Possible association between postoperative cognitive dysfunction and central neuroinflammation

Abstract

Postoperative cognitive dysfunction (POCD) is a degraded cognitive function after surgical anesthesia, and severely affects the quality of life after surgery. So far, the pathophysiological mechanism is not clear, but central inflammation is considered to be important during the process. This article reviews the progress on the possible connection between POCD and central inflammation. Surgical anesthesia causes systemic inflammatory response in the whole body, while inflammatory factors can lead to inflammation in the central nervous system through direct entry into the blood-brain barrier (BBB), and impairment of the BBB or activation of multiple signaling pathways. Central inflammation affects patients' cognitive function to cause POCD through delayed inflammation resolution, direct action of inflammatory factors or indirect action of non-inflammatory mediators. Meanwhile, the risk factors of POCD are closely related to central inflammation. Interventions based on central neuroinflammation mechanism may have positive effects on the prevention and control of POCD. Key words: Postoperative cognitive dysfunction; Central nervous system; Inflammation; Inflammatory factor; Blood brain barrier