Serum biomarkers of brain injury: S100B protein, cognitive dysfunction, and major non-cardiac surgery

摘要

Short- and long-term cognitive decline are adverse out- comes after major surgery associated with an increased risk for mortality and morbidity. 1 Cognitive dysfunction related to surgery, namely Postoperative Cognitive Dysfunc- tion (POCD), is highly prevalent in humans, affecting more than 50% of patients submitted to cardiac surgery at hospital discharge and approximately 40% at five years after surgery. 2 POCD is a common situation that may occur after any sort of surgery and defined by a reduction in cognitive perfor- mance on a set of neuropsychological tests before and after anesthesia and surgery. 3 Notably, POCD may compromise a wide range of cognitive functions, including working and long-term memory, information processing, attention and cognitive flexibility, consequently affecting quality of life. 4 Although the pathogenesis of cognitive decline after surgery is not completely understood, there is growing evidence on experimental and translational research pointing to a crit- ical role for neuroinflammation as a relevant mechanism underlying this condition.