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Neurocognitive Recovery following Surgery and General Anesthesia

手术和全身麻醉后的神经认知恢复

基本信息

批准号：
10218208
负责人：
Phillip Eleas Vlisides
金额：
$ 18.96万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-01 至 2023-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10218208
关键词：
Address Agitation Anesthesia procedures Anesthesiology Anesthetics Behavior Therapy Biological Markers Brain Cardiac Surgery procedures Caring Cerebrovascular Circulation Cerebrovascular Disorders Cerebrum Clinical Clinical Trials Clinical Trials Design Cognitive Conscious Data Delirium Education Evaluation Event Exercise Foundations Frequencies Functional disorder Future General Anesthesia Goals Hypoxemia Impaired cognition Impairment Incidence Infrastructure Intervention Investigation Lead Learning Measures Mentored Patient-Oriented Research Career Development Award Mentorship Methods Michigan Monitor Multicenter Trials Neurobiology Neurocognitive Neurocognitive Deficit Neurologic Neurological outcome Neuropsychology Neurosciences Neurosciences Research Observational Study Operative Surgical Procedures Oxygen saturation measurement Parietal Patients Pattern Perioperative Perioperative complication Phenotype Physiological Population Positioning Attribute Postoperative Period Recovery Recovery Room Research Research Methodology Research Personnel Research Technics Risk Factors Scalp structure Standardization Statistical Methods Structure Techniques Technology Testing Training United States Universities Wireless Technology base brain abnormalities brain health candidate marker cerebral oxygenation cognitive function cognitive neuroscience cognitive recovery cognitive testing cognitive training comorbidity design efficacy testing functional decline high risk improved ischemic injury medical schools mortality neural correlate neurophysiology novel novel strategies older patient postoperative delirium postoperative recovery preservation prevent professor programs public health relevance relating to nervous system risk minimization skills

项目摘要

PROJECT SUMMARY / ABSTRACT The proposed K23 program will allow Dr. Phillip E. Vlisides, an Assistant Professor of Anesthesiology at the University of Michigan Medical School, to establish an independent program of clinical neuroscience research that seeks to better understand and improve neurocognitive recovery following surgery and anesthesia. Based on emerging preliminary data, the central hypothesis is that distinct neurophysiologic patterns in the perioperative setting will predict postoperative neurocognitive recovery. To test this hypothesis, we propose an observational study to explore candidate neural biomarkers that may correlate with postoperative neurocognitive trajectory (Aims 1 and 2) followed by a clinical trial to test a behavioral intervention, cognitive prehabilitation, for improving postoperative neurocognitive function (Aim 3). Specific Aim 1 is to characterize perioperative whole-scalp electroencephalographic (EEG) patterns in relation to postoperative recovery. We hypothesize that posterior EEG alpha power and frontal-parietal connectivity, analyzed in the postanesthesia care unit, will correlate with postoperative cognitive function. The candidate will learn advanced techniques of EEG acquisition and analysis that will be critical for designing such neurophysiologic studies in clinical neuroscience. Specific Aim 2 is to measure perioperative regional cerebral oximetry (rSO2) in relation to advanced EEG patterns and cognitive recovery. We hypothesize that postoperative cerebral oximetry values will correlate with cognitive function after major surgery. In addition to the neurophysiologic training described, the candidate will receive education in cognitive testing and neuropsychology so that he can conduct sophisticated neurologic phenotyping of surgical patients. Lastly, Specific Aim 3 is to test the efficacy of cognitive prehabilitation on postoperative neurocognitive function. We hypothesize that preoperative cognitive prehabilitation (i.e., “brain training”) will improve neurocognitive function in the postoperative period. For this last aim, the candidate will train in advanced clinical trial design and conduct in order to obtain the necessary skills to independently lead multicenter trials in the future. With this proposal, the candidate will be trained in cutting edge neuroscience research methods (e.g., advanced EEG techniques, calibrated cognitive function testing) and clinical trial design and conduct. He will thus be poised to lead large-scale efforts for better understanding and improving brain health in surgical patients.

项目概要/摘要拟议的 K23 项目将允许麻醉学助理教授 Phillip E. Vlisides 博士密歇根大学医学院，建立临床神经科学研究的独立项目旨在更好地了解和改善手术和麻醉后的神经认知恢复。基于根据新出现的初步数据，中心假设是不同的神经生理模式围手术期环境将预测术后神经认知恢复。为了检验这个假设，我们提出了一个观察性研究，探索可能与术后相关的候选神经生物标志物神经认知轨迹（目标 1 和 2），然后进行临床试验来测试行为干预、认知预康复，以改善术后神经认知功能（目标 3）。具体目标 1 是表征围手术期全头皮脑电图（EEG）模式与术后恢复的关系。我们假设在麻醉后分析后脑电图α功率和额顶叶连接护理单位，将与术后认知功能相关。候选人将学习以下先进技术脑电图采集和分析对于临床设计此类神经生理学研究至关重要神经科学。具体目标 2 是测量围手术期局部脑血氧饱和度 (rSO2) 先进的脑电图模式和认知恢复。我们假设术后脑血氧饱和度值与大手术后的认知功能相关。除了所描述的神经生理学训练之外，候选人将接受认知测试和神经心理学方面的教育，以便他能够进行手术患者的复杂神经表型分析。最后，具体目标 3 是测试效果认知预康复对术后神经认知功能的影响。我们假设术前认知预康复（即“大脑训练”）将改善术后的神经认知功能。为了这最后一个目标是，候选人将接受高级临床试验设计和实施方面的培训，以获得必要的资格未来独立领导多中心试验的技能。根据该提案，候选人将接受以下方面的培训：最前沿的神经科学研究方法（例如先进的脑电图技术、校准的认知功能测试）以及临床试验的设计和实施。因此，他将准备好领导大规模的努力，以实现更好的目标。了解和改善手术患者的大脑健康。

项目成果

期刊论文数量（8）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Patient perspectives on delirium and cognitive dysfunction after surgery: a cross-sectional survey.

DOI：
10.1016/j.bja.2021.12.047
发表时间：
2022-01
期刊：
British journal of anaesthesia
影响因子：
9.8
作者：
J. Ragheb;Nabi Khatibi;Amy M. McKinney;J. Brooks;Maria Hill-Carruthers;P. Vlisides
通讯作者：
J. Ragheb;Nabi Khatibi;Amy M. McKinney;J. Brooks;Maria Hill-Carruthers;P. Vlisides

Perioperative neuroscience: a framework for clinical and scientific advancement.

围手术期神经科学：临床和科学进步的框架。