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Postoperative neuroinflammation: are we ready to intervene?

Niccolo Terrando, D.I.C., Ph.D. - Associate Professor in Anesthesiology
Assistant Research Professor in Cell Biology
Duke University Medical Center

Perioperative neurocognitive disorders (PND), including acute postoperative delirium and longer-lasting postoperative cognitive dysfunction, are quintessential geriatric complications that affects up to 60% of older adults (1). Orthopedic surgery is a routine procedure in frail and elderly patients, often resulting in high incidence of PND, thus contributing to adverse events and poorer outcomes. To understand the pathophysiology of these complications we have developed a clinically relevant mouse model of orthopedic surgery consisting of an intramedullary fixation of the tibia under general anesthesia to evaluate the impact of aseptic trauma on the central nervous system (2). Using this model we uncovered a link between peripheral cytokines and neuroinflammation in leading to cognitive deficits (3-5). We also identified the role of blood-brain barrier opening and macrophage infiltration as being pivotal for the development of postoperative neuroinflammation and ensuing hippocampal-dependent memory dysfunction (6). Harnessing inflammatory-resolving pathways, for example via cholinergic modulation or specialized pro-resolving lipid mediators, dampen glia activation in response to surgical trauma and curtail the cognitive decline that follows (7-8). Similar pathological hallmarks of blood-brain barrier opening, monocytic infiltration in the cerebrospinal fluid, and microglia reactivity are now observed in patients after non-neurological surgery (9). This suggests a possible role, and putative targeting, of these processes in the pathogenesis of PND.

 Oct 28, 2019 @ 4:00 p.m.

 Medical Center | K-207 (2-6408)

Manipulating Brain States: Invasive mapping and neuromodulation in human neurological disease

John Foxe, Ph.D., Webster Pilcher, M.D., Ph.D., Helen Mayberg, M.D. - University of Rochester, Emory University

Del Monte Symposium

 Oct 24, 2019 @ 6:00 p.m.

 Memorial Art Gallery | Auditorium

Host: John Foxe, Ph.D., Webster Pilcher, M.D., Ph.D.

NSC 503, NSC Student Seminar

Garrick Salois - Neuroscience Ph.D. Candidates

 Oct 14, 2019 @ 4:00 p.m.

 Medical Center | K-307 (3-6408)

NSC 503, NSC Student Seminar

Holly Beaulac - Neuroscience Ph.D. Candidates

 Oct 07, 2019 @ 4:00 p.m.

 Medical Center | K-307 (3-6408)

NSC 503, NSC Student Seminar

Humberto Mestre - Neuroscience Ph.D. Candidates

 Sep 30, 2019 @ 4:00 p.m.

 Medical Center | K-307 (3-6408)

NSC 503, NSC Student Seminar

Erik Musiek - Neuroscience Visiting Speaker

 Sep 23, 2019 @ 4:00 p.m.

 Medical Center | K-207 (2-6408)

NSC 503, NSC Student Seminar

Monique Mendes - Neuroscience Ph.D. Candidates

 Sep 16, 2019 @ 4:00 p.m.

 Medical Center | K-307 (3-6408)

Functional Brain Network Structure in Focal Embouchure Dystonia and Related Disorders

Aimee Morris - Neuroscience PhD Candidate

 Jul 01, 2019 @ 2:00 p.m.

 Medical Center | Lower Adolph Auditorium 1-7619

Host: Dr. Jonathan Mink

Noradrenergic modulation of microglial dynamics and synaptic plasticity

Rianne Stowell - Neuroscience PhD Candidate

 Jun 28, 2019 @ 1:00 p.m.

 Medical Center | Auditorium K-307

Host: Dr. Ania Majewska

Ameliorating Alzheimer’s Disease tau pathology through immunomodulation: A novel role for interleukin 4 and glatiramer acetate

Dawling Dionisio-Santos - Neurobiology and Anatomy PhD Candidate

 Jun 26, 2019 @ 1:00 p.m.

 Medical Center | Upper Auditorium 3-7619

Host: Dr. Kerry OBanion