A team at Rhode Island Hospital led by Lori Daiello, Pharm.D., ScM., senior research scientist at the Rhode Island Hospital Alzheimer’s Disease and Memory Disorders Center (ADMDC), will launch a groundbreaking investigation into brain health after surgery. The 5-year study, Cognitive Recovery After Elective Surgery (CREATES), is funded by a $3.8 million R01 grant from the National Institutes of Health.
Daiello, an Associate Professor of Neurology (Research) and of Health Services, Policy and Practice at Brown University, will lead a team of hospital and university colleagues on the study, which will use a new MRI technique to examine the blood-brain barrier of patients age 65+ before and after surgery to measure their post-operative brain recovery.
According to Daiello, “As we age, more time may be needed to completely recover after surgery. Researchers are increasingly interested in how the body’s usual healing and recovery processes after surgery could impact post-operative brain health.”
Over the past five decades studies have suggested that some older individuals may experience lingering memory problems after undergoing major surgery with anesthesia, but little is known about why it occurs or even which patients are at greatest risk. Results of recent research suggest that certain types of inflammation after surgery could interfere with the rate of brain recovery.
The CREATES study will expand upon these findings by using a new type of MRI brain imaging technique, recently developed at the University of Southern California, to investigate whether the health of the blood-brain barrier (BBB) is related to the rate of postoperative brain recovery. A healthy BBB is the most important natural line of defense for the brain which protects it from damaging infections, inflammation, and other threats.
Daiello notes that “Normally, the BBB protects brain cells from harmful substances circulating in the blood. A ‘leaky’ or damaged BBB could be an important risk factor for impaired brain recovery and memory issues by permitting high concentrations of circulating inflammatory factors to flood the brain during and after surgery.”
CREATES co-investigator, Brian Ott, M.D. added, “Unchecked, we think that BBB dysfunction could increase the risk of certain illnesses, such as Alzheimer’s Disease, Therefore, it is important for us to better understand the risk factors that could negatively impact brain recovery in some people who undergo major surgery.”
Beginning in Fall 2020, the CREATES project will enroll more than 200 adults, age 65+ who are scheduled for upcoming major elective non-cardiac surgeries at Rhode Island Hospital. Participants will undergo pre- and post-operative brain MRIs, donate blood for genetic and biomarker analysis, and take periodic memory and thinking tests for 18 months following surgery to monitor brain health and cognitive recovery.
Daiello concludes, “The innovative brain imaging technique we’ll be utilizing in CREATES will allow us to study pre- and post-operative brain health in an entirely new way. We anticipate that the results of this research will advance our understanding of cognitive aging and ultimately spur development of strategies aimed at improving perioperative brain resilience.”