Extracellular vesicle signalling in perioperative neurocognitive disorders
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By
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Jian Li
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Min Yu
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June 2, 2026
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Clinical Scorecard: Signaling of Extracellular Vesicles in Neurocognitive Disorders Following Surgery
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Systemic inflammation, neurovascular dysfunction, blood-brain barrier injury, glial activation, innate immune signalling, synaptic injury, neurotransmitter dysregulation |
| Target Population | |
| Care Setting | |
Key Highlights
- EVs may serve as a mechanistic link between surgical injury and brain dysfunction.
- Clinical studies link EV cargo to postoperative cognitive outcomes.
- EVs are involved in intercellular communication and may reflect the state of donor cells.
- The biological burden of surgery varies by procedure type, influencing PND risk.
- EVs may connect peripheral injury to brain dysfunction.
Guideline-Based Recommendations
Diagnosis
- Assess cognitive changes pre-surgery, immediately post-surgery, and weeks to months later.
Management
- Consider the heterogeneity of PND when developing treatment strategies.
Monitoring & Follow-up
- Monitor for signs of postoperative delirium and cognitive decline in vulnerable populations.
Risks
- Older age, frailty, baseline cognitive vulnerability, vascular comorbidity, and systemic inflammation increase susceptibility to PND.
Patient & Prescribing Data
Older surgical patients with varying degrees of cognitive vulnerability.
Current evidence suggests a multifactorial approach to managing PND.
Clinical Best Practices
- Utilize a phenotype-defined and time-aware framework for interpreting PND findings.
- Incorporate EV research into perioperative studies to enhance understanding of PND mechanisms.
- Integrate EV research into clinical protocols for PND.
Related Resources & Content
