预itbs通过诱导长期的神经保护来减轻围手术期神经认知障碍

IF 3.7 3区医学 Q2 NEUROSCIENCES

Brain Research Bulletin Pub Date : 2025-08-30 DOI:10.1016/j.brainresbull.2025.111532

Binhua Zou , Tingting Chen , Jianzhong Fan , Renhong He

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引用次数: 0

摘要

围手术期神经认知障碍（PND），包括与麻醉和手术相关的认知障碍，严重影响老年患者并增加术后风险。间歇性θ波爆发刺激（iTBS）是一种非侵入性神经调节方案，在临床研究中显示出增强认知能力的潜力。然而，它在预防PND方面的应用仍未被探索。本研究探讨了术前iTBS是否能减轻剖腹探查大鼠的PND。18个月大的雄性大鼠（n = 5只/组）在3小时异氟醚麻醉（3 %）和剖腹手术之前，每天接受10次iTBS或假刺激（只有噪音而没有真实刺激）。术前和术后通过Morris水迷宫（MWM）评估认知功能。术后72 h对大鼠实施安乐死，以量化海马小胶质细胞极化（Iba1 + /CD86 +）、促炎细胞因子（Milliplex细胞因子测定）和神经元凋亡（尼氏染色）。iTBS-treated老鼠表现出更快的麻醉复苏(17.4 ±3.6  分钟和35.2 ±11.2  分钟;P = 0.009)和减少术后认知功能减退(微波加工逃脱延迟: 39.5±5.0  年代与50.0 ±5.8  年代;P = 0.006)。这些改进与减少M1-polarized小胶质细胞(39.0 ± 7.0 vs 58.8 ± 12.2;P = 0.014),肿瘤坏死因子-α水平较低(2690.6 ±542.2  pg / mL和3532.7 ±623.8  pg / mL; P = 0.035),并降低海马细胞凋亡( 87.8±8.3  %与69.1 ±13.8  %;P = 0.006)。预itbs通过降低m1型促炎因子，增强神经元活性和对麻醉和手术损伤的抵抗，对围手术期神经认知障碍具有潜在的治疗效果。

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Pre-iTBS alleviates perioperative neurocognitive disorders by inducing long-term neuroprotection against inflammatory injury

Perioperative neurocognitive disorders (PND), encompassing cognitive impairments linked to anesthesia and surgery, significantly impact elderly patients and increase postoperative risks. Intermittent theta burst stimulation (iTBS), a non-invasive neuromodulation protocol, has shown cognitive-enhancing potential in clinical studies. However, its utility for preventing PND remains unexplored. This study investigated whether preoperative iTBS mitigates PND in aged rats undergoing exploratory laparotomy. Eighteen-month-old male rats (n = 5/group) received 10 daily iTBS sessions or sham stimulation (only noise without real stimulation) prior to 3-hour isoflurane anesthesia (3 %) and laparotomy. Cognitive function was assessed via the Morris water maze (MWM) pre- and postoperatively. Rats were euthanized at 72 h post-surgery to quantify hippocampal microglial polarization (Iba1⁺/CD86⁺), pro-inflammatory cytokines (Milliplex cytokine assays), and neuronal apoptosis (Nissl staining). iTBS-treated rats exhibited faster anesthesia recovery (17.4 ± 3.6 min vs. 35.2 ± 11.2 min; P = 0.009) and reduced postoperative cognitive decline (MWM escape latency: 39.5 ± 5.0 s vs. 50.0 ± 5.8 s; P = 0.006). These improvements correlated with decreased M1-polarized microglia (39.0 ± 7.0 vs. 58.8 ± 12.2; P = 0.014), lower TNF-α levels (2690.6 ± 542.2 pg/mL vs. 3532.7 ± 623.8 pg/mL; P = 0.035), and reduced hippocampal apoptosis (87.8 ± 8.3 % vs. 69.1 ± 13.8 %; P = 0.006). Pre-iTBS has potential therapeutic efficacy in perioperative neurocognitive disorders by reducing M1-type pro-inflammatory factors and enhancing neuronal activity and resistance to anesthesia and surgery-induced damage.

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来源期刊

Brain Research Bulletin 医学-神经科学

CiteScore

6.90

自引率

2.60%

发文量

253

审稿时长

67 days

期刊介绍： The Brain Research Bulletin (BRB) aims to publish novel work that advances our knowledge of molecular and cellular mechanisms that underlie neural network properties associated with behavior, cognition and other brain functions during neurodevelopment and in the adult. Although clinical research is out of the Journal''s scope, the BRB also aims to publish translation research that provides insight into biological mechanisms and processes associated with neurodegeneration mechanisms, neurological diseases and neuropsychiatric disorders. The Journal is especially interested in research using novel methodologies, such as optogenetics, multielectrode array recordings and life imaging in wild-type and genetically-modified animal models, with the goal to advance our understanding of how neurons, glia and networks function in vivo.