Brain Structural and Functional Changes Associated With Postoperative Neurocognitive Disorders: Research Update.

IF 4.6 2区医学 Q1 ANESTHESIOLOGY

Anesthesia and analgesia Pub Date : 2025-02-19 DOI:10.1213/ANE.0000000000007404

Huimin Wu, Yaseen Ahammed, Shouyuan Tian, Yi Liu, Robert D Sanders, Daqing Ma

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Abstract

Postoperative neurocognitive disorders (PNDs) are frequent and serious perioperative complications in the elderly, and are associated with increased morbidity and mortality, length of hospital stay, and need for long-term care. At present, the pathogenesis of PND is not completely clear, and there are various risk factors including surgical trauma and stress mediating systemic inflammation towards neuroinflammation development which causes brain structural and functional changes namely PND. For elderly patients, perioperative neurological monitoring may provide insights into brain function status. Monitoring may also help clinicians identify potential risks which would ultimately allow timely and effective intervention for better perioperative safety and prognosis for elderly patients. In this review, we summarize the risk factors and potential mechanisms of PND, and discuss preliminary evidence regarding application of electroencephalography, functional near-infrared spectroscopy, functional magnetic resonance, and positron emission tomography imaging in monitoring the central nervous system during the postoperative period.

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与术后神经认知障碍相关的脑结构和功能改变：研究进展。

术后神经认知障碍（PNDs）是老年人围手术期常见且严重的并发症，与发病率和死亡率增加、住院时间延长和需要长期护理有关。目前，PND的发病机制尚不完全清楚，手术创伤、应激介导的全身性炎症等多种危险因素可导致神经炎症的发展，从而引起脑结构和功能的改变，即PND。对于老年患者，围手术期神经监测可以提供脑功能状态的见解。监测还可以帮助临床医生识别潜在的风险，最终允许及时有效的干预，以改善老年患者的围手术期安全性和预后。本文综述了PND的危险因素和潜在机制，并讨论了脑电图、功能近红外光谱、功能磁共振和正电子发射断层成像在术后监测中枢神经系统方面的初步证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anesthesia and analgesia 医学-麻醉学

CiteScore

9.90

自引率

7.00%

发文量

817

审稿时长

2 months

期刊介绍： Anesthesia & Analgesia exists for the benefit of patients under the care of health care professionals engaged in the disciplines broadly related to anesthesiology, perioperative medicine, critical care medicine, and pain medicine. The Journal furthers the care of these patients by reporting the fundamental advances in the science of these clinical disciplines and by documenting the clinical, laboratory, and administrative advances that guide therapy. Anesthesia & Analgesia seeks a balance between definitive clinical and management investigations and outstanding basic scientific reports. The Journal welcomes original manuscripts containing rigorous design and analysis, even if unusual in their approach.