Abstract
Postoperative cognitive dysfunction is a common neurological complication, characterized by impaired learning and memory, that occurs after anesthesia and surgery, especially in elderly patients. The traditional Chinese medicine baicalin is known to have neuroprotective effects. Therefore, we have investigated whether baicalin can improve postoperative cognitive impairment in aged rats after splenectomy. A total of 60 Sprague Dawley rats were randomly divided, equally, into the splenectomy, sham operation (Sham), low-dose baicalin (Baicalin A), medium-dose baicalin (Baicalin B), and high-dose baicalin (Baicalin C) groups. Splenectomy was performed under anesthesia in all groups except for the Sham group, in which an appropriate concentration of saline was administered. The effects of baicalin on learning and memory were examined by the Y-maze behavioral experiments. Although splenectomy had a negative effect on cognitive function in the acute phase, all the rats spontaneously recovered on a postoperative day seven. Nonetheless, in the acute phase, the medium and high doses of baicalin slightly alleviated these effects of the procedure. The protein expression of the inflammatory cytokines tumor necrosis factor-α, Interleukin-6, and Interleukin-1β was assessed using enzyme-linked immunosorbent assay. Their levels were elevated in the acute phase but were returned to normal with the medium and high dose of baicalin. Real-time PCR analysis of the mRNA expression of the N-methyl-D-aspartic acid receptor TNF-α, which is known to be involved in long-term potentiation, revealed that baicalin promoted its transcription. Thus, the findings indicate that baicalin may improve postoperative cognitive memory dysfunction in postoperative cognitive dysfunction in rats via anti-inflammatory mechanisms and pathways that involve N-methyl-D-aspartate receptor 2B subunit.
Highlights
Postoperative cognitive dysfunction (POCD) is a postoperative central nervous system (CNS) complication
3.1 Effect of baicalin on spatial exploration and cognitive memory function in aged rats after splenectomy According to the results, the spatial exploration and cognitive memory function of the aged rats were ELISZAnormal before splenectomy
The post-splenectomy findings showed that the spatial exploration and cognitive memory function in the aged rats had declined
Summary
Postoperative cognitive dysfunction (POCD) is a postoperative central nervous system (CNS) complication. POCD is characterized by difficulty with cognitive, learning, memory, and thinking activities after surgery in patients who otherwise have a normal cognitive function. Some patients experience long-term cognitive dysfunction as a result of several months or years of decline in social activity, social ability, and cognitive ability. The hippocampus is essential for learning, memory, and cognition, and the NMDA receptor subtype NR2B plays an essential role in these functions of the hippocampus. NR2B is widely expressed in the brain and affects cognitive function by regulating membrane transport and the synaptic transmission processes of NMDA receptors and α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors. Surgical trauma stimulates an inflammatory response in the CNS as a result of which inflammatory cytokines are released, and the function of the CNS is regulated through the neuro-immune-endocrine network. The expression levels of pro-inflammatory cytokines (IL-1β, IL-2, IL-6, and TNFα) and anti-inflammatory cytokines (Interleukin-4 (IL-4) and Interleukin-10 (IL-10)) tend to be in a dynamic equilibrium, and the imbalance between the two affects the physiological function of the body (Fidalgo et al, 2011; Wan et al, 2007)
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