PMID- 30674067
OWN - NLM
STAT- MEDLINE
DCOM- 20200521
LR  - 20210701
IS  - 1532-5415 (Electronic)
IS  - 0002-8614 (Print)
IS  - 0002-8614 (Linking)
VI  - 67
IP  - 4
DP  - 2019 Apr
TI  - The INTUIT Study: Investigating Neuroinflammation Underlying Postoperative 
      Cognitive Dysfunction.
PG  - 794-798
LID - 10.1111/jgs.15770 [doi]
AB  - BACKGROUND/OBJECTIVES: Every year, up to 40% of the more than 16 million older 
      Americans who undergo anesthesia/surgery develop postoperative cognitive 
      dysfunction (POCD) or delirium. Each of these distinct syndromes is associated 
      with decreased quality of life, increased mortality, and a possible increased 
      risk of Alzheimer's disease. One pathologic process hypothesized to underlie both 
      delirium and POCD is neuroinflammation. The INTUIT study described here will 
      determine the extent to which postoperative increases in cerebrospinal fluid 
      (CSF) monocyte chemoattractant protein 1 (MCP-1) levels and monocyte numbers are 
      associated with delirium and/or POCD and their underlying brain connectivity 
      changes. DESIGN: Observational prospective cohort. SETTING: Duke University 
      Medical Center, Duke Regional Hospital, and Duke Raleigh Hospital. PARTICIPANTS: 
      Patients 60 years of age or older (N = 200) undergoing noncardiac/nonneurologic 
      surgery. MEASUREMENTS: Participants will undergo cognitive testing before, 6 
      weeks, and 1 year after surgery. Delirium screening will be performed on 
      postoperative days 1 to 5. Blood and CSF samples are obtained before surgery, and 
      24 hours, 6 weeks, and 1 year after surgery. CSF MCP-1 levels are measured by 
      enzyme-linked immunosorbent assay, and CSF monocytes are assessed by flow 
      cytometry. Half the patients will also undergo pre- and postoperative functional 
      magnetic resonance imaging scans. 32-channel intraoperative electroencephalogram 
      (EEG) recordings will be performed to identify intraoperative EEG correlates of 
      neuroinflammation and/or postoperative cognitive resilience. Eighty patients will 
      also undergo home sleep apnea testing to determine the relationships between 
      sleep apnea severity, neuroinflammation, and impaired postoperative cognition. 
      Additional assessments will help evaluate relationships between delirium, POCD, 
      and other geriatric syndromes. CONCLUSION: INTUIT will use a transdisciplinary 
      approach to study the role of neuroinflammation in postoperative delirium and 
      cognitive dysfunction and their associated functional brain connectivity changes, 
      and it may identify novel targets for treating and/or preventing delirium and 
      POCD and their sequelae. J Am Geriatr Soc 67:794-798, 2019.
CI  - (c) 2019 The American Geriatrics Society.
FAU - Berger, Miles
AU  - Berger M
AUID- ORCID: 0000-0002-2386-5061
AD  - Department of Anesthesiology, Duke University Medical Center, Durham, North 
      Carolina.
AD  - Center for the Study of Aging and Human Development, Duke University Medical 
      Center, Durham, North Carolina.
AD  - Center for Cognitive Neuroscience, Duke University Medical Center, Durham, North 
      Carolina.
FAU - Oyeyemi, Deborah
AU  - Oyeyemi D
AUID- ORCID: 0000-0003-4142-7505
AD  - Department of Anesthesiology, Duke University Medical Center, Durham, North 
      Carolina.
AD  - Department of Medicine, Duke University Medical Center, Durham, North Carolina.
FAU - Olurinde, Mobolaji O
AU  - Olurinde MO
AD  - Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, 
      Pennsylvania.
FAU - Whitson, Heather E
AU  - Whitson HE
AD  - Center for the Study of Aging and Human Development, Duke University Medical 
      Center, Durham, North Carolina.
AD  - Department of Medicine, Duke University Medical Center, Durham, North Carolina.
FAU - Weinhold, Kent J
AU  - Weinhold KJ
AD  - Department of Surgery, Duke University Medical Center, Durham, North Carolina.
FAU - Woldorff, Marty G
AU  - Woldorff MG
AD  - Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 
      Durham, North Carolina.
AD  - Department of Psychology and Neuroscience, Duke University, Durham, North 
      Carolina.
FAU - Lipsitz, Lewis A
AU  - Lipsitz LA
AD  - Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, 
      Massachusetts.
AD  - Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, 
      Massachusetts.
AD  - Harvard Medical School, Boston, Massachusetts.
FAU - Moretti, Eugene
AU  - Moretti E
AD  - Department of Anesthesiology, Duke University Medical Center, Durham, North 
      Carolina.
FAU - Giattino, Charles M
AU  - Giattino CM
AD  - Center for Cognitive Neuroscience, Duke University Medical Center, Durham, North 
      Carolina.
AD  - Department of Psychology and Neuroscience, Duke University, Durham, North 
      Carolina.
FAU - Roberts, Kenneth C
AU  - Roberts KC
AD  - Center for Cognitive Neuroscience, Duke University Medical Center, Durham, North 
      Carolina.
FAU - Zhou, Junhong
AU  - Zhou J
AD  - Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, 
      Massachusetts.
AD  - Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, 
      Massachusetts.
AD  - Harvard Medical School, Boston, Massachusetts.
FAU - Bunning, Thomas
AU  - Bunning T
AD  - Department of Anesthesiology, Duke University Medical Center, Durham, North 
      Carolina.
FAU - Ferrandino, Michael
AU  - Ferrandino M
AD  - Department of Surgery, Duke University Medical Center, Durham, North Carolina.
FAU - Scheri, Randall P
AU  - Scheri RP
AD  - Department of Surgery, Duke University Medical Center, Durham, North Carolina.
FAU - Cooter, Mary
AU  - Cooter M
AD  - Department of Anesthesiology, Duke University Medical Center, Durham, North 
      Carolina.
FAU - Chan, Cliburn
AU  - Chan C
AD  - Department of Biostatistics and Bioinformatics, Duke University Medical Center, 
      Durham, North Carolina.
FAU - Cabeza, Roberto
AU  - Cabeza R
AD  - Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 
      Durham, North Carolina.
AD  - Department of Psychology and Neuroscience, Duke University, Durham, North 
      Carolina.
FAU - Browndyke, Jeffrey N
AU  - Browndyke JN
AD  - Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 
      Durham, North Carolina.
FAU - Murdoch, David M
AU  - Murdoch DM
AD  - Department of Medicine, Duke University Medical Center, Durham, North Carolina.
FAU - Devinney, Michael J
AU  - Devinney MJ
AUID- ORCID: 0000-0003-3906-6421
AD  - Department of Anesthesiology, Duke University Medical Center, Durham, North 
      Carolina.
FAU - Shaw, Leslie M
AU  - Shaw LM
AD  - Department of Pathology and Laboratory Medicine, University of Pennsylvania, 
      Philadelphia, Pennsylvania.
FAU - Cohen, Harvey Jay
AU  - Cohen HJ
AD  - Center for the Study of Aging and Human Development, Duke University Medical 
      Center, Durham, North Carolina.
AD  - Department of Medicine, Duke University Medical Center, Durham, North Carolina.
FAU - Mathew, Joseph P
AU  - Mathew JP
AD  - Department of Anesthesiology, Duke University Medical Center, Durham, North 
      Carolina.
CN  - INTUIT Investigators
LA  - eng
GR  - K76 AG057022/AG/NIA NIH HHS/United States
GR  - UL1TR002553/TR/NCATS NIH HHS/United States
GR  - R01DA043241/NH/NIH HHS/United States
GR  - Society for Neuroscience in Anesthesiology and Critical Care 
      (SNACC)/International
GR  - 1K76AG057022/AG/NIA NIH HHS/United States
GR  - KL2 TR001115/TR/NCATS NIH HHS/United States
GR  - UH2AG056925/AG/NIA NIH HHS/United States
GR  - P30 AG028716/AG/NIA NIH HHS/United States
GR  - UH2 AG056925/AG/NIA NIH HHS/United States
GR  - P30AG028716/Claude Pepper Older American Independence Center, Duke 
      University/International
GR  - Foundation for Anesthesia Education and Research/International
GR  - R01 DA043241/DA/NIDA NIH HHS/United States
GR  - UH3 AG056925/AG/NIA NIH HHS/United States
GR  - UL1 TR002553/TR/NCATS NIH HHS/United States
GR  - Duke Anesthesiology Department/International
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20190123
PL  - United States
TA  - J Am Geriatr Soc
JT  - Journal of the American Geriatrics Society
JID - 7503062
SB  - IM
MH  - Aged
MH  - Delirium/*etiology
MH  - Encephalitis/*complications
MH  - Humans
MH  - Middle Aged
MH  - Postoperative Cognitive Complications/*etiology
MH  - Prospective Studies
PMC - PMC6688749
MID - NIHMS1037662
OTO - NOTNLM
OT  - delirium
OT  - monocyte
OT  - monocyte chemoattractant protein 1
OT  - neuroinflammation
OT  - postoperative cognitive dysfunction
COIS- Conflict of Interest The authors have no conflicts of interest to declare.
FIR - Akinyemi, Oladayo
IR  - Akinyemi O
FIR - Amundsen, Cindy
IR  - Amundsen C
FIR - Avasarala, Pallavi
IR  - Avasarala P
FIR - Barber, Matthew
IR  - Barber M
FIR - Beach, Rachel
IR  - Beach R
FIR - Berchuck, Andrew
IR  - Berchuck A
FIR - Blazer, Dan G 3rd
IR  - Blazer DG 3rd
FIR - Bolognesi, Michael
IR  - Bolognesi M
FIR - Brassard, Rachele
IR  - Brassard R
FIR - Bullock, W Michael
IR  - Bullock WM
FIR - Burke, Ashley
IR  - Burke A
FIR - Cai, Victor
IR  - Cai V
FIR - Cheong, Vanessa
IR  - Cheong V
FIR - Christensen, Soren
IR  - Christensen S
FIR - Cox, Mitchell
IR  - Cox M
FIR - Crabtree, Donna
IR  - Crabtree D
FIR - D'Amico, Thomas
IR  - D'Amico T
FIR - Davidson, Brittany
IR  - Davidson B
FIR - Deorio, James
IR  - Deorio J
FIR - Easley, Mark E
IR  - Easley ME
FIR - Ehieli, Eric
IR  - Ehieli E
FIR - Erdmann, Detlev
IR  - Erdmann D
FIR - Funk, Bonita
IR  - Funk B
FIR - Gadsden, Jeffrey
IR  - Gadsden J
FIR - Garrigues, Grant
IR  - Garrigues G
FIR - Greenup, Rachel
IR  - Greenup R
FIR - Habib, Ashraf
IR  - Habib A
FIR - Harpole, David Jr
IR  - Harpole D Jr
FIR - Hartwig, Matthew
IR  - Hartwig M
FIR - Havrilesky, Laura
IR  - Havrilesky L
FIR - Henley, Tarrah
IR  - Henley T
FIR - Holland, Courtney
IR  - Holland C
FIR - Hollenbeck, Scott
IR  - Hollenbeck S
FIR - Huang, Richard
IR  - Huang R
FIR - Iboaya, Ehimenem
IR  - Iboaya E
FIR - Kawasaki, Amie
IR  - Kawasaki A
FIR - Klapper, Jacob
IR  - Klapper J
FIR - Knechtle, Stuart J
IR  - Knechtle SJ
FIR - Lagoo-Deenadayalan, Sandhya
IR  - Lagoo-Deenadayalan S
FIR - Lee, Walter T
IR  - Lee WT
FIR - Lewis, Brian D
IR  - Lewis BD
FIR - Lipkin, Michael
IR  - Lipkin M
FIR - Litchfield, Heather
IR  - Litchfield H
FIR - Marlor, Ellie
IR  - Marlor E
FIR - Maxwell, Cory
IR  - Maxwell C
FIR - Migaly, John
IR  - Migaly J
FIR - Moul, Judd
IR  - Moul J
FIR - Olson, Steven
IR  - Olson S
FIR - Pappas, Theodore
IR  - Pappas T
FIR - Pellom, Gary Lee
IR  - Pellom GL
FIR - Peterson, Andrew
IR  - Peterson A
FIR - Podgoreanu, Andreea
IR  - Podgoreanu A
FIR - Polascik, Thomas
IR  - Polascik T
FIR - Preminger, Glenn
IR  - Preminger G
FIR - Previs, Rebecca
IR  - Previs R
FIR - Rampersaud, Edward
IR  - Rampersaud E
FIR - Renne, Angela
IR  - Renne A
FIR - Roman, Sanziana
IR  - Roman S
FIR - Sanders, Edward
IR  - Sanders E
FIR - Sandler, Aaron
IR  - Sandler A
FIR - Scales, Charles
IR  - Scales C
FIR - Seymour, Keri
IR  - Seymour K
FIR - Shah, Kevin N
IR  - Shah KN
FIR - Stang, Michael
IR  - Stang M
FIR - Stanley, Samuel
IR  - Stanley S
FIR - Sweeney, Katherine
IR  - Sweeney K
FIR - Szydlowska, Alicja
IR  - Szydlowska A
FIR - Terrando, Niccolo
IR  - Terrando N
FIR - Thacker, Julie
IR  - Thacker J
FIR - Thomas, Jake
IR  - Thomas J
FIR - Tong, Betty
IR  - Tong B
FIR - Toulgoat-DuBois, Yanne
IR  - Toulgoat-DuBois Y
FIR - Wellman, Samuel
IR  - Wellman S
FIR - Williams, David
IR  - Williams D
FIR - Zani, Sabino
IR  - Zani S
FIR - Enzor, Jennifer H
IR  - Enzor JH
FIR - Staats, Janet
IR  - Staats J
EDAT- 2019/01/24 06:00
MHDA- 2020/05/22 06:00
PMCR- 2020/04/01
CRDT- 2019/01/24 06:00
PHST- 2018/11/16 00:00 [received]
PHST- 2018/12/20 00:00 [revised]
PHST- 2018/12/20 00:00 [accepted]
PHST- 2019/01/24 06:00 [pubmed]
PHST- 2020/05/22 06:00 [medline]
PHST- 2019/01/24 06:00 [entrez]
PHST- 2020/04/01 00:00 [pmc-release]
AID - 10.1111/jgs.15770 [doi]
PST - ppublish
SO  - J Am Geriatr Soc. 2019 Apr;67(4):794-798. doi: 10.1111/jgs.15770. Epub 2019 Jan 
      23.