دورية أكاديمية
Melanin-Concentrating Hormone Is Associated With Delayed Neurocognitive Recovery in Older Adult Patients With Preoperative Sleep Disorders Undergoing Spinal Anesthesia.
| العنوان: | Melanin-Concentrating Hormone Is Associated With Delayed Neurocognitive Recovery in Older Adult Patients With Preoperative Sleep Disorders Undergoing Spinal Anesthesia. |
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| المؤلفون: | Gao Y; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.; Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, China., Zhou Q; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.; Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, China., Li H; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.; Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, China., Zhao Y; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China., Zhu H; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.; Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, China., Zhang X; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.; Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, China., Li Y; Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin Research Institute of Anesthesiology, Tianjin, China. |
| المصدر: | Anesthesia and analgesia [Anesth Analg] 2024 Mar 01; Vol. 138 (3), pp. 579-588. Date of Electronic Publication: 2023 Dec 05. |
| نوع المنشور: | Observational Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1310650 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1526-7598 (Electronic) Linking ISSN: 00032999 NLM ISO Abbreviation: Anesth Analg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins Original Publication: Cleveland, International Anesthesia Research Society. |
| مواضيع طبية MeSH: | Anesthesia, Spinal*/adverse effects , Hypothalamic Hormones*/cerebrospinal fluid, Humans ; Aged ; Melanins/cerebrospinal fluid ; Pituitary Hormones/cerebrospinal fluid |
| مستخلص: | Background: Aging and preoperative sleep disorders are the main risk factors affecting postoperative cognitive outcomes. However, the pathogenesis of delayed neurocognitive recovery after surgery remains ambiguous, and there is still a lack of potential biomarkers for delayed neurocognitive recovery in older adult patients with preoperative sleep disorders. Our study aimed to explore the relationship between melanin-concentrating hormone (MCH) and delayed neurocognitive recovery early after surgery in older adult patients with preoperative sleep disorders. Methods: In this monocentric prospective observational study, 156 older adult patients (aged 65 years or older) with preoperative sleep disorders undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) were included at an academic medical center in Inner Mongolia, China, from October 2021 to November 2022, and all patients underwent spinal anesthesia. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess the preoperative sleep quality of all patients, and preoperative sleep disorders were defined as a score of PSQI >5. We measured the levels of cerebrospinal fluid (CSF) MCH and plasma MCH of all patients. The primary outcome was delayed neurocognitive recovery early after surgery. All patients received cognitive function assessment through the Montreal Cognitive Assessment (MoCA) 1 day before and 7 days after surgery (postoperative day 7 [POD7]). Delayed neurocognitive recovery was defined as a score of POD7 MoCA <26. The potential confounders included variables with P < .2 in the univariate logistic analysis, as well as the important risk factors of delayed neurocognitive recovery reported in the literature. Multivariable logistic regression model based on the Enter method assessed the association of MCH and delayed neurocognitive recovery in older adult patients with preoperative sleep disorders. Results: Fifty-nine (37.8%) older adult patients with preoperative sleep disorders experienced delayed neurocognitive recovery at POD7. Increase in CSF MCH levels (odds ratio [OR] for an increase of 1 pg/mL = 1.16, 95% confidence interval [CI], 1.09-1.23, P < .001) and decrease in plasma MCH levels (OR for an increase of 1 pg/mL = 0.92, 95% CI, 0.86-0.98, P = .003) were associated with delayed neurocognitive recovery, after adjusting for age, sex, education, baseline MoCA scores, American Society of Anesthesiologists (ASA) grade, and coronary heart disease (CHD). Conclusions: In older adult patients with preoperative sleep disorders, MCH is associated with the occurrence of delayed neurocognitive recovery after surgery. Preoperative testing of CSF MCH or plasma MCH may increase the likelihood of identifying the high-risk population for delayed neurocognitive recovery in older adult patients with preoperative sleep disorders. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2023 International Anesthesia Research Society.) |
| References: | Evered L, Silbert B, Knopman DS, et al.; Nomenclature Consensus Working Group. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018. Anesthesiology. 2018;129:872–879. Travica N, Lotfaliany M, Marriott A, et al. Peri-operative risk factors associated with post-operative cognitive dysfunction (POCD): an umbrella review of meta-analyses of observational studies. J Clin Med. 2023;12:1610. Wang X, Hua D, Tang X, et al. The role of perioperative sleep disturbance in postoperative neurocognitive disorders. Nat Sci Sleep. 2021;13:1395–1410. Kong H, Xu LM, Wang DX. Perioperative neurocognitive disorders: a narrative review focusing on diagnosis, prevention, and treatment. CNS Neurosci Ther. 2022;28:1147–1167. Zhang Y, Shan GJ, Zhang YX, et al.; First Study of Perioperative Organ Protection (SPOP1) Investigators. Propofol compared with sevoflurane general anaesthesia is associated with decreased delayed neurocognitive recovery in older adults. Br J Anaesth. 2018;121:595–604. Wagner S, Ahrens E, Wachtendorf LJ, et al. Association of obstructive sleep apnea with postoperative delirium in procedures of moderate-to-high complexity: a hospital-registry study. Anesth Analg. 2023. doi:10.1213/ane.0000000000006425. (PMID: 10.1213/ane.0000000000006425) Gulia KK, Kumar VM. Sleep disorders in the elderly: a growing challenge. Psychogeriatrics. 2018;18:155–165. Lu B, Liu RJ, Meng B, et al. [Effect of fragmented sleep on postoperative cognitive function and central neuroinflammation]. Zhonghua Yi Xue Za Zhi. 2020;100:1341–1344. Vacas S, Degos V, Maze M. Fragmented sleep enhances postoperative neuroinflammation but not cognitive dysfunction. Anesth Analg. 2017;124:270–276. Butris N, Tang E, Pivetta B, et al. The prevalence and risk factors of sleep disturbances in surgical patients: a systematic review and meta-analysis. Sleep Med Rev. 2023;69:101786. Du J, Zhang H, Ding Z, et al. Development and validation of a nomogram for postoperative sleep disturbance in adults: a prospective survey of 640 patients undergoing spinal surgery. BMC Anesthesiol. 2023;23:154. Han Y, Han L, Dong MM, et al. Preoperative salivary cortisol AM/PM ratio predicts early postoperative cognitive dysfunction after noncardiac surgery in elderly patients. Anesth Analg. 2019;128:349–357. Evered LA, Vitug S, Scott DA, Silbert B. Preoperative frailty predicts postoperative neurocognitive disorders after total hip joint replacement surgery. Anesth Analg. 2020;131:1582–1588. Stewart NH, Arora VM. Sleep in hospitalized older adults. Sleep Med Clin. 2022;17:223–232. Li Y, Zhao L, Wang Y, et al. Development and validation of prediction models for neurocognitive disorders in adult patients admitted to the ICU with sleep disturbance. CNS Neurosci Ther. 2022;28:554–565. Monti JM, Torterolo P, Lagos P. Melanin-concentrating hormone control of sleep-wake behavior. Sleep Med Rev. 2013;17:293–298. Dias Abdo Agamme AL, Aguilar Calegare BF, Fernandes L, et al. MCH levels in the CSF, brain preproMCH and MCHR1 gene expression during paradoxical sleep deprivation, sleep rebound and chronic sleep restriction. Peptides. 2015;74:9–15. Bandaru SS, Khanday MA, Ibrahim N, Naganuma F, Vetrivelan R. Sleep-wake control by melanin-concentrating hormone (MCH) neurons: a review of recent findings. Curr Neurol Neurosci Rep. 2020;20:55. Jones BE. Arousal and sleep circuits. Neuropsychopharmacology. 2020;45:6–20. Le Barillier L, Léger L, Luppi PH, Fort P, Malleret G, Salin PA. Genetic deletion of melanin-concentrating hormone neurons impairs hippocampal short-term synaptic plasticity and hippocampal-dependent forms of short-term memory. Hippocampus. 2015;25:1361–1373. Oh ST, Liu QF, Jeong HJ, et al. Nasal cavity administration of melanin-concentrating hormone improves memory impairment in memory-impaired and Alzheimer’s disease mouse models. Mol Neurobiol. 2019;56:8076–8086. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213. Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695–699. Liang Y, Xin X, Wang H, et al. A novel predictive strategy for the incidence of postoperative neurocognitive dysfunction in elderly patients with mild cognitive impairment. Front Aging Neurosci. 2022;14:985406. Berger M, Schenning KJ, Brown CH, et al.; Perioperative Neurotoxicity Working Group. Best practices for postoperative brain health: recommendations from the Fifth International Perioperative Neurotoxicity Working Group. Anesth Analg. 2018;127:1406–1413. Decker J, Kaloostian CL, Gurvich T, et al. Beyond cognitive screening: establishing an interprofessional perioperative brain health initiative. J Am Geriatr Soc. 2020;68:2359–2364. Peden CJ, Miller TR, Deiner SG, Eckenhoff RG, Fleisher LA; Members of the Perioperative Brain Health Expert Panel. Improving perioperative brain health: an expert consensus review of key actions for the perioperative care team. Br J Anaesth. 2021;126:423–432. Grandner MA, Kripke DF, Yoon IY, Youngstedt SD. Criterion validity of the Pittsburgh Sleep Quality Index: investigation in a non-clinical sample. Sleep Biol Rhythms. 2006;4:129–139. Toossi H, Del Cid-Pellitero E, Jones BE. GABA receptors on orexin and melanin-concentrating hormone neurons are differentially homeostatically regulated following sleep deprivation. eNeuro. 2016;3:ENEURO.0077–ENEU16.2016. Arthaud S, Varin C, Gay N, et al. Paradoxical (REM) sleep deprivation in mice using the small-platforms-over-water method: polysomnographic analyses and melanin-concentrating hormone and hypocretin/orexin neuronal activation before, during and after deprivation. J Sleep Res. 2015;24:309–319. Briggs C, Hirasawa M, Semba K. Sleep deprivation distinctly alters glutamate transporter 1 apposition and excitatory transmission to orexin and MCH neurons. J Neurosci. 2018;38:2505–2518. Kushikata T, Sawada M, Niwa H, et al. Ketamine and propofol have opposite effects on postanesthetic sleep architecture in rats: relevance to the endogenous sleep-wakefulness substances orexin and melanin-concentrating hormone. J Anesth. 2016;30:437–443. Georgescu D, Sears RM, Hommel JD, et al. The hypothalamic neuropeptide melanin-concentrating hormone acts in the nucleus accumbens to modulate feeding behavior and forced-swim performance. J Neurosci. 2005;25:2933–2940. Schmidt FM, Kratzsch J, Gertz HJ, et al. Cerebrospinal fluid melanin-concentrating hormone (MCH) and hypocretin-1 (HCRT-1, orexin-A) in Alzheimer’s disease. PLoS One. 2013;8:e63136. Park JY, Kim SN, Yoo J, et al. Novel neuroprotective effects of melanin-concentrating hormone in Parkinson’s disease. Mol Neurobiol. 2017;54:7706–7721. Lu ZH, Fukuda S, Minakawa Y, et al. Melanin concentrating hormone induces hippocampal acetylcholine release via the medial septum in rats. Peptides. 2013;44:32–39. Calafate S, Özturan G, Thrupp N, et al. Early alterations in the MCH system link aberrant neuronal activity and sleep disturbances in a mouse model of Alzheimer’s disease. Nat Neurosci. 2023;26:1021–1031. Izawa S, Chowdhury S, Miyazaki T, et al. REM sleep-active MCH neurons are involved in forgetting hippocampus-dependent memories. Science. 2019;365:1308–1313. Edipoglu IS, Celik F. The associations between cognitive dysfunction, stress biomarkers, and administered anesthesia type in total knee arthroplasties: prospective, randomized trial. Pain Physician. 2019;22:495–507. Evered LA, Silbert BS. Postoperative cognitive dysfunction and noncardiac surgery. Anesth Analg. 2018;127:496–505. |
| معلومات مُعتمدة: | 202202327 Inner Mongolia Autonomous Region Health Science and Technology Plan Project; SZR2022217 Chifeng Natural Science Foundation; 2022KJ232 Scientific Research Project of Tianjin Municipal Education Commission |
| المشرفين على المادة: | 67382-96-1 (melanin-concentrating hormone) 0 (Hypothalamic Hormones) 0 (Melanins) 0 (Pituitary Hormones) |
| تواريخ الأحداث: | Date Created: 20231205 Date Completed: 20240219 Latest Revision: 20240219 |
| رمز التحديث: | 20240219 |
| DOI: | 10.1213/ANE.0000000000006768 |
| PMID: | 38051670 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1526-7598 |
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| DOI: | 10.1213/ANE.0000000000006768 |