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更多患有早期到晚期阿尔茨海默病(AD)和其他疾病的人 严重健康相关疾病需要麻醉相关手术的神经退行性疾病 例如心脏)、筛查(例如结肠镜检查)或改善生活质量(例如关节置换)。尽管 有证据表明，术前认知状态是手术后负面结果的危险因素，有 缺乏关于围手术期认知-生物标记物-麻醉相互作用的研究，以及基于证据的研究 麻醉-前驱症状或诊断为痴呆的患者的外科实践。K07申请者--美国国立卫生研究院 资助独立调查员和委员会认证的神经心理学家，具有认知后遗症方面的专业知识 以及AD、血管性痴呆和其他神经退行性疾病的相关神经成像标记物，以及 认知和神经影像对围手术期认知并发症和精神错乱的预测作用。申请人(连同 该机构的支持)正在为AD提出围术期认知麻醉网络(山核桃)计划 以及相关的痴呆症。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生物标记物的合作- 麻醉相互作用，并促进将研究成果转化为临床护理。申请者将完成 高级领导力培训和三个规划目标。目标1-召集一个多学科咨询团队以 建立四个针对AD及相关痴呆症围手术期研究的山核桃综合研究核心。 核心包括认知-临床核心、神经成像核心、生物标记物核心和数据科学核心。 目标2-增强通往山核桃核心的明确和支持途径，以便早期调查人员能够 有效地启动和完成围手术期神经退行性研究。申请者将整合路径 在包括NIH资助的1佛罗里达州阿尔茨海默氏症研究中心在内的多个机构资源之间， 伊夫林·F·麦克奈特脑研究所、佛罗里达大学(UF)胡椒老化研究所和UF Fixel神经疾病中心。目标3--促进出现训练有素的科学家和教育工作者 用于解决围手术期神经元风险和保护机制的创新团队科学。方法将 包括实施证书计划、跨学科团队-科学研究机会和试点 通过这笔赠款和机构配对基金提供的资金。受训人员最初将包括适当的 博士前T32实习生、神经心理学研究员和麻醉学研究员。里程碑-年度分析 计划的优势/劣势、提交的多学科建议书以及学员成功的证据 有AD及相关痴呆的围手术期研究。

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.