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

    Lars I Eriksson

    MD, PhD, FRCA, Professor and Chair
    C3 Department of Physiology and Pharmacology

    Anette Ebberyd

    lab manager
    C3 Department of Physiology and Pharmacology

    Garikoitz Azkona

    PhD, Visiting Scientist

    Marta Gómez

    PhD, Senior scientist

    Malin Hildenborg

    MD, PhD-student

    Jessica Kåhlin

    MD, PhD, physician scientist
    C3 Department of Physiology and Pharmacology

    Souren Mkrtchian

    PhD, senior scientist
    C3 Department of Physiology and Pharmacology

    Andreas Wiklund

    MD, PhD, physician scientist
    C3 Department of Physiology and Pharmacology

    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

    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

    Lars I Eriksson

    Professor/senior physician