The Role of the Intestinal Flora and Its Derivatives in Neurocognitive Disorders: A Narrative Review from Surgical Perspective

Author:

Huang Jian,Qin Tian-Shou,Bo Yun,Li Yu-Jin,Liu Rong-Sheng,Yu Yang,Li Xiao-Dong,He Jin-Can,Ma Ai-Xin,Tao Da-Peng,Ren Wen-Jun,Peng JunORCID

Abstract

AbstractPerioperative neurocognitive dysfunction is a significant concern for population health, impacting postoperative recovery and increasing the financial burden on patients. With an increasing number of surgical procedures being performed, the prevention and management of perioperative neurocognitive dysfunction have garnered significant attention. While factors such as age, lifestyle, genetics, and education are known to influence the development of cognitive dysfunction, recent research has highlighted the role of the gut microbiota in neurological health. An increased abundance of pro-inflammatory gut microbiota can trigger and worsen neuroinflammation, neuronal cell damage, and impaired cellular autophagy. Moreover, the inflammation-promoting gut microbiota can disrupt immune function, impair neuroautophagy, and affect the production and circulation of extracellular vesicles and neurotransmitters. These factors collectively play a role in the onset and advancement of cognitive impairment. This narrative review delves into the molecular mechanisms through which gut microbiota and their derivatives contribute to cognitive impairment, focusing on the impact of anesthesia surgery, changes in gut microbial populations, and perioperative cognitive impairment associations. The study suggests that alterations in the abundance of various bacterial species and their metabolites pre- and post-surgery may be linked to postoperative cognitive impairment. Furthermore, the potential of probiotics or prebiotics in addressing cognitive impairment is discussed, offering a promising avenue for investigating the treatment of perioperative neurocognitive disorders.

Funder

the Project of Basic Research Program of Yunnan Province

The Basic Research Plan Project of Yunnan Province

the Key Project of the Basic Research Program of Yunnan Province

the Talent Project–Famous Doctor Project of Yunnan Province

the Foreign Experts Affairs Bureau of Yunnan Province

Publisher

Springer Science and Business Media LLC

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