The human brain after anaesthesia and surgery

Our group, led by Lars I Eriksson, undertake translational studies of neuroinflammation and long term neurocognitive disorders after surgery or trauma.

Surgery is closely associated with long-term neurocognitive impairment, a condition also known as postoperative neurocognitive disorders.

Our translational project explores mechanisms, pathophysiology, prevention and long-term outcomes after major surgery to explore surgery-induced neuroinflammation with postoperative neurocognitive decline or dementia. Using comprehensive clinical and experimental platforms in cells and animals, combined with translational studies in surgical patients and nationwide outcome studies, our group identify and describe key mechanisms and at-risk patients for long-term postoperative neurocognitive decline or dementia.

We investigate regulatory processes involved in surgery-induced immune activation within the brain and subsequent neuronal dysfunction after surgery and trauma in relation to long-term brain dysfunction and systemic inflammation. We translate experimental findings to humans by application of state of the art brain PET-imaging,, cerebrospinal fluid neurochemistry, a broad area of cognitive test batteries with advanced pattern recognition analysis of systemic immune reactivity to trauma, in order to explore the association between trauma-induced changes in peripheral-to-brainsignaling and subsequent changes in neurocognitive function.

Clinical results are combined with nationwide outcome studies on the impact of surgery or trauma on later cognitive performance and risk for dementia, aiming to identify at-risk patients to define novel therapeutic strategies.

Group members

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Lars I Eriksson

MD, PhD, FRCA, Professor and Chair

Garikoitz Azkona

PhD, Visiting Scientist
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Marta Gómez Galán

PhD, Senior scientist
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Malin Hildenborg

MD, PhD-student

Jessica Kåhlin

MD, PhD, physician scientist

Souren Mkrtchian

PhD, senior scientist

Andreas Wiklund

MD, PhD, physician scientist


  • VR Medicine
  • The Brain Foundation
  • The Alzheimer Foundation
  • Region Stockholm ALF project grant
  • European Society for Anesthesiology
  • Swedish Medical Society
  • Swedish Society for Anesthesia and Intensive Care

Selected publications

Effects of sevoflurane anaesthesia on radioligand binding to monoamine oxidase-B in vivo.
Varnäs K, Finnema SJ, Johnström P, Arakawa R, Halldin C, Eriksson LI, Farde L
Br J Anaesth 2021 01;126(1):238-244

Association between cerebrospinal fluid biomarkers of neuronal injury or amyloidosis and cognitive decline after major surgery.
Danielson M, Wiklund A, Granath F, Blennow K, Mkrtchian S, Nellgård B, Oras J, Fagerlund MJ, Granström A, Schening A, Rasmussen LS, Harris HE, Zetterberg H, Ricksten SE, Eriksson LI
Br J Anaesth 2021 02;126(2):467-476

The impact of damage-associated molecular patterns on the neurotransmitter release and gene expression in the ex vivo rat carotid body.
Mkrtchian S, Kåhlin J, Gómez-Galán M, Ebberyd A, Yoshitake T, Schmidt S, Kehr J, Hildenborg M, Jonsson Fagerlund M, Erlandsson Harris H, Eriksson LI
Exp Physiol 2020 09;105(9):1634-1647

Neuroinflammatory markers associate with cognitive decline after major surgery: Findings of an explorative study.
Danielson M, Wiklund A, Granath F, Blennow K, Mkrtchian S, Nellgård B, Oras J, Jonsson Fagerlund M, Granström A, Schening A, Rasmussen LS, Erlandsson Harris H, Zetterberg H, Ricksten SE, Eriksson LI
Ann Neurol 2020 03;87(3):370-382

Patients' experiences of early postoperative cognition and its relation to cognitive decline and inflammatory responses: a protocol for a mixed-methods study.
Nilsson U, Liander K, Rooyackers O, Eriksson LI
BMJ Open 2019 12;9(12):e032650

Days at Home after Surgery: An Integrated and Efficient Outcome Measure for Clinical Trials and Quality Assurance.
Bell M, Eriksson LI, Svensson T, Hallqvist L, Granath F, Reilly J, Myles PS
EClinicalMedicine ;11():18-26

State of the clinical science of perioperative brain health: report from the American Society of Anesthesiologists Brain Health Initiative Summit 2018.
Mahanna-Gabrielli E, Schenning KJ, Eriksson LI, Browndyke JN, Wright CB, Culley DJ, Evered L, Scott DA, Wang NY, Brown CH, Oh E, Purdon P, Inouye S, Berger M, Whittington RA, Price CC, Deiner S
Br J Anaesth 2019 10;123(4):464-478

Hospitalization, surgery, and incident dementia.
Eriksson LI, Lundholm C, Narasimhalu K, Sandin R, Jin YP, Gatz M, Pedersen NL
Alzheimers Dement 2019 04;15(4):534-542

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study.
Kirmeier E, Eriksson LI, Lewald H, Jonsson Fagerlund M, Hoeft A, Hollmann M, Meistelman C, Hunter JM, Ulm K, Blobner M,
Lancet Respir Med 2019 02;7(2):129-140

Hypoxia Regulates MicroRNA Expression in the Human Carotid Body.
Mkrtchian S, Lee KL, Kåhlin J, Ebberyd A, Poellinger L, Fagerlund MJ, Eriksson LI
Adv Exp Med Biol ;1071():25-33

Best Practices for Postoperative Brain Health: Recommendations From the Fifth International Perioperative Neurotoxicity Working Group.
Berger M, Schenning KJ, Brown CH, Deiner SG, Whittington RA, Eckenhoff RG, Angst MS, Avramescu S, Bekker A, Brzezinski M, Crosby G, Culley DJ, Eckenhoff M, Eriksson LI, Evered L, Ibinson J, Kline RP, Kofke A, Ma D, Mathew JP, Maze M, Orser BA, Price CC, Scott DA, Silbert B, Su D, Terrando N, Wang DS, Wei H, Xie Z, Zuo Z,
Anesth Analg 2018 12;127(6):1406-1413

Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018.
Evered L, Silbert B, Knopman DS, Scott DA, DeKosky ST, Rasmussen LS, Oh ES, Crosby G, Berger M, Eckenhoff RG,
Can J Anaesth 2018 11;65(11):1248-1257

Disrupted Neuroglial Metabolic Coupling after Peripheral Surgery.
Femenía T, Giménez-Cassina A, Codeluppi S, Fernández-Zafra T, Katsu-Jiménez Y, Terrando N, Eriksson LI, Gómez-Galán M
J Neurosci 2018 01;38(2):452-464

The immune response of the human brain to abdominal surgery.
Forsberg A, Cervenka S, Jonsson Fagerlund M, Rasmussen LS, Zetterberg H, Erlandsson Harris H, Stridh P, Christensson E, Granström A, Schening A, Dymmel K, Knave N, Terrando N, Maze M, Borg J, Varrone A, Halldin C, Blennow K, Farde L, Eriksson LI
Ann Neurol 2017 Apr;81(4):572-582

Association of Anesthesia and Surgery During Childhood With Long-term Academic Performance.
Glatz P, Sandin RH, Pedersen NL, Bonamy AK, Eriksson LI, Granath F
JAMA Pediatr 2017 Jan;171(1):e163470

Acute and Long-Term Effects of Brief Sevoflurane Anesthesia During the Early Postnatal Period in Rats.
Qiu L, Zhu C, Bodogan T, Gómez-Galán M, Zhang Y, Zhou K, Li T, Xu G, Blomgren K, Eriksson LI, Vutskits L, Terrando N
Toxicol Sci 2016 Jan;149(1):121-33

Resolving postoperative neuroinflammation and cognitive decline.
Terrando N, Eriksson LI, Ryu JK, Yang T, Monaco C, Feldmann M, Jonsson Fagerlund M, Charo IF, Akassoglou K, Maze M
Ann Neurol 2011 Dec;70(6):986-995

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Lars I Eriksson

Professor/Senior Physician
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