Esketamine Prevents Postoperative Emotional and Cognitive Dysfunction by Suppressing Microglial M1 Polarization and Regulating the BDNF-TrkB Pathway in Ageing Rats with Preoperative Sleep Disturbance
Molecular Neurobiology January 15, 2024 Yuxin Wen, Jiawen Xu, Jiahong Shen et al. 57 citations
Sleep disturbance before surgery worsens postoperative depression and cognitive dysfunction by promoting microglial M1 polarization and disrupting BDNF-TrkB signaling in the brain, leading to emotional changes and cognitive impairments. Treatment with esketamine, the S-enantiomer of ketamine, reversed these behavioral abnormalities by inhibiting microglial M1 polarization and the inflammatory response, thereby improving BDNF-TrkB signaling both in living organisms and in cell cultures. Esketamine also restored impaired hippocampal synaptic plasticity caused by sleep disturbance and surgery. These results suggest that preoperative sleep disruption contributes to postoperative brain complications through inflammatory and neurotrophic mechanisms, and esketamine may offer a protective intervention.