Neuroinflammatory markers associate with cognitive decline after major surgery:Findings of an explorative study
| Autor: | Anna Schening, Souren Mkrtchian, Jonatan Oras, Sven-Erik Ricksten, Lars Eriksson, Helena Erlandsson Harris, Lars S. Rasmussen, Bengt Nellgård, Kaj Blennow, A. Wiklund, Fredrik Granath, Mattias Danielson, Anna Granström, Henrik Zetterberg, Malin Jonsson Fagerlund |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Time Factors Serum albumin Inflammation S100 Calcium Binding Protein beta Subunit Permeability 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Postoperative Cognitive Complications Glial Fibrillary Acidic Protein medicine Humans Orthopedic Procedures Cognitive decline Aged biology Glial fibrillary acidic protein business.industry Case-control study Cognition 3. Good health Surgery 030104 developmental biology Neurology Blood-Brain Barrier Case-Control Studies Cohort biology.protein Female Neurology (clinical) medicine.symptom Inflammation Mediators business 030217 neurology & neurosurgery |
| Zdroj: | Danielson, M, Wiklund, A, Granath, F, Blennow, K, Mkrtchian, S, Nellgård, B, Oras, J, Jonsson Fagerlund, M, Granström, A, Schening, A, Rasmussen, L S, Erlandsson Harris, H, Zetterberg, H, Ricksten, S E & Eriksson, L I 2020, ' Neuroinflammatory markers associate with cognitive decline after major surgery : Findings of an explorative study ', Annals of Neurology, vol. 87, no. 3, pp. 370-382 . https://doi.org/10.1002/ana.25678 |
| DOI: | 10.1002/ana.25678 |
| Popis: | Objective: Long-term cognitive decline is an adverse outcome after major surgery associated with increased risk for mortality and morbidity. We studied the cerebrospinal fluid (CSF) and serum biochemical inflammatory response to a standardized orthopedic surgical procedure and the possible association with long-term changes in cognitive function. We hypothesized that the CSF inflammatory response pattern after surgery would differ in patients having long-term cognitive decline defined as a composite cognitive z score of ≥1.0 compared to patients without long-term cognitive decline at 3 months postsurgery. Methods: Serum and CSF biomarkers of inflammation and blood–brain barrier (BBB) integrity were measured preoperatively and up to 48 hours postoperatively, and cognitive function was assessed preoperatively and at 2 to 5 days and 3 months postoperatively. Results: Surgery was associated with a pronounced increase in inflammatory biomarkers in both CSF and blood throughout the 48-hour study period. A principal component (PC) analysis was performed on 52 inflammatory biomarkers. The 2 first PC (PC1 and PC2) construct outcome variables on CSF biomarkers were significantly associated with long-term cognitive decline at 3 months, but none of the PC construct serum variables showed a significant association with long-term cognitive decline at 3 months. Patients both with and patients without long-term cognitive decline showed early transient increases of the astroglial biomarkers S-100B and glial fibrillary acidic protein in CSF, and in BBB permeability (CSF/serum albumin ratio). Interpretation: Surgery rapidly triggers a temporal neuroinflammatory response closely associated with long-term cognitive outcome postsurgery. The findings of this explorative study require validation in a larger surgical patient cohort. Ann Neurol 2020;87:370–382. |
| Databáze: | OpenAIRE |
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