Previous work in animal models suggests that inhalational anesthetic agents may accelerate Alzheimer's disease pathogenesis, but it is unclear to what extent this may happen in humans. Here, the investigators propose to measure Alzheimer's disease-related neural markers in the cerebrospinal fluid (CSF) of patients exposed to anesthesia while undergoing neurosurgical procedures that require lumbar drain placement. Patients will be randomized to either receive inhalation anesthesia with isoflurane or intravenous anesthesia with propofol. CSF and blood samples will each be collected at the induction of anesthesia, and then again ten and twenty-four hours later. CSF samples will be assayed for amyloid beta, tau, and other Alzheimer's disease-associated markers; blood samples will be assayed for serum inflammatory markers and used for genotyping studies. These studies should clarify the effect of common anesthetic agents on Alzheimer's disease related neural markers.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
105
patients randomized to the propofol arm of the study will receive general anesthesia with propofol
patients randomized to the isoflurane arm of the study will receive general anesthesia with isoflurane
Duke University Medical Center
Durham, North Carolina, United States
Ratio of cerebrospinal fluid tau to amyloid beta
Time frame: twenty four hours after the induction of anesthesia
the relationship between anesthetic exposure and CSF biomarker changes
Time frame: up to 24 hrs after induction of anesthesia
the relationship between anesthetic exposure and CSF biomarker changes, and demographics (age, gender, and race)
Time frame: up to 24 hrs after induction of anesthesia
the relationship between CSF biomarker changes and serum markers of metabolic and/or inflammatory status
Time frame: up to 24 hrs after induction of anesthesia
the relationship between anesthetic exposure and biomarker changes and serum markers of metabolic and/or inflammatory status
Time frame: up to 24 hrs after induction of anesthesia
the relationship between anesthetic exposure and biomarker changes and neuroimaging results obtained as dictated by routine standard of care
Time frame: up to 24 hours after induction of anesthesia
the relationship between anesthetic exposure and biomarker changes and depth of anesthesia, based on average BIS (bispectral index) monitoring signal
Time frame: up to 24 hours after induction of anesthesia
the relationship between anesthetic exposure and biomarker changes and the time of day that surgery is performed
Time frame: up to 24 hours after induction of anesthesia
the relationship between anesthetic exposure and biomarker changes with genetic polymorphisms in ApoE (apolipoprotein E) and other genes related to inflammation, metabolism, brain function and/or Alzheimer's disease
Time frame: up to 24 hours after induction of anesthesia
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