Preoperative Pain Facilitates Postoperative Cognitive Dysfunction via Periaqueductal Gray Matter-Dorsal Raphe Circuit. 2023

Haoyue Deng, and Yi Wu, and Po Gao, and Dexu Kong, and Chao Pan, and Saihong Xu, and Dan Tang, and Yingfu Jiao, and Daxiang Wen, and Weifeng Yu
Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, P.O. Box 200127, No. 160 Pujian Road, Shanghai, China; Key Laboratory of Anesthesiology (Shanghai Jiao Tong University), Ministry of Education, China.

Postoperative cognitive dysfunction (POCD) is a medically induced, rapidly occurring postoperative disease, which is hard to recover and seriously threatens the quality of life, especially for elderly patients, so it is important to identify the risk factors for POCD and apply early intervention to prevent POCD. As we have known, pain can impair cognition, and many surgery patients experience different preoperative pain, but it is still unknown whether these patients are vulnerable for POCD. Here we found that chronic pain (7 days, but not 1 day acute pain) induced by Complete Freund's Adjuvant (CFA) injected in the hind paw of rats could easily induce spatial cognition and memory impairment after being exposed to sevoflurane anesthesia. Next, for the mechanisms, we focused on the Periaqueductal Gray Matter (PAG), a well-known pivotal nucleus in pain process. It was detected the existence of neural projection from ventrolateral PAG (vlPAG) to adjacent nucleus Dorsal Raphe (DR), the origin of serotonergic projection for the whole cerebrum, through virus tracing and patch clamp recordings. The Immunofluorescence staining and western blot results showed that Tryptophan Hydroxylase 2 (TPH2) for serotonin synthesis in the DR was increased significantly in the rats treated with CFA for 7 days and sevoflurane for 3 hours, while chemo-genetic inhibition of the vlPAG-DR projection induced obvious spatial learning and memory impairment. Our study suggests that preoperative chronic pain may facilitate cognitive function impairment after receiving anesthesia through the PAG-DR neural circuit, and preventative analgesia should be a considerable measure to reduce the incidence of POCD.

UI MeSH Term Description Entries
D010487 Periaqueductal Gray Central gray matter surrounding the CEREBRAL AQUEDUCT in the MESENCEPHALON. Physiologically it is probably involved in RAGE reactions, the LORDOSIS REFLEX; FEEDING responses, bladder tonus, and pain. Mesencephalic Central Gray,Midbrain Central Gray,Central Gray Substance of Midbrain,Central Periaqueductal Gray,Griseum Centrale,Griseum Centrale Mesencephali,Periaqueductal Gray Matter,Substantia Grisea Centralis,Substantia Grisea Centralis Mesencephali,Central Gray, Mesencephalic,Central Gray, Midbrain,Gray Matter, Periaqueductal,Gray, Central Periaqueductal,Griseum Centrale Mesencephalus,Periaqueductal Grays, Central
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077149 Sevoflurane A non-explosive inhalation anesthetic used in the induction and maintenance of general anesthesia. It does not cause respiratory irritation and may also prevent PLATELET AGGREGATION. BAX 3084,Fluoromethyl Hexafluoroisopropyl Ether,Fluoromethyl-2,2,2-trifluoro-1-(trifluoromethyl)ethyl Ether,Sevorane,Ultane
D000079690 Postoperative Cognitive Complications COGNITIVE IMPAIRMENT or functional decline after a surgical procedure. Postoperative Cognitive Decline,Postoperative Cognitive Disorders,Postoperative Cognitive Dysfunction,Postoperative Dementia,Cognitive Complication, Postoperative,Cognitive Decline, Postoperative,Cognitive Disorder, Postoperative,Cognitive Dysfunction, Postoperative,Complication, Postoperative Cognitive,Decline, Postoperative Cognitive,Dementia, Postoperative,Dementias, Postoperative,Disorder, Postoperative Cognitive,Dysfunction, Postoperative Cognitive,Postoperative Cognitive Complication,Postoperative Cognitive Disorder,Postoperative Dementias
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D051381 Rats The common name for the genus Rattus. Rattus,Rats, Laboratory,Rats, Norway,Rattus norvegicus,Laboratory Rat,Laboratory Rats,Norway Rat,Norway Rats,Rat,Rat, Laboratory,Rat, Norway,norvegicus, Rattus
D059350 Chronic Pain Aching sensation that persists for more than a few months. It may or may not be associated with trauma or disease, and may persist after the initial injury has healed. Its localization, character, and timing are more vague than with acute pain. Chronic Primary Pain,Chronic Secondary Pain,Pain, Chronic,Widespread Chronic Pain,Chronic Pain, Widespread,Pain, Chronic Primary,Pain, Chronic Secondary,Pain, Widespread Chronic,Primary Pain, Chronic,Secondary Pain, Chronic
D065847 Dorsal Raphe Nucleus The dorsal region of the raphe nucleus which is a source of the SEROTONERGIC NEURONS innervating the TELENCEPHALON; DIENCEPHALON; MESENCEPHALON; and RHOMBENCEPHALON. Dorsal Nucleus Of The Raphe,Dorsal Nucleus Raphe,Dorsal Raphe,Linear Nucleus,Linear Nucleus of the Raphe,Medial Raphe Nucleus,Nucleus Linearis,Nucleus Raphe Dorsalis,Nucleus Raphes Dorsalis,Dorsal Raphes,Linearis, Nucleus,Nucleus Raphe, Dorsal,Nucleus, Dorsal Raphe,Nucleus, Linear,Nucleus, Medial Raphe,Raphe Nucleus, Dorsal,Raphe Nucleus, Medial,Raphe, Dorsal,Raphe, Dorsal Nucleus

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