Post-Operative Cognitive Dysfunction: An exploration of the inflammatory hypothesis and novel therapies

David R Skvarc; Michael Berk; Linda K Byrne; Olivia M Dean; Seetal Dodd; Matthew Lewis; Andrew Marriott; Eileen M Moore; Gerwyn Morris; Richard S Page; Laura Gray

doi:10.1016/j.neubiorev.2017.11.011

Post-Operative Cognitive Dysfunction: An exploration of the inflammatory hypothesis and novel therapies

Neurosci Biobehav Rev. 2018 Jan:84:116-133. doi: 10.1016/j.neubiorev.2017.11.011. Epub 2017 Nov 26.

Authors

David R Skvarc¹, Michael Berk², Linda K Byrne³, Olivia M Dean⁴, Seetal Dodd⁵, Matthew Lewis⁶, Andrew Marriott⁷, Eileen M Moore⁸, Gerwyn Morris⁹, Richard S Page¹⁰, Laura Gray¹¹

Affiliations

¹ School of Psychology, Deakin University, Melbourne, Australia; Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia. Electronic address: dskvarc@deakin.edu.au.
² Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, The Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia. Electronic address: mikebe@barwonhealth.org.au.
³ School of Psychology, Deakin University, Melbourne, Australia. Electronic address: linda.byrne@deakin.edu.au.
⁴ Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, The Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia.
⁵ Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia.
⁶ School of Psychology, Deakin University, Melbourne, Australia; Aged Psychiatry Service, Caulfield Hospital, Alfred Health, Caulfield, Australia.
⁷ Department of Anaesthesia, Perioperative Medicine & Pain Management, Barwon Health, Geelong, Australia; Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia; Deakin University, School of Medicine, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, The Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia.
⁸ Department of Anaesthesia, Perioperative Medicine & Pain Management, Barwon Health, Geelong, Australia; Deakin University, Innovations in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, Barwon Health, Geelong, Australia.
⁹ Tir Na Nog, Cardiff, Wales, United Kingdom. Electronic address: activatedmicroglia@gmail.com.
¹⁰ Deakin University, School of Medicine, Geelong, Australia; Department of Orthopaedics, Barwon Health, Geelong, Australia.
¹¹ Deakin University, School of Medicine, Geelong, Australia. Electronic address: dskvarc@deakin.edu.au.

PMID: 29180259
DOI: 10.1016/j.neubiorev.2017.11.011

Abstract

Post-Operative Cognitive Dysfunction (POCD) is a highly prevalent condition with significant clinical, social and financial impacts for patients and their communities. The underlying pathophysiology is becoming increasingly understood, with the role of neuroinflammation and oxidative stress secondary to surgery and anaesthesia strongly implicated. This review aims to describe the putative mechanisms by which surgery-induced inflammation produces cognitive sequelae, with a focus on identifying potential novel therapies based upon their ability to modify these pathways.

Keywords: Biomarkers; Cognition; Neuroinflammation; Oxidative stress; Post-operative cognitive dysfunction.

Publication types

Review

MeSH terms

Anesthetics / adverse effects
Animals
Cognitive Dysfunction / complications
Cognitive Dysfunction / drug therapy*
Cognitive Dysfunction / etiology*
Humans
Inflammation / complications
Inflammation / drug therapy*
Inflammation / physiopathology*
Postoperative Complications / drug therapy*
Postoperative Complications / physiopathology*

Substances

Anesthetics