# Commentary: Early-in-life Isoflurane Exposure Alters Resting-State Functional Connectivity in Juvenile Non-human Primates - a Role for Neuroinflammation?

## TL;DR

Early exposure to isoflurane in non-human primates may lead to brain connectivity changes and behavioral issues, possibly linked to neuroinflammation.

## Contribution

Highlights a potential mechanism involving neuroinflammation and altered brain connectivity in anesthesia-induced developmental neurotoxicity.

## Key findings

- Chronic astrogliosis in the amygdala correlates with altered brain connectivity in juvenile NHPs.
- Altered connectivity is associated with behavioral impairments following early anesthesia exposure.
- Findings suggest a possible role for neuroinflammation in developmental neurotoxicity.

## Abstract

The concern about anesthesia-induced developmental neurotoxicity (AIDN) in infants and young children arises from animal studies indicating potential long-term neurobehavioral impairments following early-in-life anesthesia exposure. While initial clinical studies provided ambiguous results, recent prospective assessments in children indicate associations between early-in-life anesthesia exposure and later behavioral alterations. Ethical constraints and confounding factors in clinical studies pose challenges in establishing a direct causal link and in investigating its mechanisms. This commentary on a recent study in non-human primates (NHPs) focuses on exploring the role of neuroinflammation and alterations in brain functional connectivity in the behavioral impairments following early-in-life anesthesia exposure. In juvenile NHPs, chronic astrogliosis in the amygdala correlates with alterations in functional connectivity between this area with other regions of the brain and with the behavioral impairments, suggesting a potential mechanism for AIDN. Despite acknowledging the study’s limitations, these findings emphasize the need for further research with larger cohorts to confirm these associations and to establish a causal link between the neuroinflammation and the behavioral alterations associated with early-in-life anesthesia exposure.