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The Relationship between Postoperative Cognitive Dysfunction and Cerebral Small Vessel Disease: A Comprehensive Review
  • Xuhua Xu,
  • Zhiya Chen,
  • Feng Gao
Xuhua Xu
The Fourth Affiliated Hospital Zhejiang University School of Medicine
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Zhiya Chen
Peking University School of Life Sciences
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Feng Gao
Zhejiang University School of Medicine Second Affiliated Hospital

Corresponding Author:[email protected]

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Abstract

Postoperative cognitive dysfunction (POCD) is a common complication in elderly patients, and cerebral small vessel disease (CSVD) has been suggested as a potential risk factor. This review examines the relationship between POCD and CSVD from epidemiological, pathophysiological, and clinical perspectives. Epidemiological studies have shown that POCD and CSVD are associated in terms of common risk factors, including advanced age, vascular comorbidities, impaired baseline cognitive function, and certain population characteristics. Animal studies have revealed that CSVD and POCD share similar neuropathological changes, including abnormal cerebral hypoperfusion, inflammatory responses, and blood-brain barrier disruption. Neuroimaging studies have further demonstrated that preoperative CSVD burden and postoperative CSVD progression are associated with the development of POCD. The association between CSVD and POCD has important implications for the perioperative management of elderly patients, including preoperative assessment, choice of anesthesia and surgical methods, intraoperative management, postoperative care, and long-term follow-up. A better understanding of the relationship between CSVD and POCD will guide evidence-based strategies to prevent and manage this debilitating complication in the aging population.
Submitted to European Journal of Neuroscience
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