Department of Anesthesiology Renji Hospital School of Medicine Shanghai Jiaotong University Shanghai China.
Brain Behav. 2018 Mar 23;8(5):e00957. doi: 10.1002/brb3.957. eCollection 2018 May.
Postoperative cognitive dysfunction (POCD) is consistently associated with increased morbidity and mortality, which has become a major concern of patients and caregivers. Although POCD occurs mainly in aged patients, it happens at any age. Previous studies demonstrated that anesthesia/surgery had no effects on reference memory of adult mice. However, whether it impairs working memory remains unclear. Working memory deficit would result in many deficits of executive function. We hypothesized that anesthesia/surgery impaired the working memory of adult mice and the central cholinergic system was involved.
Tibial fracture internal fixation under the anesthesia of isoflurane was performed in two-month-old C57BL/6 mice. Two days later, the spatial reference memory and working memory were measured by a Morris Water Maze (MWM). Donepezil, an inhibitor of acetylcholinesterase (AChE), was administered in another cohort mice for 4 weeks. Then, the working memory was measured by MWM 2 days after anesthesia/surgery. Western blot was used to detect the protein levels of acetylcholine transferase (ChAT), AChE, vesicular acetylcholine transporter (VAChT), and choline transporter (ChT) in the prefrontal cortex (PFC).
We found that anesthesia/surgery had no effects on the reference memory, but it impaired the working memory in adult mice. Meanwhile, we also found that the protein level of ChAT in PFC decreased significantly compared with that in control group. Donepezil pretreatment prevented working memory impairment and the decrease of the protein levels of ChAT induced by anesthesia/surgery.
These results suggest that anesthesia/surgery leads to working memory deficits in adult mice and central cholinergic system impairment is involved.
术后认知功能障碍(POCD)与发病率和死亡率的增加密切相关,这已成为患者和护理人员的主要关注点。虽然 POCD 主要发生在老年患者中,但它也可能发生在任何年龄。先前的研究表明,麻醉/手术对成年小鼠的参考记忆没有影响。然而,它是否会损害工作记忆尚不清楚。工作记忆缺陷会导致许多执行功能缺陷。我们假设麻醉/手术会损害成年小鼠的工作记忆,且中枢胆碱能系统参与其中。
在两个月大的 C57BL/6 小鼠中进行异氟烷麻醉下的胫骨骨折内固定。两天后,通过 Morris 水迷宫(MWM)测量空间参考记忆和工作记忆。在另一组小鼠中,给予乙酰胆碱酯酶抑制剂多奈哌齐(donepezil)4 周。然后,在麻醉/手术后 2 天通过 MWM 测量工作记忆。使用 Western blot 检测前额叶皮层(PFC)中乙酰胆碱转移酶(ChAT)、乙酰胆碱酯酶(AChE)、囊泡乙酰胆碱转运体(VAChT)和胆碱转运体(ChT)的蛋白水平。
我们发现麻醉/手术对参考记忆没有影响,但会损害成年小鼠的工作记忆。同时,我们还发现 PFC 中的 ChAT 蛋白水平与对照组相比显著降低。多奈哌齐预处理可预防麻醉/手术引起的工作记忆障碍和 ChAT 蛋白水平下降。
这些结果表明,麻醉/手术会导致成年小鼠出现工作记忆缺陷,且涉及中枢胆碱能系统损伤。