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Inhaled sevoflurane may promote progression of amnestic mild cognitive impairment: a prospective, randomized

Yongzhe Liu1, Ningling Pan, Yaqun Ma

  • 1Department of Anesthesiology, Beijing Military General Hospital, Beijing, China.

The American Journal of the Medical Sciences
|October 10, 2012
PubMed
Abstract

Insights

Inhaled sevoflurane anesthesia accelerated the progression of amnestic mild cognitive impairment (aMCI) to progressive MCI. This study highlights potential risks associated with sevoflurane in patients with aMCI.

Area of Science:

  • Neuroscience
  • Anesthesiology
  • Gerontology

Background:

  • Amnestic mild cognitive impairment (aMCI) is a precursor to Alzheimer's disease (AD).
  • Inhalational anesthetics like isoflurane may promote AD pathology by increasing beta-amyloid (Aβ) aggregation and apoptosis.
  • Investigating anesthetic effects on aMCI progression is crucial for patient safety.

Purpose of the Study:

  • To determine if exposure to different anesthetics influences the progression of aMCI.
  • To compare the effects of sevoflurane, propofol, and lidocaine epidural anesthesia on aMCI.
  • To assess the long-term impact of anesthesia on cognitive decline.

Main Methods:

  • A prospective, randomized study involving 180 aMCI patients undergoing spinal surgery.
  • Patients were assigned to sevoflurane, propofol, or lidocaine epidural anesthesia groups (n=60 each), with 60 aMCI outpatients as controls.
  • Neuropsychological assessments and cerebrospinal fluid (CSF) analysis (Aβ42, tau, p-tau181) were performed before surgery and repeated after 2 years.

Main Results:

  • No significant difference in Alzheimer's disease (AD) incidence across groups.
  • Sevoflurane group showed a higher incidence of progressive MCI compared to the control group.
  • Lower CSF Aβ42 and higher total tau/phosphorylated tau levels were observed in patients with progressive MCI and AD.

Conclusions:

  • Inhaled sevoflurane accelerated aMCI progression to progressive MCI in this Chinese population.
  • Age was a significant factor in aMCI progression, while sex was not.
  • Anesthetic choice may impact cognitive trajectory in individuals with aMCI.

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