REVIEW article
Front. Neurosci.
Sec. Neurodegeneration
Structure and Function of the Blood–Brain Barrier in Perioperative Neurocognitive Disorders
Provisionally accepted
- 1School of Basic Medicine, Fujian Medical University, Fuzhou, China
- 2Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
- 3Fujian Provincial Hospital, Fuzhou, China
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Background: Perioperative neurocognitive disorders (PNDs) are the most common neurological complications in elderly patients undergoing surgery. Patients with PNDs have significantly greater incidences of postoperative disability and mortality. Currently, there are no specific treatments for PNDs. Methods: This review integrates the latest evidence examining the role of structural and functional changes in the blood–brain barrier (BBB) in the pathological mechanisms of PNDs, with the aim of identifying innovative preventive strategies and promising therapeutic targets for PNDs. Results: Researchers have proposed various hypotheses to shed light on the pathogenesis of PNDs, including neuroinflammation, neurotransmitter or receptor abnormalities, beta-amyloid (Aβ) deposition and tau protein phosphorylation, oxidative stress, iron homeostasis imbalance, circadian rhythm disruption, and changes in the gut microbiota. Damage to the BBB plays a critical role in the pathogenesis of PNDs. Conclusions: This article summarizes the role of BBB structural and functional changes in the pathogenesis of PNDs reported in recent studies, with the goal of providing new ideas for preventing and treating PNDs.
Keywords: Perioperative neurocognitive disorders, blood–brain barrier, Endothelial Cells, Neuroinflammation, Pathogenesis
Received: 21 Aug 2025; Accepted: 23 Oct 2025.
Copyright: © 2025 Su, Chen, Zheng, Huang, Liao, Zheng and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fei Gao, fjmugaofei@163.com
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