The brain function network mechanism of postoperative cognitive dysfunction is revealed

The brain function network mechanism of postoperative cognitive dysfunction is revealed

The brain function network mechanism of postoperative cognitive dysfunction was revealed

Recently, Professor Wang Liwei’s research team from the Department of Anesthesiology, Xuzhou Central Hospital, Professor Yang Qi’s team from Beijing Chaoyang Hospital affiliated to Capital Medical University, and Professor Ma Daqing’s team from Imperial College London have made important breakthroughs in the study of the brain function network mechanism of postoperative cognitive dysfunction.

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Related research results were published online in the well-known journal "Annals of Surgery" (Annals of Surgery) in the field of surgery

Postoperative cognitive dysfunction (POCD) is a postoperative complication with cognitive impairment as the main manifestation.
It is more common in cardiovascular surgery and the elderly.
Its pathogenesis is complicated and there is no effective prevention and treatment method
.

Previous basic research has explored the pathogenesis of POCD in multiple dimensions from genes, molecules, neurons to neural circuits.

In this study, the researchers found that multiple cognitive domains were impaired in patients undergoing heart valve replacement surgery, especially the impaired executive function
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Through brain functional magnetic resonance imaging (fMRI) studies, it is found that the functional connection of the bilateral dorsolateral prefrontal lobe (DLPFC) is enhanced before the operation in patients undergoing cardiac surgery and continues until the operation, suggesting that the internal functional connection of the preoperative executive control network (ECN) is Enhancement appears

As a high-level cognitive function, the content of executive function is complex, including task switching, reaction inhibition, working memory and so on
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When performing cognitive tasks, ECN does not work independently.

Professor Wang Liwei and Professor Ma Daqing found through a large number of animal experiments in the early stage that the inflammatory response caused by the activation of the immune system by surgical trauma is an important pathogenic factor of POCD
.

In this study, the peripheral blood TNF-α level of patients after cardiac surgery is correlated with DMN-ECN functional connection.

The results of this research are expected to promote the establishment of diagnostic criteria for POCD neuroimaging and provide new targets and ideas for targeted interventions in POCD
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According to Professor Wang Liwei, their next step will be to study the feasibility of non-invasive targeted physical therapy technology to prevent and treat POCD, and comprehensively use fMRI, electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) to assess postoperative consciousness and Cognitive function

Inflammation-mediated executive function-related brain network functional connection abnormalities lead to impaired cognitive function Mechanism: surgical trauma activates the body’s immune response, causing systemic inflammation and spreading to the central nervous system, leading to neuroinflammation.
Inflammation changes the functional connection of the executive control network and Coupling between other networks in turn leads to postoperative cognitive dysfunction
.

(Photo courtesy of the interviewee)

Inflammation-mediated executive function-related brain network functional connection abnormalities lead to impaired cognitive function Mechanism: surgical trauma activates the body’s immune response, causing systemic inflammation and spreading to the central nervous system, leading to neuroinflammation.

Related paper information: https://pubmed.

https://pubmed.
ncbi.
nlm.
nih.
gov/34225294/