中国神经再生研究(英文版) ›› 2026, Vol. 21 ›› Issue (9): 4271-4272.doi: 10.4103/NRR.NRR-D-25-01120

• 观点:神经损伤修复保护与再生 • 上一篇    下一篇

手术和麻醉对术后认知功能障碍淋巴系统的重塑

  

  • 出版日期:2026-09-15 发布日期:2026-05-14

Surgical and anesthetic rewiring of the glymphatic system in postoperative cognitive dysfunction

Bandy Chen*   

  1. Department of Medicine, UC San Diego School of Medicine, La Jolla, CA, USA
  • Online:2026-09-15 Published:2026-05-14
  • Contact: Bandy Chen, bac008@health.ucsd.edu.

摘要: https://orcid.org/0009-0009-9099-1218 (Bandy Chen)

Abstract: Postoperative cognitive dysfunction (POCD) is a condition characterized by a variety of neurological deficits, including memory deficits, difficulty with attention and executive function, and behavioral changes or deliriumlike symptoms. These changes can be transient or long-lasting; however the exact mechanisms involved in POCD pathogenesis remain unclear. Well-established pathways that can contribute to POCD are neuroinflammation, blood-brain barrier disruption, and neurovascular dysfunction. An emerging candidate is the glymphatic system due to anesthesia’s profound effects on modulating glymphatic flow. This system is intimately linked to other brain processes, collectively referred to as the neuro-glial-vascular landscape. The central hypothesis linking POCD and the glymphatic system is that surgical stress and anesthesia impair glymphatic function, which results in the accumulation of neurotoxic waste products (e.g., amyloid-beta and tau) in the brain. While this accumulation may not lead to symptoms in every individual, people with baseline glymphatic dysfunction, such as older individuals or individuals with neurological disorders, may be more susceptible to POCD. This perspective delves into the surgical and anesthetic impairment of glymphatic function, how the disruption can lead to POCD, and possible therapeutic interventions to mitigate these effects.