Anesthesia, surgery, illness and Alzheimer's disease

Abstract

Patients and their families have, for many decades, detected subtle changes in cognition subsequent to surgery, and only recently has this been subjected to scientific scrutiny. Through a combination of retrospective human studies, small prospective biomarker studies, and experiments in animals, it is now clear that durable consequences of both anesthesia and surgery occur, and that these intersect with the normal processes of aging, and the abnormal processes of chronic neurodegeneration. It is highly likely that inflammatory cascades are at the heart of this intersection, and if confirmed, this suggests a therapeutic strategy to mitigate enhanced neuropathology in vulnerable surgical patients.

Keywords: 3xTgAD; ADNI; ADRC; ARDS; Alzheimer Disease Neuro Imaging; Alzheimer Disease Research Center; Alzheimer transgenic mice; Biomarkers; CABG; CSF; Cytokines; IL-10; IL-4; IL-6; Interleukin-10; Interleukin-4; Interleukin-6; LFA-1α; MCI; NSAID; Neuroinflammation; POCD; Peripheral inflammation; SAE; TGFβ; TNFα; Tumor Necrosis Factor-α; WT; adult respiratory distress syndrome; cerebrospinal fluid; coronary artery bypass surgery; leukocyte functional antigen-1α; mild cognitive impairment; non-steroidal anti-inflammatory drugs; post-operative cognitive decline; sepsis associated encephalopathy; transforming growth factor-β; triple transgenic mouse model of Alzheimer disease; wild type.