Background: The pathogenesis of postoperative delirium is largely unknown. The primary objective of this study is to assess whether increased levels of monocyte chemoattractant protein-1 (MCP-1) and high-sensitivity C-reactive protein (hsCRP) are associated with postoperative delirium in patients who have undergone cardiac surgery. The secondary objective is to investigate whether any association between raised inflammatory biomarkers levels and delirium is related to surgical and anesthetic procedures or mediated by pre-existing psychiatric conditions associated with raised pro-inflammatory markers levels. Methods: The patients were screened for cognitive impairment one day preoperatively with the use of the Mini-Mental State Examination Test and the Clock Drawing Test. A diagnosis of major depressive disorder (MDD) and anxiety disorders was established on the basis of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Blood samples were collected pre- and postoperatively for hsCRP and chemokine levels. Results: Postoperative delirium developed in 34% (61 of 177) of patients. Both pre- and postoperative hsCRP, and preoperative MCP-1 levels were associated with postoperative delirium in univariate comparisons; p = 0.001; p < 0.001; p < 0.001, respectively. However, according to a multivariable logistic regression analysis, only a raised MCP-1 concentration before surgery was independently associated with postoperative delirium, and related to advancing age, preoperative anxiety disorders and prolonged intubation. Conclusions: The present study suggests that an elevated preoperative MCP-1 concentration is associated with delirium after cardiac surgery. Monitoring of this inflammatory marker may reveal the cardiovascular disease (CVD) patients who are at risk of neuropsychiatric syndromes development.
Background: Photobiomodulation (PBM), also referred to as low-level light therapy (LLLT), is an emerging non-pharmacological approach. This treatment is considered low-risk, cost-effective, and non-invasive, utilizing near-infrared light (NIR). The purpose of this paper is to explore the underlying mechanism of action and conduct a systematic review of pre-clinical and clinical research on the use of PBM for psychiatric disorders. Methods: A search on the PubMed, Cochrane Library, and EMBASE databases was performed on 18 and 26 January 2024. Publications focused on PBM treatment in psychiatric disorders such as major depressive disorder, general anxiety disorder, dementia, Parkinson’s disease, traumatic brain injury, schizophrenia, and sexual disfunctions were included (n = 23). Results: Near-infrared stimulation is presented as an effective method, comparable to psychopharmacological treatment. The primary suggested mechanism for PBM is the stimulation of mitochondrial metabolism following the absorption of NIR energy by cytochrome C oxidase. Because of the method of implementation, which omits the liver metabolism of cytochrome P450, PMB is recognized as safe as it does not interact with other drugs. Limitations: Clinical studies vary in terms of population and treatment parameters, and most do not include a suitable control group. Conclusions: Preliminary results support the potential of NIR stimulation as a novel and innovative treatment for psychiatry. Further studies are needed to estimate the proper protocols of parameters singly for any disease.