Caffeine and Postoperative Neurocognitive Recovery
咖啡因与术后神经认知恢复
基本信息
- 批准号:10517443
- 负责人:
- 金额:$ 57.37万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-08-02 至 2027-04-30
- 项目状态:未结题
- 来源:
- 关键词:AcetylcholineAcuteAffectAlzheimer&aposs DiseaseAlzheimer&aposs disease related dementiaAnestheticsAreaArousalAwarenessBlindedBrainCaffeineCaringCharacteristicsClinicalClinical TrialsCognitionCognitiveConsumptionDataDeliriumDementiaDiagnosticDistressDoseElderlyFailureFamilyFoundationsFutureGoalsHealth ExpendituresHospitalizationHourImpaired cognitionIncidenceInterventionIntravenousLength of StayMeasuresMemoryNeurobiologyNeurocognitiveOperative Surgical ProceduresOutcomeParticipantPatientsPharmacologyPlacebo ControlPlacebosPostoperative PeriodProcessPublic HealthPurinergic P1 ReceptorsRandomizedRandomized Clinical TrialsRecoveryReportingResearchRiskScalp structureSeveritiesSubgroupSurgical complicationSyndromeSystemTechniquesTestingTherapeuticTimeWakefulnessarmbasecognitive functioncognitive testingdensitydesigneffective interventioneffective therapyexperiencefallsflexibilityfunctional declineimprovedinsightmeetingsmild cognitive impairmentmortalityneurocognitive disordernovelpostoperative deliriumpreventprimary outcomepublic health relevancerandomized placebo controlled trialrecruitrelating to nervous systemsecondary analysissecondary outcomewireless
项目摘要
TITLE: CAFFEINE AND POSTOPERATIVE NEUROCOGNITIVE RECOVERY
PROJECT SUMMARY
Delirium is a distressing clinical syndrome characterized by failure of basic cognitive functions that affects
approximately 20-50% of older surgical patients. Delirium during surgical recovery is associated with increased
mortality, increased healthcare expenditures, and future cognitive and functional decline. Moreover, there is
pathophysiologic overlap between delirium and Alzheimer’s Disease-Related Dementias; patients experiencing
delirium demonstrate increased risk of future dementia. Unfortunately, the underlying neurobiology of delirium
remains incompletely understood, and there are no biologically informed, effective therapies for preventing
postoperative delirium and related complications. Our preliminary data suggest that caffeine reduces delirium
in the postanesthesia care unit (PACU) after major surgery by shifting cortical dynamics towards neural
criticality. Criticality refers to a system state that is poised to dynamically fluctuate to meet demands. For
cognition, neural criticality is a potential mechanism by which functionally segregated areas of the brain can be
dynamically integrated over space and time to optimize cognition. In our preliminary trial, participants receiving
caffeine at the end of surgery demonstrated increased electroencephalographic (EEG) markers of criticality in
the PACU concurrent with delirium reduction. Nonetheless, the relationships among caffeine, neural criticality,
and postoperative neurocognitive recovery require additional, rigorous testing. Our long-term goal is to improve
neurobiological understanding of delirium and related neurocognitive disorders, such that effective therapies
can be developed. The objectives of this proposal are to (1) test an intervention for reducing early
postoperative delirium while (2) identifying dynamic brain changes that reflect cognitive vulnerability. The
central hypothesis is that caffeine will improve postoperative neurocognitive recovery in older adults. We will
test this hypothesis via a randomized, placebo-controlled, quadruple-blinded clinical trial. Aim 1 will determine
whether caffeine reduces the incidence of early postoperative delirium. Participants (n=250) will be randomized
to placebo, low-dose caffeine, or high-dose caffeine in a three-arm parallel design. A sequential randomization
design will also be used to test one vs. two days of caffeine therapy. Aim 2 will identify cortical dynamics
underlying early postoperative delirium. A wireless, high-density whole-scalp EEG system will enable the
analysis of neural criticality and the associations with caffeine and delirium. Lastly, Aim 3 will use the same
EEG system to test baseline neural criticality in trial participants meeting criteria for Mild Cognitive Impairment,
as deviations from criticality have been reported in patients with this condition as well as Alzheimer’s Disease.
Overall, the proposed research is significant because results may provide an effective, neurobiologically
informed intervention for reducing early postoperative delirium and related consequences. Additionally, results
will provide neurobiological insight into vulnerable cortical dynamics that portend delirium and, possibly,
subsequent neurocognitive disorders.
标题:咖啡因与术后神经认知恢复
项目成果
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Phillip Eleas Vlisides其他文献
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{{ truncateString('Phillip Eleas Vlisides', 18)}}的其他基金
Caffeine and Postoperative Neurocognitive Recovery
咖啡因与术后神经认知恢复
- 批准号:
10674966 - 财政年份:2022
- 资助金额:
$ 57.37万 - 项目类别:
Neurocognitive Recovery following Surgery and General Anesthesia
手术和全身麻醉后的神经认知恢复
- 批准号:
10218208 - 财政年份:2018
- 资助金额:
$ 57.37万 - 项目类别:
Neurocognitive Recovery following Surgery and General Anesthesia
手术和全身麻醉后的神经认知恢复
- 批准号:
9979648 - 财政年份:2018
- 资助金额:
$ 57.37万 - 项目类别:
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