Kynurenine metabolism predicts cognitive function in patients following cardiac bypass and thoracic surgery

Journal of Neurochemistry

Volumn 119, Issue 1, 2011, Pages 136-152

  Forrest, Caroline M ^a   MacKay, Gillian M ^a,d   Oxford, Lynn ^a   Millar, Keith ^a   Darlington, L Gail ^b   Higgins, Michael J ^c,e   Stone, Trevor W ^a  

^a UNIVERSITY OF GLASGOW   (United Kingdom)

^b Ashtead Hospital   (United Kingdom)

^c GLASGOW ROYAL INFIRMARY   (United Kingdom)

^d CXR Biosciences Ltd   (United Kingdom)

^e GOLDEN JUBILEE NATIONAL HOSPITAL   (United Kingdom)

Author keywords

biomarkers; bypass; cognition; kynurenines; predictors of cognition; tryptophan

Indexed keywords

3 HYDROXYANTHRANILIC ACID; ACETYLSALICYLIC ACID; ANTHRANILIC ACID; INDOLEAMINE 2,3 DIOXYGENASE; KYNURENIC ACID; KYNURENINE; NEOPTERIN; NONSTEROID ANTIINFLAMMATORY AGENT; PROTEIN S100B; TRYPTOPHAN; TRYPTOPHAN 2,3 DIOXYGENASE; TUMOR NECROSIS FACTOR ALPHA;

ADULT; AGED; AORTA CLAMPING; ARTICLE; BLOOD SAMPLING; CLINICAL ARTICLE; COGNITION; CONTROLLED STUDY; CORONARY ARTERY BYPASS SURGERY; EXTRACORPOREAL CIRCULATION; FEMALE; HIGH PERFORMANCE LIQUID CHROMATOGRAPHY; HUMAN; LIPID PEROXIDATION; MALE; POSTOPERATIVE PAIN; POSTOPERATIVE PERIOD; PREDICTION; PRIORITY JOURNAL; PSYCHOLOGIC TEST; STROOP TEST; THORAX SURGERY;

ADULT; AGED; BIOLOGICAL MARKERS; CHROMATOGRAPHY, HIGH PRESSURE LIQUID; COGNITION; CORONARY ARTERY BYPASS; ENZYME-LINKED IMMUNOSORBENT ASSAY; EXTRACORPOREAL CIRCULATION; FEMALE; HUMANS; INFLAMMATION; KYNURENINE; LIPID PEROXIDATION; MALE; MIDDLE AGED; NEOPTERIN; NERVE GROWTH FACTORS; NEUROPSYCHOLOGICAL TESTS; POSTOPERATIVE COMPLICATIONS; PREDICTIVE VALUE OF TESTS; PSYCHOMOTOR PERFORMANCE; REPRODUCIBILITY OF RESULTS; S100 PROTEINS; STROOP TEST; THORACIC SURGICAL PROCEDURES; TRAIL MAKING TEST; TRYPTOPHAN; TUMOR NECROSIS FACTOR-ALPHA; VERBAL LEARNING;

EID: 80052679156     PISSN: 00223042     EISSN: 14714159     Source Type: Journal    
DOI: 10.1111/j.1471-4159.2011.07414.x     Document Type: Article

References (97)

1. Aebert H., Kirchner S., Keyser A., Birnbaum D. E., Holler E., Andreesen R., and, Eissner G., (2000) Endothelial apoptosis is induced by serum of patients after cardiopulmonary bypass. Europ. J. Cardio-Thor. Surg. 18, 589-593.
2. Agarwal R., Kalita J., Pandey S., Agarwal S. K., and, Misra U. K., (2010) Evaluation of cognitive function and P300 in patients undergoing cardiac surgery. Electromyogr. Clin. Neurophysiol. 50, 259-264.
3. Ancelin M. L., de Roquefeuil G., Scali J., Bonnel F., Adam J. F., and, Cheminal J. C., (2010) Long-term post-operative cognitive decline in the elderly: the effects of anaesthesia type, apolipoprotein E genotype, and clinical antecedents. J. Alzheimers Dis. 22 (Suppl. 3), 105-113.
4. Badawy A. A. B., (1982) Mechanisms of elevation of rat brain tryptophan concentrations by various doses of salicylate. Br. J. Pharmacol. 76, 211-213. (Pubitemid 12153494)
5. Baran H., and, Schwarcz R., (1990) Presence of 3-hydroxyanthranilic acid in rat tissues and evidence for its production from anthranilic acid in the brain. J. Neurochem. 55, 738-744.
6. Baran H., Kepplinger B., Herrera-Marschitz M., Stolze K., Lubec G., and, Nohl H., (2001) Increased kynurenic acid in the brain after neonatal asphyxia. Life Sci. 69, 1249-1256. (Pubitemid 32758695)
7. Baran H., Staniek K., Kepplinger B., Stur J., Draxler M., and, Nohl H., (2003) Kynurenines and the respiratory parameters on rat heart mitochondria. Life Sci. 72, 1103-1115. (Pubitemid 36050794)
8. Blasko I., Knaus G., Weiss E., Kemmler G., Winkler C., Falkensammer G., Greismacher A., Wurzner R., Marksteiner J., and, Fuchs D., (2007) Cognitive deterioration in Alzheimer's disease is accompanied by an increase of plasma neopterin. J. Psychiatry Res. 41, 694-701. (Pubitemid 46498100)
9. Cannazza G., Baraldi M., Braghiroli D., Tait A., and, Parenti C., (2003) High performance liquid chromatography method for the quantification of anthranilic and 3-hydroxyanthranilic acid in rat brain dialysate. J. Pharm. Biomed. Anal. 32, 287-293. (Pubitemid 36588729)
10. Cao X.-Z., Ma H., Wang J.-K., Liu F., Wu B.-Y., Tian A.-Y., Wang L.-L., and, Tan W.-F., (2010) Postoperative cognitive deficits and neuroinflammation in the hippocampus triggered by surgical trauma are exacerbated in aged rats. Prog. Neuropsychopharmacol. Biol. Psychiatry 34, 1426-1432.
11. Capuron L., Ravaud A., Nevey P. J., Miller A. H., Maes M., and, Dantzer R., (2002) Association between decreased serum tryptophan concentrations and depressive symptoms in cancer patients undergoing cytokine therapy. Mol. Psychiatry 7, 468-473. (Pubitemid 34712898)
12. Castner S. A., and, Williams G. V., (2007) Tuning the engine of cognition: a focus on NMDA/D1 receptor interactions in prefrontal cortex. Brain Cogn. 63, 94-122.
13. Clark C. J., Mackay G. M., Smythe G. A., Bustamante S., Stone T. W., and, Phillips R. S., (2005) Prolonged survival of a murine model of cerebral malaria by kynurenine pathway inhibition. Infect. Immun. 73, 5249-5251. (Pubitemid 41105691)
14. Collie A., Darby D. G., Fallet M. G., Silbert B. S., and, Maruff P., (2002) Determining the extent of cognitive change after coronary artery surgery: a review of statistical procedures. Ann. Thorac. Surg. 73, 2005-2011. (Pubitemid 34596771)
15. Cozzi A., Carpenedo R., and, Moroni F., (1999) Kynurenine hydroxylase inhibitors reduce ischemic brain damage: Studies with (m-nitrobenzoyl)-alanine (mNBA) and 3,4-dimethoxy-[-N-4-(nitrophenyl)thiazol-2YL]-benzenesulfonamide (Ro 61-8048) in models of focal or global brain ischemia. J. Cereb. Blood Flow Metab. 19, 771-777. (Pubitemid 30159803)
16. Darlington L. G., Mackay G. M., Forrest C. M., Stoy N., George C., and, Stone T. W., (2007) Altered kynurenine metabolism correlates with infarct volume in stroke. Eur. J. Neurosci. 26, 2211-2221. (Pubitemid 47620487)
17. Dieleman J., Sauer A. M., Klijn C., Nathoe H., Moons K., Kalkman C., Kappelle L., and, Van Dijk D., (2009) Presence of coronary collaterals is associated with a decreased incidence of cognitive decline after coronary artery bypass surgery. Eur. J. Cardiothorac. Surg. 35, 48-53.
18. van Dijk D., Spoor M., Hijman R., Nathoe H. M., Borst C., Jansen E. W., Grobbee D. E., de Jaegere P. P., and, Kalkman C. J., (2007) Cognitive and cardiac outcomes 5 years after off-pump vs on-pump coronary artery bypass graft surgery. J. Am. Med. Assoc. 297, 701-708. (Pubitemid 46294559)
19. van Dijk D., Moons K. G., Nathoe H. M., van Aarnhem E. H., Borst C., Keizer A. M., Kalkman C. J., and, Hijman R., (2008) Cognitive outcomes five years after not undergoing coronary artery bypass graft surgery. Ann. Thorac. Surg. 85, 60-64. (Pubitemid 350284583)
20. Eastman C. L., and, Guilarte T. R., (1989) Cytotoxicity of 3-hydroxykynurenine in a neuronal hybrid cell line. Brain Res. 495, 225-231. (Pubitemid 19213559)
21. Eastman C. L., and, Guilarte T. R., (1990) The role of hydrogen peroxide in the in vitro cytotoxicity of 3-hydroxykynurenine. Neurochem. Res. 15, 1101-1107.
22. Ernest C. S., Murphy B. M., Worcester M. U., Higgins R. O., Elliot P. C., and, Goble A. J., (2006) Cognitive function in candidates for coronary artery bypass graft surgery. Ann. Thorac. Surg. 82, 812-818.
23. Evered L. A., Silbert B. S., Scott D. A., Maruff P., Laughton K. M., and, Volitakis I., (2009) Plasma amyloid beta-42 and amyloid beta-40 levels are associated with early cognitive dysfunction after cardiac surgery. Ann. Thorac. Surg. 88, 1426-1432.
24. Forrest C. M., Mackay G. M., Stoy N., Egerton M., Christofides J., Stone T. W., and, Darlington L. G., (2004) Tryptophan loading induces oxidative stress. Free Radic. Res. 38, 1167-1171. (Pubitemid 39654505)
25. Forrest C. M., Mackay G. M., Oxford L., Stoy N., Stone T. W., and, Darlington L. G., (2006) Kynurenine pathway metabolism in patients with osteoporosis after two years of drug treatment. Clin. Exp. Pharmacol. Physiol. 33, 1078-1087. (Pubitemid 44581571)
26. Funder K. S., Steinmetz J., and, Rasmussen L. S., (2009) Cognitive dysfunction after cardiovascular surgery. Minerva Anesthesiol. 75, 329-332.
27. Giles G. I., Collins C. A., Stone T. W., and, Jacob C., (2003) Electrochemical and in vitro evaluation of the redox properties of kynurenine species. Biochem. Biophys. Res. Comm. 300, 719-724. (Pubitemid 36268896)
28. Gulyaeva N. V., Stepanichev M. Y., Onufriev M. V., Lazareva N. A., Zarzhetsky Y. V., Gurvitch A. M., and, Volkov A. V., (1996) Cardiac arrest induces decrease of nitric oxide synthase activity and increase of free radical generation in rat brain regions. Neurosci. Lett. 220, 147-150. (Pubitemid 27023598)
29. Hervé C., Beyne P., Jamault H., and, Delacoux E., (1996) Determination of tryptophan and its kynurenine pathway metabolites in human serum by HPLC with simultaneous UV and fluorimetric detection. J. Chromatogr. B Biomed. Appl. 675, 157-161. (Pubitemid 26036980)
30. Heyes M. P., Saito K., Crowley J. S., et al. (1992a) Quinolinic acid and kynurenine pathway metabolism in inflammatory and non-inflammatory neurologic disease. Brain 115, 1249-1273.
31. Heyes M. P., Brew B. J., Saito K., Quearry B. J., Price R. W., Lee K., Bhalla R. B., Der M., and, Markey S. P., (1992b) Inter-relationships between neuroactive kynurenines, neopterin and β2 microglobulin in CSF and serum of HIV-1 infected patients. J. Neuroimmunol. 40, 71-80.
32. Hilmas C., Pereira E. F. R., Alkondon M., Rassoulpour A., Schwarcz R., and, Albuquerque E. X., (2001) The brain metabolite kynurenic acid inhibits alpha 7 nicotinic receptor activity and increases non-alpha 7 nicotinic receptor expression: physiopathological implications. J. Neurosci. 21, 7463-7473. (Pubitemid 32904945)
33. Huang A., Fuchs D., Widner B., Glover C., Henderson D. C., and, Allen-Mersh T. G., (2002) Serum tryptophan decrease correlates with immune activation and impaired quality of life in colorectal cancer. Br. J. Cancer 86, 1691-1696. (Pubitemid 34712909)
34. Hudetz J. A., Patterson K. M., Byrne A. J., Pagel P. S., and, Warltier D. C., (2009) Postoperative delirium is associated with postoperative cognitive dysfunction at one week after cardiac surgery with cardiopulmonary bypass. Psychol. Rep. 105, 921-932.
35. Iwagaki H., Hizuta A., Tanaka N., and, Orita K., (1995) Decreased serum tryptophan in patients with cancer cachexia correlates with increased serum neopterin. Immunol. Invest. 24, 467-478.
36. Jonsson H., Johnsson P., Alling C., Backstrom M., Bergh C., and, Blomquist S., (1999) S100 beta after coronary artery surgery: release pattern, source of contamination, and relation to neuropsychological outcome. Ann. Thorac. Surg. 68, 2202-2208. (Pubitemid 30027850)
37. Jonsson H., Johnsson P., Backstrom M., Alling C., Dautiovio-Bergh C., and, Blomquist S., (2004) Controversial significance of early S100B levels after cardiac surgery. BMC Neurol. 4, 24.
38. Kalman J., Juhasz A., Bogats G., Babik B., Rimanoczy A., Janka Z., Penke B., and, Palotas A., (2006) Elevated levels of inflammatory biomarkers in the cerebrospinal fluid after coronary artery bypass surgery are predictors of cognitive decline. Neurochem. Int. 48, 177-180. (Pubitemid 43083620)
39. Kepplinger B., Baran H., Kainz A., Ferraz-Leite H., Newcombe J., and, Kalina P., (2005) Age-related increase of kynurenic acid in human cerebrospinal fluid-IgG and beta(2)-microglobulin changes. Neurosignals 14, 126-135. (Pubitemid 41160299)
40. Knipp S. C., Matatko N., Wilhelm H., Schlamann M., Thielmann M., Losch C., Diener H. C., and, Jakob H., (2008) Cognitive outcomes three years after coronary artery bypass surgery: relation to diffusion-weighted magnetic resonance imaging. Ann. Thorac. Surg. 85, 872-879. (Pubitemid 351260022)
41. Kohl C., Walch T., Huber R., Kemmler G., Neurater G., Fuchs D., Solder E., Schroecksnadel H., and, Sperner-Unterweger B., (2005) Measurement of tryptophan, kynurenine and neopterin in women with and without postpartum blues. J. Affect. Dis. 86, 135-142. (Pubitemid 40780025)
42. Kotani T., Kotake Y., Morisaki H., Takeda J., Shimizu H., Ueda T., and, Ishizaka A., (2006) Activation of a neutrophil-derived inflammatory response in the airways during cardiopulmonary bypass. Anesth. Analg. 103, 1394-1399. (Pubitemid 44949202)
43. Kozora E., Kongs S., Collins J. F., Hattler B., Balta J., Hampton M., Grover F. L., Novitzky D., and, Shroyer A. L., (2010) Cognitive outcomes after on- versus off-pump coronary artery bypass surgery. Ann. Thorac. Surg. 90, 1134-1141.
44. Lafayette Instrument Company (1985) Purdue Pegboard Test. Lafayette Instrument Company, Lafayette, IN, USA.
45. Liu Y. H., Wang D. X., Li L. H., et al. (2009) The effects of cardiopulmonary bypass on the number of cerebral microemboli and the incidence of cognitive dysfunction after coronary artery bypass graft surgery. Anesth. Analg. 109, 1013-1022.
46. Mackay G. M., Forrest C. M., Stoy N., Christofides J., Egerton M., Stone T. W., and, Darlington L. G., (2006) Tryptophan metabolism and oxidative stress in patients with chronic brain injury. Eur. J. Neurol. 13, 30-42.
47. Marfella A., Bilancio A., Polese C., Iodice F., Edmondo C., Cerasuolo D., Esposito G., Zannoni V., and, Beneduce G., (1999) Urinary neopterin and kynurenine in patients submitted to surgical stress with different inhalational anesthetics (halothane or isoflurane). Int. J. Immunopharmacol. 21, 423-433. (Pubitemid 29306924)
48. Mathew J. P., Podgoreanu M. V., Grocott H. P., et al. (2007) Genetic variants in P-selectin and C-reactive protein influence susceptibility to cognitive decline after cardiac surgery. J. Am. Coll. Cardiol. 49, 1934-1942. (Pubitemid 46694283)
49. McDonagh D. L., Mathew J. P., White W. D., Phillips-Bute B., Laskowitz D. T., Podgoreanu M. V., and, Newman M. F., (2010) Cognitive function after major noncardiac surgery, apolipoprotein E4 genotype, and biomarkers of brain injury. Anesthesiology 112, 852-859.
50. Millar K., Asbury A. J., and, Murray G. D., (2001) Pre-existing cognitive impairment as a factor influencing outcome after cardiac surgery. Br. J. Anaesth. 86, 63-67. (Pubitemid 32014124)
51. Monk T. G., Weldon B. C., Garvan G. W., Dede D. E., van der Aa M. T., Heilman K. M., and, Gravenstein J. S., (2008) Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology 108, 18-30.
52. Murkin J. M., Newman S. P., Stump D. A., and, Blumenthal J. A., (1995) Statement of consensus on assessment of neurobehavioural outcomes after cardiac surgery. Ann. Thorac. Surg. 59, 1289-1295.
53. Murkin J. M., Stump D. A., Blumenthal J. A., and, McKhann G., (1997) Defining dysfunction: group means versus incidence analysis-a statement of consensus. Ann. Thorac. Surg. 64, 904-905. (Pubitemid 27435734)
54. Murr C., Gerlach D., Widner B., Dierich M. P., and, Fuchs D., (2001) Neopterin production and tryptophan degradation in human infected by Streptococcus pyogenes. Med. Microbiol. Immunol. 189, 161-163. (Pubitemid 33726402)
55. Newcomer J. W., and, Krystal J. H., (2001) NMDA receptor regulation of memory and behaviour in humans. Hippocampus 11, 529-542. (Pubitemid 33100374)
56. Newman M. F., Croughwell N. D., Blumenthal J. A., et al. (1994) Effect of aging on cerebral autoregulation with postoperative cognitive dysfunction. Circulation 90, 243-249.
57. Newman S., Stygall J., Hirani S., Shaefi S., and, Maze M., (2007) Postoperative cognitive dysfunction after noncardiac sugery: a systematic review. Anaesthesiology 106, 572-590. (Pubitemid 46662224)
58. Okuda S., Nishiyama N., Saito H., and, Katsuki H., (1996) Hydrogen peroxide-mediated neuronal cell death induced by an endogenous neurotoxin, 3-hydroxykynurenine. Proc. Natl Acad. Sci. USA 93, 12553-12558. (Pubitemid 26367182)
59. Okuda S., Nishiyama N., Saito H., and, Katsuki H., (1998) 3-Hydroxykynurenine, an endogenous oxidative stress generator, causes neuronal cell death with apoptotic features and region selectivity. J. Neurochem. 70, 299-307. (Pubitemid 28020856)
60. Ouattara A., Amour J., and, Bouzguenda H., (2009) Cognitive impairment after cardiac surgery. Presse Med. 28, 1607-1612.
61. Pedersen E. R., Midttun O., Ueland P. M., et al. (2011) Systemic markers of interferon-γ-mediated immune activation and long-term prognosis in patients with stable coronary artery disease. Arteriosclerosis Thromb. Vasc. Biol. 31, 698-704.
62. Perkins M. N., and, Stone T. W., (1982) An iontophoretic investigation of the action of convulsant kynurenines and their interaction with the endogenous excitant quinolinic acid. Brain Res. 247, 184-187. (Pubitemid 12028646)
63. Pertovaara M., Raitala A., Lehtimaki T., Karhunen P. J., Oja S. S., Jylha M., Hervonen A., and, Hurme M., (2006) Indoleamine 2,3-dioxygenase activity in nonagenarians is markedly increased and predicts mortality. Mech. Ageing Dev. 127, 497-499.
64. Rodgers J., Stone T. W., Barratt M. P., Bradley B., and, Kennedy P. G., (2009) Kynurenine pathway inhibition reduces central nervous system inflammation in a model of human African trypanosomiasis. Brain 132, 1259-1267.
65. Royter V., Bornstein N. M., and, Russell D., (2005) Coronary artery bypass grafting (CABG) and cognitive decline: a review. J. Neurol. Sci. 229, 65-67. (Pubitemid 40341566)
66. Rudolph J. L., Schreiber K. A., Culley D. J., McGlinchey R. E., Crosby G., Levitsky S., and, Marcantonio E. R., (2010) Measurement of post-operative cognitive dysfunction after cardiac surgery: a systematic review. Acta Anaesthesiol. Scand. 54, 663-677.
67. Saito K., Fujigaki S., Heyes M. P., Shibata K., Takemura M., Fujii H., Wada H., Noma A., and, Seishima M., (2000) Mechanism of increases in l-kynurenine and quinolinic acid in renal insufficiency. Am. J. Physiol. Renal Physiol. 279, F565-F572.
68. Savageau J. A., Stanton B. A., Jenkins C. D., and, Klein M. D., (1982a) Neuropsychological dysfunction following elective cardiac operation.1. Early assessment. J. Thorac. Cardiovasc. Surg. 84, 585-594. (Pubitemid 14213468)
69. Savageau J. A., Stanton B. A., Jenkins C. D., and, Frater R. W. M., (1982b) Neuropsychological dysfunction following elective cardiac operation. 2. A 6-month reassessment. J. Thorac. Surg. 84, 595-600. (Pubitemid 14213469)
70. Schmidt M., (1996) Rey Auditory and Verbal Learning Test: A Handbook. Western Psychological Services, Los Angeles.
71. Schroecksnadel K., Winkler C., Fuith L. C., and, Fuchs D., (2005a) Tryptophan degradation in patients with gynaecological cancer correlates with immune activation. Cancer Lett. 223, 323-329. (Pubitemid 40719630)
72. Schroecksnadel K., Winkler C., Wirleitner B., Schennach H., and, Fuchs D., (2005b) Aspirin down-regulates tryptophan degradation in stimulated human peripheral blood mononuclear cells in vitro. Clin. Exp. Immunol. 140, 41-45. (Pubitemid 40461071)
73. Schroecksnadel K., Winkler C., Duftner C., Wirleitner B., Schirmer M., and, Fuchs D., (2006) Tryptophan degradation increases with stage in patients with rheumatoid arthritis. Clin. Rheumatol. 25, 334-337.
74. Selnes O. A., Grega M. A., Bailey M. M., Pham L. D., Zeger S. L., Baumgartner W. A., and, McKhann G. M., (2008) Cognition 6 years after surgical or medical therapy for coronary artery disease. Ann. Neurol. 63, 581-590.
75. Shaw P. J., Bates D., Cartlidge N. E. F., French J. M., Heaviside D., Julian D. G., and, Shaw D. A., (1987a) Neurologic and neuropsychological morbidity following major surgery-comparison of coronary artery bypass and peripheral vascular surgery. Stroke 18, 700-707. (Pubitemid 17093858)
76. Shaw P. J., Bates D., Cartlidge N. E. F., French J. M., Heaviside D., Julian D. G., and, Shaw D. A., (1987b) Long-term intellectual dysfunction following coronary artery bypass graft surgery-a 6-month follow-up study. Quart. J. Med. 62, 259-268. (Pubitemid 17073557)
77. Shibata K., (1988) Fluorimetric micro-determination of kynurenic acid, an endogenous blocker of neurotoxicity, by HPLC. J. Chromatogr. B Biomed. Appl. 430, 376-380.
78. Silbert B. S., Scott D. A., Evered L. A., Lewis M. S., and, Maruff P. T., (2007) Preexisting cognitive impairment in patients scheduled for elective coronary artery bypass graft surgery. Anesth. Analg. 104, 1023-1028. (Pubitemid 46649915)
79. Silbert B. S., Evered L. A., Scott D. A., and, Cowie T. F., (2008) The apolipoprotein E epsilon4 allele is not associated with cognitive dysfunction in cardiac surgery. Ann. Thorac. Surg. 86, 841-847.
80. Snyder-Ramos S. A., Gruhlke T., Bauer H., Lunta A. P., Motsch J., Martin E., Vahl C. F., Missler U., Wiessmann M., and, Bottiger B. W., (2004) Cerebral and extracerebral release of protein S100B in cardiac surgical patients. Anaesthesia 59, 344-349. (Pubitemid 38489293)
81. Steinmetz J., Funder K. S., Dahl B. T., and, Rasmussen L. S., (2010) Depth of anaesthesia and post-operative cognitive dysfunction. Acta Anaesthesiol. Scand. 54, 162-168.
82. Stone T. W., (2001) Kynurenines in the CNS-from obscurity to therapeutic importance. Prog. Neurobiol. 64, 185-218. (Pubitemid 32195412)
83. Stone T. W., (2007) Kynurenic acid blocks nicotinic synaptic transmission to hippocampal interneurons in young rats. Eur. J. Neurosci. 25, 2656-2665. (Pubitemid 46888851)
84. Stone T. W., and, Darlington L. G., (2002) Endogenous kynurenines as targets for drug discovery and development. Nat. Rev. Drug Discov. 1, 609-620. (Pubitemid 37361524)
85. Stone T. W., and, Perkins M. N., (1981) Quinolinic acid: a potent endogenous excitant at amino acid receptors in CNS. Eur. J. Pharmacol. 72, 411-412. (Pubitemid 11081065)
86. Stoy N., Mackay G. M., Forrest C. M., Christofides J., Egerton M., Stone T. W., and, Darlington L. G., (2005) Tryptophan metabolism and oxidative stress in patients with Huntington's disease. J. Neurochem. 93, 611-623. (Pubitemid 40617621)
87. Stroobant N., and, Vingerhoets G., (2009) Pre-existing cognitive impairment in candidates for cardiac surgery: an overview. Heart 95, 1820-1825.
88. Svenmarker S., Sandstrom E., Karlsson T., and, Aberg T., (2002) Is there an association between release of protein S100B during cardiopulmonary bypass and memory disturbances? Scand. Cardiovasc. J. 36, 117-122. (Pubitemid 34578432)
89. Sweet J. J., Finnin E., Wolfe P. L., Beaumont J. L., Hahn E., Marymont J., Sanborn T., and, Rosengart T. K., (2008) Absence of cognitive decline one year after coronary artery bypass surgery: comparison to nonsurgical and healthy controls. Ann. Thorac. Surg. 85, 1571-1578. (Pubitemid 351621916)
90. Tagarakis G. I., Tsolaki-Tagaraki F., Tsolaki M., Diegeler A., Tsilimingas N. B., and, Papassotiropoulos A., (2007) The role of apolipoprotein E in cognitive decline and delirium after bypass heart operations. Am. J. Alzheimers Dis. Other Demen. 22, 223-228. (Pubitemid 47025522)
91. Trenerry M. R., Crosson B., DeBoe J., and, Leber W. R., (1989) Stroop Neuropsychological Screening Test. Psychological Assessment Resources, Odessa, FL.
92. Wan Y., Xu J., Meng F., et al. (2010) Cognitive decline following major surgery is associated with gliosis, β-amyloid accumulation and τ phosphorylation in old mice. Crit. Care Med. 38, 2190-2198.
93. Werner E. R., Werner-Felmayer G., Fuchs D., Hausen A., Reibnegger G., and, Wachter H., (1989) Parallel induction of tetrahydrobiopterin biosynthesis and indoleamine 2,3-dioxygenase activity in human cell lines by interferon-gamma. Biochem. J. 262, 861-866. (Pubitemid 19225160)
94. Westaby S., Saatvedt K., White S., Katsumata T., van Oeveren W., Bhatnagar N. K., Brown S., and, Halligan P. W., (2000) Is there a relationship between serum S-100 beta protein and neuropsychologic dysfunction after cardiopulmonary bypass? J. Thorac. Cardiovasc. Surg. 119, 132-137. (Pubitemid 30046324)
95. Widner B., Leblhuber F., Walli J., Tilz G. P., Demel U., and, Fuchs D., (2000) Tryptophan degradation and immune activation in Alzheimer's disease. J. Neural Transm. 107, 343-353. (Pubitemid 30162696)
96. Widner B., Leblhuber F., and, Fuchs D., (2002) Increased neopterin and tryptophan degradation in advanced Parkinson's disease. J. Neural Transm. 109, 181-189. (Pubitemid 34185664)
97. Zaitseva T., Schears G., Schultz S., Creed J., Antoni D., Wilson D. F., and, Pastusszko A., (2005) Circulatory arrest and low-flow cardiopulmonary bypass alter CREB phosphorylation in piglet brain. Ann. Thorac. Surg. 80, 245-250. (Pubitemid 40840217)