title: Anaesthetic neurotoxicity and neuroplasticity: an expert group report and statement based on the BJA Salzburg Seminar.
abstract: Although previously considered entirely reversible, general anaesthesia is now being viewed as a potentially significant risk to cognitive performance at both extremes of age. A large body of preclinical as well as some retrospective clinical evidence suggest that exposure to general anaesthesia could be detrimental to cognitive development in young subjects, and might also contribute to accelerated cognitive decline in the elderly. A group of experts in anaesthetic neuropharmacology and neurotoxicity convened in Salzburg, Austria for the BJA Salzburg Seminar on Anaesthetic Neurotoxicity and Neuroplasticity. This focused workshop was sponsored by the British Journal of Anaesthesia to review and critically assess currently available evidence from animal and human studies, and to consider the direction of future research. It was concluded that mounting evidence from preclinical studies reveals general anaesthetics to be powerful modulators of neuronal development and function, which could contribute to detrimental behavioural outcomes. However, definitive clinical data remain elusive. Since general anaesthesia often cannot be avoided regardless of patient age, it is important to understand the complex mechanisms and effects involved in anaesthesia-induced neurotoxicity, and to develop strategies for avoiding or limiting potential brain injury through evidence-based approaches.
authors.affiliation: Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA. vj3w@hscmail.mcc.virginia.edu
authors.forename: V
authors.initials: V
authors.lastname: Jevtovic-Todorovic
authors.forename: A R
authors.initials: AR
authors.lastname: Absalom
authors.forename: K
authors.initials: K
authors.lastname: Blomgren
authors.forename: A
authors.initials: A
authors.lastname: Brambrink
authors.forename: G
authors.initials: G
authors.lastname: Crosby
authors.forename: D J
authors.initials: DJ
authors.lastname: Culley
authors.forename: G
authors.initials: G
authors.lastname: Fiskum
authors.forename: R G
authors.initials: RG
authors.lastname: Giffard
authors.forename: K F
authors.initials: KF
authors.lastname: Herold
authors.forename: A W
authors.initials: AW
authors.lastname: Loepke
authors.forename: D
authors.initials: D
authors.lastname: Ma
authors.forename: B A
authors.initials: BA
authors.lastname: Orser
authors.forename: E
authors.initials: E
authors.lastname: Planel
authors.forename: W
authors.initials: W
authors.lastname: Slikker
authors.forename: S G
authors.initials: SG
authors.lastname: Soriano
authors.forename: G
authors.initials: G
authors.lastname: Stratmann
authors.forename: L
authors.initials: L
authors.lastname: Vutskits
authors.forename: Z
authors.initials: Z
authors.lastname: Xie
authors.forename: H C
authors.initials: HC
authors.lastname: Hemmings
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000009:adverse effects*; D018681:Anesthetics, General / Q000009:adverse effects*; D000818:Animals; D001317:Austria; D001921:Brain / Q000187:drug effects*; D003072:Cognition Disorders / Q000139:chemically induced; D006801:Humans; D007223:Infant; D009473:Neuronal Plasticity / Q000187:drug effects*; D020258:Neurotoxicity Syndromes / Q000209:etiology*; D010506:Periodicals as Topic; D006113:United Kingdom
chemical_list: D018681:Anesthetics, General
keywords: anaesthesia, general; anaesthetics; cognitive disorder; neurotoxicity syndromes; postoperative complications