Basic cellular and molecular mechanisms of anesthetic-induced developmental neurotoxicity: Potential strategies for alleviation

Abstract

There is an increasing concern regarding the risk of anesthetic-induced developmental neurotoxicity (AIDN) in children. Evidence has shown that exposure to most of the commonly used anaesthetic and sedatives can cause neurodegeneration in the developing brain. Anesthetic effects on the brain during its growth spurt can initiate a cascade of alterations in neurodevelopment, which can be detected structurally or functionally. Anesthetic exposure induces apoptosis and neurodegeneration in a dose and time-dependent fashion consistent with the pattern of N-methyl D-aspartate antagonism and gamma-amino butyric acid type A activation by these drugs. Understanding the cellular and molecular mechanisms of AIDN may help in developing methods that are safe and do not interfere with the beneficial properties of anaesthetic drugs and yet inactivate the intracellular signals that trigger neuroapoptosis.