Gerontology · 2025
Exploring Neuroinflammation and Its Role in Postoperative Cognitive Dysfunction following Spine Surgery.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Ruhnau Johanna, Müller Jonas, Nowak Stephan, Strack Sarah, Sperlich Denise, Pohl Anna, Dilz Jasmin, Rehberg Sebastian, Usichenko Taras, Hahnenkamp Klaus, Weidemeier Martin, Ehler Johannes, Flöel Agnes, Schroeder Henry W S, Müller Jan-Uwe, Fleischmann Robert, Vogelgesang Antje
Аннотация
UNLABELLED: <p>Introduction: Progress in spine surgery has significantly improved the safety of procedures for older patients with disabling spine disease. However, postoperative cognitive dysfunction (POCD) remains a concern due to their link with poorer outcomes and higher long-term care risk. This study aimed to determine if pro-neuroinflammatory states accelerate neurodegeneration, contributing to POCD development, and explore whether specific biomarkers could predict POCD risk.
METHODS: Patients (aged ≥ 60 years) scheduled for elective spine surgery between February 2018 and March 2020 were enrolled. Biomarkers tested included IL-6, C-reactive protein, S100 calcium-binding protein β, brain-derived neurotrophic factor, serum neurofilament light chain protein (sNFL), gasdermin D, and soluble ectodomain of triggering receptor expressed on myeloid cells 2 (sTREM2), measured preoperatively and postoperatively. Cognitive outcomes were assessed using the CERAD test battery at baseline and 3 months postoperatively.
RESULTS: Postoperative levels of sTREM2 and gasdermin D were significantly associated with cognitive performance changes 3 months after surgery, particularly in memory function. Higher sTREM2 levels were associated with greater cognitive decline, with six out of twelve CERAD items showing an inverse association (e.g., overall β = -0.010, p = 0.0003). Similarly, higher postoperative gasdermin D levels were linked to worse performance, particularly in recognition memory (e.g., word list recognition β = -0.615, p = 0.032). Additionally, higher preoperative sNFL levels were associated with poorer cognitive outcomes across multiple domains.
CONCLUSIONS: This study highlights potential associations between neuroinflammation and cognitive decline following spine surgery. Targeting neuroinflammatory pathways could be crucial in mitigating POCD in older patients. Biomarkers may help identify high-risk patients and guide the development of targeted interventions. </p>.
METHODS: Patients (aged ≥ 60 years) scheduled for elective spine surgery between February 2018 and March 2020 were enrolled. Biomarkers tested included IL-6, C-reactive protein, S100 calcium-binding protein β, brain-derived neurotrophic factor, serum neurofilament light chain protein (sNFL), gasdermin D, and soluble ectodomain of triggering receptor expressed on myeloid cells 2 (sTREM2), measured preoperatively and postoperatively. Cognitive outcomes were assessed using the CERAD test battery at baseline and 3 months postoperatively.
RESULTS: Postoperative levels of sTREM2 and gasdermin D were significantly associated with cognitive performance changes 3 months after surgery, particularly in memory function. Higher sTREM2 levels were associated with greater cognitive decline, with six out of twelve CERAD items showing an inverse association (e.g., overall β = -0.010, p = 0.0003). Similarly, higher postoperative gasdermin D levels were linked to worse performance, particularly in recognition memory (e.g., word list recognition β = -0.615, p = 0.032). Additionally, higher preoperative sNFL levels were associated with poorer cognitive outcomes across multiple domains.
CONCLUSIONS: This study highlights potential associations between neuroinflammation and cognitive decline following spine surgery. Targeting neuroinflammatory pathways could be crucial in mitigating POCD in older patients. Biomarkers may help identify high-risk patients and guide the development of targeted interventions. </p>.