Zhang Peng, Xu Feifei, Zhao Guangchao, Zhang Xinxin, Li Ao, Dong Hailong, Xiong Lize
Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, the Fourth Military Medical University, Xi'an, China.
Front Psychiatry. 2019 Sep 3;10:642. doi: 10.3389/fpsyt.2019.00642. eCollection 2019.
Attention-deficit hyperactivity disorder (ADHD) is a typical neuropsychiatric disorder characterized by inattention, impulsivity, and hyperactivity, particularly in children. Recent studies demonstrated a close relationship between the development of ADHD and surgery under general anesthesia. However, few studies illustrated if ADHD symptoms changed after surgery. Meanwhile, whether these individuals with natural neural impairment were sensitive to postoperative neurocognitive disorder (PND) still remain unclear. Spontaneously hypertensive rats (SHR) were utilized as spontaneous ADHD animal model and Wistar-Kyoto (WKY) rats as non-ADHD animal model. We evaluated the variation of neurocognitive function and locomotor activity of the rats undergoing experimental laparotomy with general anesthesia by isoflurane. Neurocognitive function was assessed by fear conditioning test for contextual memory and Morris water maze (MWM) for spatial memory. Depressive-like behavior after surgery was detected by forced swim test, and open-field test and elevated plus maze test were utilized to evaluate locomotor activities and anxiety. Furthermore, we compared electroencephalogram (EEG) signal in ADHD and WKY rats under free-moving conditions. Afterward, staining was also utilized to detect the excitatory activity of neurons in these rats to explore the neural mechanism. Locomotor activity of SHR assessed by average speed and number of line crossings in the open-field test decreased 1 week after surgery under general anesthesia, but there was no difference concerning anxiety levels between SHR and WKY rats after surgery. This phenomenon was also paralleled with the change in EEG signal (delta band 0∼3 Hz). Surgery under general anesthesia had no effect on spatial and contextual memory, while it improved spontaneous depression in SHR. The expression of was downregulated for at least 1 week in the nucleus accumbens (NAc) area of ADHD rats' brain after surgery. ADHD rats were not sensitive to PND. Surgery with general anesthesia could partly improve the hyperactivity symptom of ADHD rats. This mechanism was related to the suppression of neural activity in the cerebral NAc of ADHD rats induced by general anesthetics.
注意缺陷多动障碍（ADHD）是一种典型的神经精神障碍，其特征为注意力不集中、冲动和多动，在儿童中尤为常见。最近的研究表明ADHD的发展与全身麻醉下的手术之间存在密切关系。然而，很少有研究说明手术后ADHD症状是否发生了变化。与此同时，这些具有天然神经损伤的个体对术后神经认知障碍（PND）是否敏感仍不清楚。自发性高血压大鼠（SHR）被用作自发性ADHD动物模型，而Wistar-Kyoto（WKY）大鼠作为非ADHD动物模型。我们评估了接受异氟烷全身麻醉下实验性剖腹手术的大鼠的神经认知功能和运动活动的变化。通过用于情境记忆的恐惧条件测试和用于空间记忆的莫里斯水迷宫（MWM）评估神经认知功能。通过强迫游泳测试检测手术后的抑郁样行为，并利用旷场试验和高架十字迷宫试验评估运动活动和焦虑。此外，我们比较了自由活动条件下ADHD大鼠和WKY大鼠的脑电图（EEG）信号。之后，还利用染色来检测这些大鼠中神经元的兴奋性活动，以探索神经机制。在全身麻醉下手术后1周，通过旷场试验中的平均速度和穿越线的数量评估的SHR的运动活动下降，但手术后SHR和WKY大鼠之间的焦虑水平没有差异。这种现象也与EEG信号（δ波段0∼3Hz）的变化平行。全身麻醉下的手术对空间和情境记忆没有影响，但改善了SHR中的自发性抑郁。手术后，ADHD大鼠大脑伏隔核（NAc）区域中[此处原文缺失相关内容]的表达至少下调1周。ADHD大鼠对PND不敏感。全身麻醉手术可以部分改善ADHD大鼠的多动症状。这种机制与全身麻醉剂诱导的ADHD大鼠大脑NAc中神经活动的抑制有关。
