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Excitation-inhibition imbalance underlies perioperative neurocognitive disorders: a single-nucleus transcriptomic perspective in mice hippocampus.

Molecular psychiatry2026-07-23PubMed
Total: 82.5Innovation: 8Impact: 0Rigor: 0Citation: 0

Summary

Single-nucleus RNA-seq of 119,109 hippocampal cells from aged mouse PND models revealed excitation–inhibition imbalance with impaired inhibitory control of excitatory plasticity. Distinct astrocyte and oligodendrocyte states linked to E/I imbalance were identified, suggesting multicellular contributions to PND pathogenesis.

Key Findings

  • Single-nucleus RNA-seq (119,109 cells) from aged mouse hippocampus shows E/I imbalance with dysregulated inhibitory control of excitatory plasticity in PND.
  • Distinct PND-associated astrocyte and oligodendrocyte phenotypes—different from other cognitive disorders—link glial states to E/I imbalance.
  • Electrophysiology and protein assays support transcriptomic findings, indicating convergent mechanistic evidence.

Clinical Implications

Motivates perioperative strategies to preserve inhibitory tone and synaptic balance (e.g., choice/dose of anesthetics, analgesics), and development of E/I-targeted therapeutics and biomarkers for cognitive risk stratification.

Why It Matters

Defines a cellular–molecular framework for PND centered on E/I imbalance, guiding biomarker discovery and mechanism-based interventions relevant to anesthesiology.

Limitations

  • Mouse-based model without human validation in this study
  • Causality for specific cellular targets remains to be established in vivo

Future Directions

Translate signatures to human perioperative cohorts; test interventions restoring E/I balance (e.g., GABAergic modulators) and evaluate anesthetic regimens for cognitive protection.

Study Information

Study Type
Basic/Mechanistic research
Research Domain
Pathophysiology
Evidence Level
V - Preclinical mechanistic evidence from animal models with supportive physiology and protein assays
Study Design
OTHER