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Published on: October 16, 2013
Comparison of Cognitive Deterioration Between Propofol and Remimazolam Anesthesia in ApoE4 Knock-In Mouse Model
Jong-Ho Kim1,2, Songyi Park2, Harry Jung2
1Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon 24253, Republic of Korea.
Abstract:
Perioperative neurocognitive disorder (PND) is a concern following anesthesia, particularly in individuals at risk for Alzheimer's disease (AD). This study compared the cognitive and pathological effects of propofol and remimazolam in a mouse model with AD following surgery. Five-month-old male ApoE4-KI mice underwent abdominal surgery under either propofol (170 mg/kg) or remimazolam (85 mg/kg) anesthesia. Cognitive function was assessed using the Morris water maze and Y-maze, and neuronal apoptosis and amyloid-beta (Aβ) deposition in the CA3 and dentate gyrus (DG) of the hippocampus were evaluated preoperatively and at 2, 4, and 7 days postoperatively. Both groups showed similar postoperative cognitive functions, with increased relative escape latency at day 2 and decreased relative spontaneous alternation at days 4 and 7. However, the neuropathological analysis revealed that propofol-induced significantly more neuronal death in the CA3 (days 4 and 7) and DG (days 2, 4, and 7), and greater Aβ accumulation in the CA3 (days 2 and 4) and DG (days 2 and 7) compared to remimazolam (p < 0.05). Propofol was associated with more pronounced neuropathologic changes in the hippocampus compared to remimazolam. These findings suggest remimazolam may be a safer anesthetic for patients at risk for neurodegenerative disorders, as it is associated with less severe hippocampal pathology, which is characteristic of AD.
Insights
Remimazolam anesthesia showed fewer negative impacts on the brain than propofol in mice at risk for Alzheimer's disease (AD). This suggests remimazolam may be a safer anesthetic choice for neurodegenerative disorder patients.
Area of Science:
- Neuroscience
- Anesthesiology
- Pharmacology
Background:
- Perioperative neurocognitive disorder (PND) is a significant concern after anesthesia, especially in individuals predisposed to Alzheimer's disease (AD).
- Understanding the differential effects of anesthetic agents on AD-related neuropathology is crucial for patient safety.
Purpose of the Study:
- To compare the cognitive and neuropathological effects of propofol versus remimazolam anesthesia in a mouse model of AD following surgery.
- To evaluate neuronal apoptosis and amyloid-beta (Aβ) deposition in the hippocampus after propofol or remimazolam anesthesia.
Main Methods:
- ApoE4-KI mice underwent abdominal surgery under propofol or remimazolam anesthesia.
- Cognitive function was assessed using Morris water maze and Y-maze tests.
- Hippocampal neuronal apoptosis and Aβ deposition were analyzed at multiple postoperative time points.
Main Results:
- Both anesthetic groups exhibited similar short-term cognitive impairments post-surgery.
- Propofol anesthesia led to significantly increased neuronal death and Aβ accumulation in the hippocampus compared to remimazolam.
- Remimazolam was associated with less pronounced neuropathological changes in the hippocampus.
Conclusions:
- Remimazolam may be a safer anesthetic option for patients at risk of Alzheimer's disease due to reduced hippocampal pathology.
- Anesthetic choice can influence neurodegenerative processes, highlighting the need for careful selection in at-risk populations.
