Correlations of plasma concentrations of β-amyloid peptide and S-100β with postoperative cognitive dysfunction in patients undergoing oral and maxillofacial cancer surgery

Abstract

Abstract: PURPOSE: To evaluate the changes of perioperative plasma concentrations of Aβ_1-40 and S-100β to determine the relationship with postoperative cognitive dysfunction in elderly patients undergoing oral and maxillofacial cancer surgeries. METHODS: One hundred and fifteen patients aged at least 60 years undergoing oral and maxillofacial tumor resection were investigated between May 2014 to December 2014.Neuropsychological tests for detecting postoperative cognitive dysfunction(POCD) were performed one day before surgery and 7 days postoperatively. According to the results of neuropsychological tests on day 7, patients were divided into POCD group and non-POCD group.Plasma values of Aβ_1-40 and S-100β were determined with enzyme linked immunosorbent assay (ELISA) before anesthesia induction, 24 h and 7 days after surgery. The data were analyzed using SPSS 19.0 software package. RESULTS: According to the definition, POCD was present in 37 of 115 (32.3%) patients 1 week after surgery. Compared with pre-anesthesia, S-100β levels in POCD group were significantly increased (P<0.05); the level of Aβ_1-40 was significantly higher 24 h after surgery (P<0.05). Compared with non-POCD group, S-100β levels were significantly increased 24 h postoperatively (P<0.05); Aβ_1-40 levels were significantly higher 24 h and 7 days postoperatively (P<0.05). CONCLUSIONS: POCD was present in 32.2% of patients on day 7 after oral and maxillofacial surgeries with general anesthesia. The increasing levels of Aβ_1-40, S-100β may be associated with the occurence of POCD. Patients with long-lasting operation and high concentrations of Aβ_1-40 and S-100β after surgeries were at a higher risk of POCD. The clinical values of Aβ_1-40 and S-100 as predictive measurements of POCD after oral and maxillofacial cancer surgery appear to be reasonable.

Key words: Oral and maxillofacial cancer surgery, Postoperative cognitive dysfunction, Aβ, 1-40, S-100β

CLC Number:

R739.8

LIANG Bing, SUN Yuan-qing, JIANG Jue, XU Hui. Correlations of plasma concentrations of β-amyloid peptide and S-100β with postoperative cognitive dysfunction in patients undergoing oral and maxillofacial cancer surgery[J]. Shanghai Journal of Stomatology, 2016, 25(6): 707-710.

References

[1] Abildstrom H, Rasmussen LS, Rentowl P, et al. Cognitive dysfunction 1-2 years after non-cardiac surgery in the elderly. ISPOCD group. International Study of Post-Operative Cognitive Dysfunction[J]. Acta Anaesthesiol Scand, 2000, 44(10): 1246-1251.
[2] Li YC, Xi CH, An YF, et al. Perioperative inflammatory response and protein S-100β concentrations-relationship with post-operative cognitive dysfunction in elderly patients[J]. Acta Anaesthesiol Scand, 2012, 56(5): 595-600.
[3] Linstedt U, Meyer O, Kropp P, et al. Serum concentration of S-100 protein in assessment of cognitive dysfunction after general anesthesia in different types of surgery[J]. Acta Anaesthesiol Scand, 2002, 46(4): 384-389.
[4] Wan Y, Xu J, Meng F, et al. Cognitive decline following major surgery is associated with gliosis, beta-amyloid accumulation, and phosphorylation in old mice [J]. Crit Care Med, 2010, 38(11): 2190-2198.
[5] 张明圆. 简明精神病量表(BPRS) [J].上海精神医学, 1984, 25(2): 58-60.
[6] 龚耀先. 中国修订韦氏成人智力量表手册[M]. 长沙: 湖南地图出版社, 1992.
[7] Moller JT, Cluitmans P, Rasmussen LS, et al. Long-term postoperative cognitive dysfunction in the elderly ISPOCD study. ISPOCD investigators. International Study of Postoperative Cognitive Dysfunction [J]. Lancet, 1998, 351(9106): 857-861.
[8] Fodale V, Santamaria LB, Schifilliti D, et al. Anaesthetics and postoperative cognitive dysfunction: a pathological mechanism mimicking Alzheimer's disease[J]. Anaesthesia, 2010, 65(4): 388-395.
[9] Bittner EA, Yue Y, Xie Z. Brief review: anesthetic neurotoxicity in the elderly, cognitive dysfunction and Alzheimer's disease [J]. Can J Anaesth, 2011, 58(2): 216-223.
[10] Xie Z, Culley DJ, Dong Y, et al. The common inhalation anesthetic isoflurane induces caspase activation and increases amyloid beta-protein level in vivo [J]. Ann Neurol, 2008, 64(6): 618-627.
[11] Xie Z, Dong Y, Maeda U, et al. The common inhalation anesthetic isoflurane induces apoptosis and increases amyloid beta protein levels [J]. Anesthesiology, 2006, 104(5): 988-994.
[12] Zhang B, Tian M, Zheng H, et al. Effects of anesthetic isoflurane and desflurane on human cerebrospinal fluid Aβ and τ level [J]. Anesthesiology, 2013, 119(1): 52-60.
[13] Mercier E, Boutin A, Lauzier F, et al. Predictive value of S-100β protein for prognosis in patients with moderate and severe traumatic brain injury: systematic review and meta-analysis [J]. BMJ, 2013, 346(4): f1757.
[14] van Boven WJ, Morariu A, Salzberg SP, et al. Impact of different surgical strategies on perioperative protein S-100β release in elderly patients undergoing coronary artery bypass grafting [J]. Innovations (Phila), 2013, 8(3): 230-236.
[15] Shi LH, Zhou Y, Guo MF, et al. Serum levels of S-100β correlate with the clinical status and severity of hypoxic-ischemic encephalopathy in neonates [J].Genet Mol Res, 2015, 14(4): 14760-14771.
[16] Petrova TV, Hu J, Van Eldik LJ. Modulation of glial activation by astrocyte-derived protein S100β: differential responses of astrocyte and microglial cultures [J]. Brain Res, 2000, 853(1): 74-80.
[17] Jönsson H, Johnsson P, Bäckström M, et al. Controversial significance of early S100β levels after cardiac surgery[J]. BMC Neurol, 2004, 4(1): 24.