Intergenerational Perioperative Neurocognitive Disorder

Area of Science:

• Neuroscience
• Anesthesiology
• Public Health

Background:

• Perioperative neurocognitive disorder (PND) is a significant public health concern, particularly affecting older adults due to age-related increases in stress and inflammation.
• Younger adults are generally more resilient to PND, but underlying conditions involving stress and inflammation may increase their vulnerability.
• Emerging evidence suggests that parental PND might have lasting effects on offspring, a concept known as intergenerational PND.

Purpose of the Study:

• To review existing literature and present experimental findings on the potential for intergenerational PND.
• To highlight the roles of stress, inflammation, and epigenetic changes in PND development.
• To introduce a novel animal model investigating the transmission of PND-related alterations to offspring.

Main Methods:

• Literature review of perioperative neurocognitive disorder (PND) and related factors.
• Experimental studies in rodent models involving surgery, traumatic brain injury, and sevoflurane exposure.
• Assessment of stress response systems, inflammation markers, and behavioral changes in exposed adult rats and their offspring.

Main Results:

• Surgery, TBI, and sevoflurane exposure in young adult male rats induced persistent dysregulation of stress response and inflammation.
• These alterations were observed in the offspring of exposed rats, even without direct exposure to trauma or anesthesia.
• This provides an animal model supporting the concept of intergenerational PND.

Conclusions:

• Parental exposure to anesthesia/surgery may induce lasting neurocognitive and physiological changes transmissible to offspring.
• Stress, inflammation, and epigenetic mechanisms are key factors in PND and its potential intergenerational transmission.
• Intergenerational PND represents a potentially significant, previously unrecognized population affected by parental perioperative events.