysiological mechanisms underlying remain inadequately characterized, underscoring need for more integrated framework to guide targeted interventions. To better understand molecular therapeutic targets PND, this narrative review synthesized evidence from peer-reviewed studies, identified through comprehensive searches PubMed, Embase, Cochrane Library, Web Science. Key findings highlight neuroinflammation, oxidative stress, mitochondrial dysfunction, neurotransmitter imbalances, microvascular changes, white matter lesions as central pathophysiology, with particular parallels encephalocele- sepsis-associated impairments. Among these, mediated pathways such NLRP3 inflammasome blood-brain barrier disruption, emerges pivotal driver, triggering cascades exacerbate neuronal injury. Oxidative stress synergistically amplify these effects, while imbalances alterations, including lesions, contribute synaptic decline. Anesthetic agents modulate interconnected pathways, exhibiting both protective detrimental effects. Propofol dexmedetomidine demonstrate neuroprotective properties suppressing neuroinflammation microglial activation, whereas inhalational anesthetics like sevoflurane intensify inflammatory responses. Ketamine, its anti-inflammatory potential, offers promise but requires further evaluation determine long-term safety efficacy. By bridging insights practice, highlights critical role personalized anesthetic strategies mitigating improving patients. It aims inform future decision-making address multifaceted

Language: Английский

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The bidirectional relationship between sleep disturbance and anxiety: Sleep disturbance is a stronger predictor of anxiety

Sleep Medicine, Journal Year: 2024, Volume and Issue: 121, P. 63 - 68

Published: June 22, 2024

Language: Английский

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Dexmedetomidine for chronic pain patients with anxiety and depression: a propensity score matching cohort study

BMC Anesthesiology, Journal Year: 2025, Volume and Issue: 25(1)

Published: April 29, 2025

Chronic pain patients often experience moderate to severe anxiety and depressive symptoms. Growing evidence supporting dexmedetomidine as a potential treatment for mental health conditions, research on its application in chronic with comorbid depression remains limited. Patients who received intravenous infusions of during their interventional management procedures from January July 2024 were compared those underwent similar without infusion the same period, utilizing propensity score matching. A total 290 included analysis 2024. Propensity matching resulted 92 matched pairs further analysis. At one-month follow-up, perioperative was associated greater improvement disorders, measured by Generalized Anxiety Disorder 7-item scale, showing reduction -4.43 points (95% CI, -4.98 -3.88) -2.42 -2.97 -1.87) local analgesia group Patient Health Questionnaire-9 scores indicated -6.19 -6.84 -5.55) versus -3.92 -4.56 -3.28) group. The use also pain(-3.32 vsurs -2.62 points). Intraoperative significantly improves pain. Therefore, may serve promising adjunctive patients, particularly depression. Not applicable.

Language: Английский

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Ectopic expression of Slc1a2 in the prefrontal cortex of sleep-deprived male mice counteracts the glutamate/GABA-glutamine dysfunction

BMC Biology, Journal Year: 2025, Volume and Issue: 23(1)

Published: March 26, 2025

Language: Английский

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Promising immunomodulators for management of substance and alcohol use disorders

Expert Opinion on Pharmacotherapy, Journal Year: 2024, Volume and Issue: 25(7), P. 867 - 884

Published: May 2, 2024

Introduction The neuroimmune system has emerged as a novel target for the treatment of substance use disorders (SUDs), with immunomodulation producing encouraging therapeutic benefits in both preclinical and clinical settings.

Language: Английский

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Remimazolam alleviates sleep deprivation induced anxiety-like behaviors via regulating the STING pathway

Neuroscience Letters, Journal Year: 2024, Volume and Issue: 847, P. 138095 - 138095

Published: Dec. 25, 2024

Sleep loss becomes a major problem in modern life and increases the incidence of anxiety disorders. Benzodiazepines are most commonly used anxiolytic medications. Remimazolam is an ultra-short-acting benzodiazepine, which has been shown to reduce preoperative levels patients. However, effects on anxiety-like behaviors caused by chronic sleep deprivation (CSD) underlying molecular mechanisms remain unclear. Here, we found that administration remimazolam can effectively alleviate induced CSD. Furthermore, significantly preserve deprivation-induced deficits neuronal calcium activity CA1 hippocampus. In addition, stimulator interferon genes (STING) was activated after CSD, while sufficient block activation STING pathway. Further study showed inhibiting also alleviates symptoms Overall, our research offers new insight promising therapeutic agent for disorders deprivation.

Language: Английский

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Exploring β-caryophyllene: a non-psychotropic cannabinoid's potential in mitigating cognitive impairment induced by sleep deprivation

Archives of Pharmacal Research, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 9, 2024

Language: Английский

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