Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients.
Open medicine (Warsaw, Poland) – January 01, 2025
Source: PubMed
Summary
A promising breakthrough shows that low doses of esketamine may protect brain function in elderly stroke patients. When administered during treatment, this medication reduced inflammation markers and improved cognitive scores on standard mental tests (MMSE). The research tracked 120 patients, finding that those receiving esketamine showed better mental function and lower levels of inflammatory proteins, including NLRP3, after their procedures. This suggests a new way to prevent cognitive decline in stroke patients.
Abstract
This study investigates the effects of subclinical doses of esketamine on serum NLRP3 levels and early cognitive dysfunction in elderly ischemic stroke patients after neurointerventional procedures under general anesthesia. A prospective cohort study included 120 elderly ischemic stroke patients undergoing general anesthesia from January 2022 to September 2023. The esketamine group received 0.25 mg/kg of esketamine. Serum levels of NLRP3, C-reactive protein, interleukin-6 (IL-6), IL-1β, and IL-17 were measured before surgery and 24 h postoperatively. Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE). At 24 h postoperatively, the esketamine group had significantly higher MMSE scores (p < 0.05) and lower serum levels of NLRP3, IL-17, and IL-6. Pearson's correlation showed a link between NLRP3 levels and cognitive outcomes. Logistic regression identified heart rate, mean arterial pressure, preoperative NLRP3, IL-6, IL-17, and esketamine treatment as risk factors for cognitive dysfunction. Subclinical doses of esketamine might reduce postoperative cognitive dysfunction risk and offer neuroprotection, presenting potential therapeutic options for elderly ischemic stroke patients.