Kynurenine metabolism predicts cognitive function in patients following cardiac bypass and thoracic surgery

Forrest, C.M., Mackay, G.M., Oxford, L., Millar, K., Gail Darlington, L., Higgins, M. and Stone, T.W. (2011) Kynurenine metabolism predicts cognitive function in patients following cardiac bypass and thoracic surgery. Journal of Neurochemistry, 119(1), pp. 136-152. (doi: 10.1111/j.1471-4159.2011.07414.x)

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Publisher's URL: http://dx.doi.org/10.1111/j.1471-4159.2011.07414.x

Abstract

ABSTRACT Cardiac surgery involving extra-corporeal circulation can lead to cognitive dysfunction. Since such surgery is associated with signs of inflammation and pro-inflammatory mediators activate tryptophan oxidation to neuroactive kynurenines which modulate NMDA receptor function and oxidative stress, we have measured blood concentrations of kynurenines and inflammatory markers in 28 patients undergoing coronary arterial graft surgery and, for comparison, 28 patients undergoing non-bypass thoracic surgery. A battery of cognitive tests was completed before and after the operations. The results show increased levels of tryptophan with decreased levels of kynurenine, anthranilic acid and 3-hydroxyanthranilic acid associated with bypass, and a later increase in kynurenic acid. Levels of neopterin and lipid peroxidation products rose after surgery in non-bypass patients whereas TNF-+¦ and S100B levels increased after bypass. Changes of neopterin levels were greater after non-bypass surgery. Cognitive testing showed that the levels of tryptophan, kynurenine, kynurenic acid and the kynurenine / tryptophan ratio, correlated with aspects of post-surgery cognitive function, and were significant predictors of cognitive performance in tasks sensitive to frontal executive function and memory. Thus, anaesthesia and major surgery are associated with inflammatory changes and alterations in tryptophan oxidative metabolism which predict, and may play a role in, post-surgical cognitive function

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Forrest, Dr Caroline and Millar, Professor Keith and Mackay, Ms Gillian and Oxford, Ms Lynn and Stone, Professor Trevor
Authors: Forrest, C.M., Mackay, G.M., Oxford, L., Millar, K., Gail Darlington, L., Higgins, M., and Stone, T.W.
College/School:College of Medical Veterinary and Life Sciences > Institute of Neuroscience and Psychology
Journal Name:Journal of Neurochemistry
ISSN:0022-3042

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