The Peri-Operative Neurocognitive Research Team (PORT) Studies
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The PORT lab is interested in perioperative neurocognitive disorders, as well as mechanisms by which the APOE4 allele leads to long term neurocognitive decline. Available data includes samples from approximately 600 subjects collected before, during and after surgery. Data collected includes demographics, cognitive testing, and delirium screening, and samples of blood, plasma, and CSF supernatant and CSF cell pellets. Some subjects also have: fMRI data, intra-op EEG. Samples are stored in MSRB3.
The Peri-Operative Neurocognitive Research Team (PORT) Laboratory is led by Dr Miles Berger (miles.berger@duke.edu) and studies neurocognitive function in older adults, particularly in the setting of major surgery. We are especially interested in interactions between patient factors (including neurodegenerative pathology), perioperative stressors, postoperative delirium, longer term cognitive and physical function, and the risk of developing Alzheimer’s disease and related dementias. To date we have completed three studies and have a fourth currently enrolling participants.
- MADCO-PC (Markers of Alzheimer’s Disease and Neurocognitive Outcomes following Perioperative Care) was a prospective observational cohort study in older elective non-cardiac/non-neurologic surgery patients, which examined whether postoperative CSF tau increases are associated with the severity of postoperative cognitive dysfunction and changes in functional brain connectivity.
- The INTUIT study (Investigating Neuroinflammation Underlying Postoperative Neurocognitive Dysfunction, Delirium, and Brain Connectivity Changes) examined the role of CSF cellular and molecular markers of inflammation in the pathogenesis of perioperative neurocognitive disorders and associated brain functional connectivity changes.
- MARBLE (Modulating ApoE to Reduce Brain inflammation, deLirium and cognitivE dysfunction after surgery in older adults) was a phase II randomized, controlled, triple blind, dose escalation clinical trial of the ApoE mimetic peptide drug CN-105 in older elective non-cardiac/non-neurologic surgery patients at Duke. MARBLE tested the safety of CN-105 administration (its primary outcome), and secondary outcomes including: A) the feasibility of administering CN-105 q6 hours in these patients while they were hospitalized, B) its effect on postoperative delirium incidence and severity, C) its effect on 6 week postoperative cognitive function, D) its effect on intraoperative anesthetic-induced EEG patterns, and E) its effect on postoperative changes in CSF cytokine levels.
- Our current study, ALADDIN (Low Neurophysiologic Resistance to Anesthetics as a Marker of Preclinical/Prodromal Alzheimer’s Disease and Neurovascular Pathology, Delirium Risk and Inattention) is investigating the association between anesthetic induced EEG waveform patterns and 1) prodromal/latent Alzheimer’s Disease related brain changes, 2) prodromal/latent neurovascular disease markers, and 3) post-operative delirium and specific types of attentional and other cognitive deficits.
Samples from all of these studies include a pre-op timepoint and various timepoints post-surgery. The samples are biobanked and are currently being used in several ongoing projects. Investigators interested in collaborating with the PORT lab should email Drs. Hsia and Berger with a statement of their interests, and a description of how they would like to collaborate with the PORT lab.