Neurocognitive Recovery following Surgery and General Anesthesia

项目总结/摘要 拟议中的K23计划将允许菲利普博士E。Vlisides，麻醉学助理教授， 密歇根大学医学院，建立临床神经科学研究的独立计划 旨在更好地理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， 围手术期环境可预测术后神经认知恢复。为了验证这一假设，我们提出了一个 一项观察性研究，旨在探索可能与术后 神经认知轨迹（目标1和2），然后进行临床试验，以测试行为干预，认知 目的3：改善术后神经认知功能。具体目标1： 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EEG α功率和额-顶叶连接 护理单元，将与术后认知功能相关。候选人将学习先进的技术， EEG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（rSO 2）， 先进的脑电图模式和认知恢复我们假设术后脑血氧值 与大手术后的认知功能有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， 复杂的神经系统表型分析。最后，具体目标3是测试 认知障碍对术后神经认知功能的影响。我们假设术前认知 早产儿（即，“大脑训练”）将改善术后时期的神经认知功能。为此 最后一个目标，候选人将接受先进的临床试验设计和实施培训，以获得必要的 未来独立领导多中心试验的技能。根据本建议书，候选人将接受以下方面的培训： 尖端神经科学研究方法（例如，先进的脑电图技术，校准的认知功能 试验）和临床试验设计和实施。因此，他将准备好领导大规模的努力， 了解和改善手术患者的大脑健康。

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.