Gut microbiota: a new player in the pathogenesis of perioperative neurocognitive disorder?
Liang Dong1, Juan Li1, Chao Zhang1
1Department of Anesthesiology Affiliated Hospital of Zunyi Medical University Zunyi Guizhou China.
Insights
Perioperative neurocognitive disorder (PND) in elderly patients is linked to gut microbiome changes. Targeting gut microbiota may offer future therapeutic strategies for preventing cognitive decline after surgery.
Area of Science:
- Neuroscience
- Gastroenterology
- Geriatrics
Background:
- Perioperative neurocognitive disorder (PND), encompassing postoperative delirium and cognitive dysfunction, frequently affects elderly patients, increasing morbidity and mortality.
- The exact mechanisms driving PND remain unclear, necessitating identification of modifiable risk factors for improved patient outcomes.
- The microbiota-gut-brain axis is increasingly recognized for its influence on central nervous system functions, including behavior and cognition.
Purpose of the Study:
- To review the existing literature on the role of gut microbiota in the development of PND.
- To explore the mechanisms linking gut microbiome alterations to PND pathogenesis.
- To evaluate the potential of gut microbiota as a therapeutic target for PND.
Main Methods:
- Comprehensive literature review of preclinical and human studies.
- Analysis of research investigating the microbiota-gut-brain axis in relation to cognitive function.
- Synthesis of evidence on gut microbiome disorders in patients with postoperative cognitive dysfunction.
Main Results:
- Studies indicate a correlation between gut microbiome disorders and cognitive dysfunction following surgery and anesthesia.
- Preclinical investigations support the influence of surgery and anesthesia on the central nervous system via the gut microbiota.
- Evidence suggests the microbiota-gut-brain axis plays a significant role in PND.
Conclusions:
- Gut microbiota alterations are implicated in the pathogenesis of perioperative neurocognitive disorder.
- The gut microbiome represents a potential therapeutic target for mitigating PND.
- Further research into the microbiota-gut-brain axis could lead to novel PND prevention strategies.
Abstract:
Perioperative neurocognitive disorder (PND), including postoperative delirium and postoperative cognitive dysfunction (POCD), is a common postoperative complication in elderly patients, who represent an expanding segment of our population. PND is a multifactorial disease resulting in higher morbidity and mortality. The precise mechanism of PND is yet to be fully delineated. Identifying the modifiable risk factors and mechanisms for PND would be an important step forward in preventing such adverse events and thus improving patients' outcomes. It is increasingly recognized that gut microbiota also manifest effects in the central nervous system via the microbiota-gut-brain axis, which has emerged as an important player in shaping aspects of behavior and cognitive function. Recent studies have found that patients with cognitive dysfunction after surgery and anesthesia have obvious gut microbiome disorders. These findings are paralleled by a growing body of preclinical investigations aimed at better understanding how surgery and anesthesia affect the central nervous system and possibly contribute to cognitive decline. Here, we present a broad topical review of the literature supporting the role of gut microbiota in PND. We provide an overview of the mechanisms underlying the pathogenesis of PND from pre-clinical and human studies. Therefore, gut microbiota could be a putative therapeutic target for PND in the future.
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