Cognitive Change Associated with Anesthesia and Surgery: An Introduction to POCD for Neuroscientists

Area of Science:

• Neuroscience
• Gerontology
• Anesthesiology

Background:

• Postoperative cognitive dysfunction (POCD) is a significant central nervous system (CNS) complication in elderly patients following surgery and anesthesia.
• Characterized by deficits in memory, comprehension, and attention, the underlying pathophysiologic mechanisms of POCD remain poorly understood.
• Current prevention and treatment strategies for POCD are lacking, highlighting a critical need for further research.

Purpose of the Study:

• To review and summarize the contributing factors to POCD development, including oxidative stress, autophagy, impaired synaptic function, and neuroinflammation.
• To describe the methodologies for constructing animal models of POCD.
• To bridge the gap between clinical and basic research by proposing recommendations for developing clinically relevant animal models and conducting future clinical studies.

Main Methods:

• Comprehensive literature review of basic and clinical research on POCD.
• Analysis of factors implicated in POCD pathogenesis: oxidative stress, autophagy, synaptic dysfunction, and neuroinflammation.
• Evaluation of existing animal models for POCD and recommendations for improved model development.

Main Results:

• Identified key pathophysiologic mechanisms contributing to POCD, such as oxidative stress, autophagy, impaired synaptic function, and neuroinflammation.
• Detailed the construction and utility of various animal models used in POCD research.
• Highlighted discrepancies between current animal models and clinical manifestations of POCD.

Conclusions:

• Understanding the complex interplay of factors like oxidative stress and neuroinflammation is crucial for elucidating POCD etiology.
• Development of more clinically relevant animal models is essential for advancing POCD research.
• Enhanced understanding of POCD mechanisms will facilitate the development of effective prevention and treatment strategies for affected elderly patients.