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Anesthesia, Surgery, Illness, and Alzheimer’s Disease

Anesthesia, Surgery, Illness, and Alzheimer’s Disease. By: Joshua Radparvar RE|NOUS Winter Quarter 2014. “That foggy feeling”. Post-operative cognitive decline (POCD) Regional vs. General Anesthesia Initial Decline Later Decline. Biomarkers.

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Anesthesia, Surgery, Illness, and Alzheimer’s Disease

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  1. Anesthesia, Surgery, Illness, and Alzheimer’s Disease By: Joshua Radparvar RE|NOUS Winter Quarter 2014

  2. “That foggy feeling” • Post-operative cognitive decline (POCD) • Regional vs. General Anesthesia • Initial Decline • Later Decline

  3. Biomarkers CSF tau and amyloidβ replicates MCI 6 months after CABG surgery Even minor surgeries changed CSF tau/amyloidβ Cortical and hippocampal gray matter volume decreased by 10% in 6 months

  4. Causation? Anesthesia vs. Surgery What’s behind it?

  5. Neuroinflammation • Accumulation of pathologic protein aggregates (i.e. amyloidβ, prion protein, hyperphoshorylated tau, etc.) activate immune response in brain (microglia cells) • Scavenging and removal of misfolded proteins and debris results in collateral damage • Secondary anti-inflammatory component mitigates the positive feedback • Microglia are not “resting”

  6. NSAIDs Non-steroidal anti-inflammatory drug Elderly NSAID users have lower age-related loss of gray matter volume than age matched controls NSAIDs and steroids show diminished inflammation post operation

  7. Presentation adapted from: Eckenhoff, Roderic G., and Krzysztof F. Laudansky. "Anesthesia, surgery, illness and Alzheimer's disease." Progress in Neuro-Psychopharmacology and Biological Psychiatry (2012). http://dx.doi.org/10.1016/j.pnpbp.2012.06.011

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