The INTUIT Study: Investigating Neuroinflammation Underlying Postoperative Cognitive Dysfunction.

Berger, Miles

Oyeyemi, Deborah

Olurinde, Mobolaji O

Whitson, Heather E

Weinhold, Kent J

Woldorff, Marty G

Lipsitz, Lewis A

Moretti, Eugene

Giattino, Charles M

Roberts, Kenneth C

Zhou, Junhong

Bunning, Thomas

Ferrandino, Michael

Scheri, Randall P

Cooter, Mary

Chan, Cliburn

Cabeza, Roberto

Browndyke, Jeffrey N

Murdoch, David M

Devinney, Michael J

Shaw, Leslie M

Cohen, Harvey Jay

Mathew, Joseph P

INTUIT Investigators

2019-02-01T14:59:18Z

2019-02-01T14:59:18Z

2019-01-23

2019-02-01T14:59:17Z

BACKGROUND/OBJECTIVES:Every year, up to 40% of the more than 16 million older Americans who undergo anesthesia/surgery develop postoperative cognitive dysfunction (POCD) or delirium. Each of these distinct syndromes is associated with decreased quality of life, increased mortality, and a possible increased risk of Alzheimer's disease. One pathologic process hypothesized to underlie both delirium and POCD is neuroinflammation. The INTUIT study described here will determine the extent to which postoperative increases in cerebrospinal fluid (CSF) monocyte chemoattractant protein 1 (MCP-1) levels and monocyte numbers are associated with delirium and/or POCD and their underlying brain connectivity changes. DESIGN:Observational prospective cohort. SETTING:Duke University Medical Center, Duke Regional Hospital, and Duke Raleigh Hospital. PARTICIPANTS:Patients 60 years of age or older (N = 200) undergoing noncardiac/nonneurologic surgery. MEASUREMENTS:Participants will undergo cognitive testing before, 6 weeks, and 1 year after surgery. Delirium screening will be performed on postoperative days 1 to 5. Blood and CSF samples are obtained before surgery, and 24 hours, 6 weeks, and 1 year after surgery. CSF MCP-1 levels are measured by enzyme-linked immunosorbent assay, and CSF monocytes are assessed by flow cytometry. Half the patients will also undergo pre- and postoperative functional magnetic resonance imaging scans. 32-channel intraoperative electroencephalogram (EEG) recordings will be performed to identify intraoperative EEG correlates of neuroinflammation and/or postoperative cognitive resilience. Eighty patients will also undergo home sleep apnea testing to determine the relationships between sleep apnea severity, neuroinflammation, and impaired postoperative cognition. Additional assessments will help evaluate relationships between delirium, POCD, and other geriatric syndromes. CONCLUSION:INTUIT will use a transdisciplinary approach to study the role of neuroinflammation in postoperative delirium and cognitive dysfunction and their associated functional brain connectivity changes, and it may identify novel targets for treating and/or preventing delirium and POCD and their sequelae.

0002-8614

1532-5415

https://hdl.handle.net/10161/17958

eng

Wiley

Journal of the American Geriatrics Society

10.1111/jgs.15770

and the INTUIT Investigators

The INTUIT Study: Investigating Neuroinflammation Underlying Postoperative Cognitive Dysfunction.

Journal article

Berger, Miles|0000-0002-2386-5061

Whitson, Heather E|0000-0002-8417-4846

Woldorff, Marty G|0000-0002-2683-4551

Ferrandino, Michael|0000-0002-5097-0318

Chan, Cliburn|0000-0001-5901-6806

Cabeza, Roberto|0000-0001-7999-1182

Browndyke, Jeffrey N|0000-0002-8573-7073

Murdoch, David M|0000-0001-7201-7950

Devinney, Michael J|0000-0003-3906-6421

Mathew, Joseph P|0000-0002-3815-4131

School of Medicine

Duke

Duke-UNC Center for Brain Imaging and Analysis

Institutes and Centers

Duke Institute for Brain Sciences

University Institutes and Centers

Institutes and Provost's Academic Units

Psychiatry & Behavioral Sciences, Geriatric Behavioral Health

Psychiatry & Behavioral Sciences

Clinical Science Departments

Published