Perioperative Cognitive Anesthesia Network (PeCAN) Program for Alzheimer’s Disease and Related Dementias

摘要 我们的医疗保健系统面临着大量患有早期至晚期阿尔茨海默病（AD）和其他疾病的个体。 神经退行性疾病，需要麻醉相关手术治疗严重健康相关疾病 (e.g.,心脏）、筛查（例如，结肠镜检查），或生活质量改善（例如，关节置换）。尽管 有证据表明，术前认知状态是术后不良结局的危险因素， 缺乏关于围手术期认知生物标志物麻醉相互作用的研究， 有前驱症状或诊断为痴呆的病人的麻醉手术实践。K 07申请人-NIH 受资助的独立调查员和委员会认证的神经心理学家，在认知后遗症方面具有专业知识 以及AD、血管性痴呆和其他神经退行性疾病的相关神经影像学标志物，以及 围手术期认知并发症和谵妄的认知和神经影像学预测因子。申请人（与 该机构的支持）正在提出一个AD围手术期认知麻醉网络（PeCAN）计划 和相关的痴呆症。目的-促进机构和社区对认知和记忆的认识 在选择麻醉手术的老年人中，加强AD生物标志物的合作- 麻醉的相互作用，并促进研究成果的临床护理的翻译。申请人将完成 高级领导培训和三个方案目标。目标1-召集一个多学科咨询小组， 建立四个针对AD和相关痴呆症围手术期研究的综合PeCAN研究核心。 核心包括认知临床核心，神经影像核心，生物标志物核心和数据科学核心。 目标2-增强PeCAN核心的定义和支持性途径，以便早期研究人员能够 有效地启动和完成围手术期神经退行性研究。申请人将整合途径 在包括NIH资助的佛罗里达阿尔茨海默病研究中心在内的多个机构资源之间， Evelyn F.麦克奈特大脑研究所，佛罗里达大学（UF）研究所老化辣椒中心，和UF 菲克尔神经疾病中心。目标3-促进培养训练有素的科学家和教育工作者 创新团队科学解决围手术期神经元的风险和保护机制。方法将 涉及证书计划的实施，跨学科团队科学研究的机会，和试点 通过这一赠款和机构配套资金提供的资金。学员最初将包括适当的 博士前T32学员，神经心理学研究员和麻醉学研究员。千年发展目标- 计划的优势/劣势、多学科提案提交以及受训者成功的证据 AD和相关痴呆症的围手术期研究

ABSTRACT Our healthcare system faces larger numbers of individuals with early to late Alzheimer’s Disease (AD) and other neurodegenerative disorders requiring anesthesia associated procedures for serious health related conditions (e.g., cardiac), screening (e.g., colonoscopy), or quality of life improvement (e.g., joint replacement). Despite evidence that preoperative cognitive status is a risk factor for negative post-operative outcomes, there is a scarcity of research addressing perioperative cognitive-biomarker-anesthesia interactions, and evidence based anesthesia-surgical practices for patients with prodromal or diagnosed dementias. The K07 applicant- an NIH funded independent investigator and board certified neuropsychologist with expertise in the cognitive sequelae and associated neuroimaging markers of AD, vascular dementia, and other neurodegenerative disorders, and cognitive and neuroimaging predictors of perioperative cognitive complications and delirium. The applicant (with support of the institution) is proposing a Perioperative Cognitive Anesthesia Network (PeCAN) Program for AD and related dementia. The purpose– to promote institutional and community awareness of cognition and memory in older adults electing surgical procedures with anesthesia, intensify collaborations on AD biomarkers- anesthesia interactions, and promote translation of research findings to clinical care. The applicant will complete advanced leadership training and three programmatic aims. Aim 1- convene a multidisciplinary advisory team to establish four integrated PeCAN research cores targeting AD and related dementia perioperative research. Cores include a Cognitive-Clinical Core, a Neuroimaging Core, a Biomarker Core, and a Data Science Core. Aim 2- enhance defined and supportive pathways to the PeCAN cores so that early stage investigators can efficiently initiate and complete perioperative-neurodegenerative research. The applicant will integrate pathways between multiple institutional resources including NIH funded 1Florida Alzheimer’s Disease Research Center, Evelyn F. McKnight Brain Institute, the University of Florida (UF) Institute on Aging Pepper Center, and the UF Fixel Center for Neurological Diseases. Aim 3- promote the emergence of highly trained scientists and educators for innovative team science addressing perioperative neuronal risk and mechanisms for protection. Methods will involve implementation of a certificate program, interdisciplinary team-science research opportunities, and pilot funding supported through this grant and institutional matching funds. Trainees will initially include appropriate predoctoral T32 trainees, neuropsychology fellows, and anesthesiology fellows. Milestones- annual analyses of programmatic strengths/weaknesses, multidisciplinary proposal submissions, and evidence of trainee success with perioperative research for AD and related dementias.