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The human brain after anaesthesia and surgery

Our group 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

Funding

  • 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

    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, et al
    Br J Anaesth 2019 10;123(4):464-478

    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, et al
    EClinicalMedicine ;11():18-26

    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, et al
    Anesth. Analg. 2018 11;127(5):1189-1195

    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, Amgst 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 D-S, Wei H, Xie Z, Zuo Z
    Anesthesia & Analgesia: December 2018 - Volume 127 - Issue 6 - p 1406-1413

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

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

    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

    Orthopedic surgery modulates neuropeptides and BDNF expression at the spinal and hippocampal levels.
    Zhang MD, Barde S, Yang T, Lei B, Eriksson LI, Mathew JP, et al
    Proc. Natl. Acad. Sci. U.S.A. 2016 10;113(43):E6686-E6695

    Neural Control of Inflammation: Implications for Perioperative and Critical Care.
    Steinberg BE, Sundman E, Terrando N, Eriksson LI, Olofsson PS
    Anesthesiology 2016 May;124(5):1174-89

    The human carotid body releases acetylcholine, ATP and cytokines during hypoxia.
    Kåhlin J, Mkrtchian S, Ebberyd A, Hammarstedt-Nordenvall L, Nordlander B, Yoshitake T, et al
    Exp. Physiol. 2014 Aug;99(8):1089-98

    Aspirin-triggered resolvin D1 prevents surgery-induced cognitive decline.
    Terrando N, Gómez-Galán M, Yang T, Carlström M, Gustavsson D, Harding RE, et al
    FASEB J. 2013 Sep;27(9):3564-71

    Resolving postoperative neuroinflammation and cognitive decline.
    Terrando N, Eriksson LI, Ryu JK, Yang T, Monaco C, Feldmann M, et al
    Ann. Neurol. 2011 Dec;70(6):986-995

    Contact

    Lars I Eriksson

    Professor/senior physician