Miles Berger, MD, PhD, Medical Instructor in the Otolaryngology, Head, Neck, and Neuroanesthesiology Division was awarded a two-year $150,000 International Anesthesia Research Society Mentored Research Award entitled “The trajectory and significance of perioperative changes in AD biomarkers”.
Multiple independent laboratories have used cell culture studies, biochemical assays and animal models to show that surgical exposure and anesthetic drugs can accelerate Alzheimer’s Disease pathology. In particular, surgical exposure and/or anesthetic drugs have been shown to increase the levels of amyloid beta and tau, two key proteins thought to play key roles in causing Alzheimer’s Disease. Furthermore, surgery and anesthesia have been associated with post-operative delirium and cognitive impairments in some of our patients. It is less clear, however, whether surgery and/or anesthesia actually promote Alzheimer’s disease pathology in our patients, and whether such effects might explain part of the post-operative delirium and/or cognitive impairments seen in some patients. Our preliminary results show that cerebrospinal fluid (CSF) tau levels increase significantly within the first day after surgery and anesthesia in a subset of patients. In this research study, we propose to assess the long term trajectory of these CSF tau increases, and to determine whether these tau increases are associated with post- operative delirium and/or cognitive trajectory. Furthermore, we will use in vivo neuroimaging to determine whether perioperative CSF tau increases are associated with altered functional brain connectivity after anesthesia and surgery. These studies will help provide a translational framework to determine how anesthesia and surgery affect Alzheimer’s Disease pathology in the human brain, and/or whether such affects correlate with post-operative delirium and cognitive trajectory.