The neuroinflammatory response of postoperative cognitive decline

S Vacas, V Degos, X Feng, M Maze - British medical bulletin, 2013 - academic.oup.com
S Vacas, V Degos, X Feng, M Maze
British medical bulletin, 2013academic.oup.com
Background Aseptic surgical trauma provokes a homeostatic neuroinflammatory response to
promote healing and protect the organism from further injury. When this response is
dysregulated, harmful consequences can follow, including postoperative cognitive decline.
Sources of data We performed a comprehensive search on PubMed related to postoperative
cognitive dysfunction (POCD). Areas of agreement Although the precise pathogenic
mechanisms for POCD remain unclear, certain risk factors are known. Areas of controversy …
Background
Aseptic surgical trauma provokes a homeostatic neuroinflammatory response to promote healing and protect the organism from further injury. When this response is dysregulated, harmful consequences can follow, including postoperative cognitive decline.
Sources of data
We performed a comprehensive search on PubMed related to postoperative cognitive dysfunction (POCD).
Areas of agreement
Although the precise pathogenic mechanisms for POCD remain unclear, certain risk factors are known.
Areas of controversy
The mechanisms that lead to exaggerated and persistent neuroinflammation and the best way to counteract it are still unknown.
Areas for developing research
It is imperative that we identify the underlying processes that increase the risk of cognitive decline in elderly surgical patients. In this review we explore non-resolution of inflammation as an underlying cause of developing exaggerated and persistent POCD. If interventions can be developed to promote resolution of neuroinflammation, the patient's postoperative recovery will be enhanced and long-term consequences can be prevented.
Oxford University Press