Investigating NeuroinflammaTion UnderlyIng Postoperative Brain Connectivity Changes, POCD, Delirium in Older Adults
| Status: | Recruiting |
|---|---|
| Conditions: | Neurology, Psychiatric |
| Therapuetic Areas: | Neurology, Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 60 - 127 |
| Updated: | 10/27/2018 |
| Start Date: | June 15, 2017 |
| End Date: | August 3, 2022 |
| Contact: | Miles Berger, MD, PhD |
| Email: | miles.berger@duke.edu |
| Phone: | 919-684-8679 |
(From NIH reporter) Each year >16 million older Americans undergo anesthesia and surgery, and
up to 40% of these patients develop postoperative cognitive dysfunction (POCD), a syndrome of
postoperative thinking and memory deficits. Although distinct from delirium, POCD (like
delirium) is associated with decreased quality of life, long term cognitive decline, early
retirement, increased mortality, and a possible increased risk for developing dementia such
as Alzheimer's disease. Understanding the etiology of POCD will likely help promote
strategies to treat and/or prevent it. A dominant theory holds that brain inflammation causes
POCD, but little work has directly tested this theory in humans. The preliminary data of this
team strongly suggest that there is significant postoperative neuro-inflammation in older
adults who develop POCD. In this K76 award, the investigators will prospectively obtain pre-
and post-operative cognitive testing, fMRI imaging and CSF samples in 200 surgical patients
over age 65. This will allow the investigators to evaluate the role of specific
neuro-inflammatory processes in POCD and its underlying brain connectivity changes.
up to 40% of these patients develop postoperative cognitive dysfunction (POCD), a syndrome of
postoperative thinking and memory deficits. Although distinct from delirium, POCD (like
delirium) is associated with decreased quality of life, long term cognitive decline, early
retirement, increased mortality, and a possible increased risk for developing dementia such
as Alzheimer's disease. Understanding the etiology of POCD will likely help promote
strategies to treat and/or prevent it. A dominant theory holds that brain inflammation causes
POCD, but little work has directly tested this theory in humans. The preliminary data of this
team strongly suggest that there is significant postoperative neuro-inflammation in older
adults who develop POCD. In this K76 award, the investigators will prospectively obtain pre-
and post-operative cognitive testing, fMRI imaging and CSF samples in 200 surgical patients
over age 65. This will allow the investigators to evaluate the role of specific
neuro-inflammatory processes in POCD and its underlying brain connectivity changes.
Each year >16 million older Americans undergo anesthesia and surgery, and up to 40% of these
patients develop postoperative cognitive dysfunction (POCD), a syndrome of postoperative
thinking and memory deficits. Although distinct from delirium, POCD (like delirium) is
associated with decreased quality of life, long term cognitive decline, early retirement,
increased mortality, and a possible increased risk for developing dementia such as
Alzheimer's disease. Understanding the etiology of POCD will likely help promote strategies
to treat and/or prevent it. A dominant theory holds that brain inflammation causes POCD, but
little work has directly tested this theory in humans. The preliminary data of this team
strongly suggest that there is significant postoperative neuro-inflammation in older adults
who develop POCD. In this K76 award, the investigators will prospectively obtain pre- and
post-operative cognitive testing, fMRI imaging and CSF samples in 200 surgical patients over
age 65. This will allow the investigators to evaluate the role of specific neuro-inflammatory
processes in POCD and its underlying brain connectivity changes.
patients develop postoperative cognitive dysfunction (POCD), a syndrome of postoperative
thinking and memory deficits. Although distinct from delirium, POCD (like delirium) is
associated with decreased quality of life, long term cognitive decline, early retirement,
increased mortality, and a possible increased risk for developing dementia such as
Alzheimer's disease. Understanding the etiology of POCD will likely help promote strategies
to treat and/or prevent it. A dominant theory holds that brain inflammation causes POCD, but
little work has directly tested this theory in humans. The preliminary data of this team
strongly suggest that there is significant postoperative neuro-inflammation in older adults
who develop POCD. In this K76 award, the investigators will prospectively obtain pre- and
post-operative cognitive testing, fMRI imaging and CSF samples in 200 surgical patients over
age 65. This will allow the investigators to evaluate the role of specific neuro-inflammatory
processes in POCD and its underlying brain connectivity changes.
Inclusion Criteria:
- Age 60 and above
- Having surgery scheduled to last > or = to 2 hours at Duke University Medical Center
(ie Duke Hospital, Duke Medicine Pavilion, Duke Regional Hospital, Durham VA, Duke
Raleigh Hospital)
Exclusion Criteria:
- Anticoagulants (per ASRA guidelines)
- Current use of chemotherapeutic agents with known cognitive effects.
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