Neuroscience Program, Emory University, Atlanta, GA, USA.
School of Medicine, Emory University, Atlanta, GA, USA.
Neurosci Lett. 2021 Apr 23;751:135808. doi: 10.1016/j.neulet.2021.135808. Epub 2021 Mar 8.
Diabetes has been demonstrated to be one of the strongest predictors of risk for postoperative delirium and functional decline in older patients undergoing surgery. Exercise is often prescribed as a treatment for diabetic patients and regular physical activity is hypothesized to decrease the risk of postoperative cognitive impairments. Prior studies suggest that anesthetic emergence trajectories and recovery are predictive of risk for later postoperative cognitive impairments. Therapeutic strategies aimed at improving emergence and recovery from anesthesia may therefore be beneficial for diabetic patients. Wistar (n = 32) and Goto-Kakizaki (GK) type 2 diabetic (n = 32) rats between 3-4 months old underwent treadmill exercise for 30 min/day for ten days or remained inactive. Pre-anesthesia spontaneous alternation behavior was recorded with a Y-maze. Rats then received a 2-h exposure to 1.5-2 % isoflurane or oxygen only. The time to reach anesthetic emergence and post-anesthesia recovery behaviors was recorded for each rat. Postsynaptic density protein-95 (PSD-95), an important scaffolding protein required for synaptic plasticity, protein levels were quantified from hippocampus using western blot. Spontaneous alternation behavior (p = 0.044) and arm entries (p < 0.001) were decreased in GK rats. There was no difference between groups in emergence times from isoflurane, but exercise hastened the recovery time (p = 0.008) for both Wistar and GK rats. Following 10 days of exercise, both Wistar and GK rats show increased levels of PSD-95 in the hippocampus. Prehabilitation with moderate intensity exercise, even on a short timescale, is beneficial for recovery from isoflurane in rats, regardless of metabolic disease status.
糖尿病已被证明是预测老年手术患者术后谵妄和功能下降风险的最强因素之一。运动常被开给糖尿病患者作为一种治疗方法，而有规律的体育活动被假设可以降低术后认知障碍的风险。先前的研究表明，麻醉苏醒轨迹和恢复情况可预测术后认知障碍的风险。因此，旨在改善麻醉苏醒和恢复的治疗策略可能对糖尿病患者有益。3-4 月龄的 Wistar（n = 32）和 Goto-Kakizaki（GK）2 型糖尿病（n = 32）大鼠每天进行 30 分钟的跑步机运动，持续 10 天，或保持不运动。在麻醉前，使用 Y 迷宫记录自发交替行为。然后，大鼠接受 2 小时 1.5-2%异氟烷或仅氧气暴露。记录每只大鼠达到麻醉苏醒和麻醉后恢复行为的时间。使用 Western blot 从海马体定量测定突触后密度蛋白-95（PSD-95），一种突触可塑性所必需的重要支架蛋白。GK 大鼠的自发交替行为（p = 0.044）和臂进入次数（p < 0.001）减少。异氟烷苏醒时间在两组之间没有差异，但运动加快了 Wistar 和 GK 大鼠的恢复时间（p = 0.008）。经过 10 天的运动，Wistar 和 GK 大鼠的海马体中 PSD-95 水平均增加。即使在短时间内，中等强度的预康复运动对大鼠从异氟烷中恢复是有益的，而与代谢疾病状态无关。
