Department of Anesthesiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, People's Republic of China.
Mol Neurobiol. 2024 Jul;61(7):4663-4676. doi: 10.1007/s12035-023-03864-0. Epub 2023 Dec 19.
Perioperative neurocognitive disorders (PNDs) are now considered the most common neurological complication in older adult patients undergoing surgical procedures. A significant increase exists in the incidence of post-operative disability and mortality in patients with PNDs. However, no specific treatment is still available for PNDs. Recent studies have shown that exercise may improve cognitive dysfunction-related disorders, including PNDs. Neuroinflammation is a key mechanism underlying exercise-induced neuroprotection in PNDs; others include the regulation of gut microbiota and mitochondrial and synaptic function. Maintaining optimal skeletal muscle mass through preoperative exercise is important to prevent the occurrence of PNDs. This review summarizes current clinical and preclinical evidence and proposes potential molecular mechanisms by which perioperative exercise improves PNDs, providing a new direction for exploring exercise-mediated neuroprotective effects on PNDs. In addition, it intends to provide new strategies for the prevention and treatment of PNDs.
围手术期神经认知障碍（PND）现在被认为是老年手术患者中最常见的神经并发症。PND 患者术后残疾和死亡率显著增加。然而，目前仍然没有针对 PND 的特定治疗方法。最近的研究表明，运动可能改善与认知功能障碍相关的疾病，包括 PND。神经炎症是运动诱导的 PND 神经保护的关键机制；其他机制包括调节肠道微生物群和线粒体及突触功能。通过术前运动保持最佳的骨骼肌质量对于预防 PND 的发生很重要。本综述总结了目前的临床和临床前证据，并提出了围手术期运动改善 PND 的潜在分子机制，为探索运动对 PND 的神经保护作用提供了新的方向。此外，它旨在为 PND 的预防和治疗提供新的策略。
