Miles Berger
Associate Professor of Anesthesiology
Overview
My research team focuses on understanding the cause of postoperative cognitive dysfunction (POCD) and delirium, and whether these disorders are caused by perioperative changes in Alzheimer's disease pathways. We are also interested in whether delirium or POCD are associated with an increased long term risk of developing Alzheimer's disease. Towards these ends, we use a combination of methods including cognitive testing, CSF and blood sampling, functional neuroimaging, and rigorous biochemical assays. This work has the potential to improve long term outcomes for the more than 16 million Americans over age 60 who undergo anesthesia and surgery each year.
Selected Grants
Integrated Training in Anesthesiology Research awarded by National Institutes of Health (Mentor). 1996 to 2026
Geroscience signaling metabolites NAD+ and beta-hydroxybutyrate modulating acute neuroinflammation in delirium awarded by Buck Institute for Research on Aging (Principal Investigator). 2020 to 2025
Pathogenesis of Neuroinflammation and Neurocognitive Impairment In HIV-infected Young Adult Cannabis Users awarded by National Institutes of Health (Collaborator). 2019 to 2025
Duke Creating ADRD Researchers for the Next Generation - Stimulating Access to Research in Residency Program (CARiNG-StARR)" awarded by National Institutes of Health (Preceptor). 2020 to 2024
The Association of Blood-brain Barrier Breakdown with Sleep Apnea and Postoperative Delirium awarded by Foundation for Anesthesia Education and Research (Mentor). 2021 to 2023
The Association of Blood-Brain Barrier Breakdown with Sleep Apnea and Postoperative Delirium awarded by National Institutes of Health (Mentor). 2021 to 2023
Neurovascular dysfunction in delirium superimposed on dementia awarded by National Institutes of Health (Collaborator). 2017 to 2023
Neuro-inflammation in Postoperative Cognitive Dysfunction: CSF and fMRI Studies awarded by National Institutes of Health (Principal Investigator). 2017 to 2023
A Phase II Study of an ApoE mimetic peptide to reduce Postoperative Delirium, Cognitive Dysfunction after Non-Cardiac Surgery in Older Adults awarded by Alzheimer's Drug Discovery Foundation (Principal Investigator). 2018 to 2023
Proteomic Determination of APOE4-induced Neuroinflammation in the Pathogenesis of Alzheimer's Disease awarded by Ruth K. Broad Biomedical Research Foundation (Principal Investigator). 2020 to 2022
Pages
Doshi, A., et al. “Geriatric anesthesia: Age-dependent changes in the central and peripheral nervous systems.” Geriatric Anesthesiology: Third Edition, 2017, pp. 145–60. Scopus, doi:10.1007/978-3-319-66878-9_10. Full Text
Berger, M., and B. Roth. “Pharmacology of serotonergic and central adrenergic neurotransmission.” Principles of Pharmacology: The Pathophysiologic Basis of Drug Therapy: Third Edition, 2012, pp. 481–519.
Nobuhara, Chloe, et al. “Regional vs General Anesthesia and Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery.” Jama, vol. 327, no. 17, May 2022, pp. 1707–08. Pubmed, doi:10.1001/jama.2022.3538. Full Text
Berger, Miles, et al. “Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.” Ann Clin Transl Neurol, vol. 9, no. 2, Feb. 2022, pp. 155–70. Pubmed, doi:10.1002/acn3.51499. Full Text
Berger, Miles, et al. “Developing a Real-Time Electroencephalogram-Guided Anesthesia-Management Curriculum for Educating Residents: A Single-Center Randomized Controlled Trial.” Anesth Analg, vol. 134, no. 1, Jan. 2022, pp. 159–70. Pubmed, doi:10.1213/ANE.0000000000005677. Full Text
Oyeyemi, Deborah M., et al. “Relationship Between Depression/Anxiety and Cognitive Function Before and 6 Weeks After Major Non-Cardiac Surgery in Older Adults.” J Geriatr Psychiatry Neurol, vol. 35, no. 1, Jan. 2022, pp. 145–54. Pubmed, doi:10.1177/0891988720978791. Full Text
Cooter Wright, Mary, et al. “A Processed Electroencephalogram-Based Brain Anesthetic Resistance Index Is Associated With Postoperative Delirium in Older Adults: A Dual Center Study.” Anesth Analg, vol. 134, no. 1, Jan. 2022, pp. 149–58. Pubmed, doi:10.1213/ANE.0000000000005660. Full Text
Zietlow, Kahli E., et al. “Geriatric Preoperative Optimization: A Review.” Am J Med, vol. 135, no. 1, Jan. 2022, pp. 39–48. Pubmed, doi:10.1016/j.amjmed.2021.07.028. Full Text
Browndyke, Jeffrey N., et al. “Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study.” Br J Anaesth, vol. 127, no. 6, Dec. 2021, pp. 917–28. Pubmed, doi:10.1016/j.bja.2021.08.012. Full Text Open Access Copy
Meier, J., et al. “Use of local anesthesia for inguinal hernia repair has decreased over time in the VA system.” Hernia, Nov. 2021. Pubmed, doi:10.1007/s10029-021-02532-3. Full Text
Whitson, Heather E., et al. “A template for physical resilience research in older adults: Methods of the PRIME-KNEE study.” J Am Geriatr Soc, vol. 69, no. 11, Nov. 2021, pp. 3232–41. Pubmed, doi:10.1111/jgs.17384. Full Text
Meier, Jennie, et al. “Local Anesthesia is Associated with Fewer Complications in Umbilical Hernia Repair in Frail Veterans.” J Surg Res, vol. 266, Oct. 2021, pp. 88–95. Pubmed, doi:10.1016/j.jss.2021.04.006. Full Text
Pages
Meier, Jennie, et al. “Locoregional Anesthesia for Major Surgery in Frail Adults May Reduce Postoperative Morbidity and Mortality.” Journal of the American College of Surgeons, vol. 233, no. 5, 2021, pp. E62–E62.
Yang, Rosa O., et al. “Perioperative neurocognitive and neuroimaging trajectories in older APOE4 carriers vs non-carriers: A prospective cohort study.” Anesthesia and Analgesia, vol. 132, no. 5S_SUPPL, 2021, pp. 545–46.
Au, S., et al. “Preoperative EEG: A Potential Predictor of Postoperative Delirium in Older Adults.” Journal of the American Geriatrics Society, vol. 69, 2021, pp. S222–23.
Meier, Jennie, et al. “Local Anesthesia Can Reduce Complications in Adults Undergoing Umbilical Hernia Repair.” Journal of the American College of Surgeons, vol. 231, no. 4, 2020, pp. S100–01.
Ha, Christine, et al. “Cognitive and Cerebrospinal fluid Alzheimer's Disease biomarker changes over time in older surgical patients and matched nonsurgical controls.” Anesthesia and Analgesia, vol. 130, 2020, pp. 502–502.
Devinney, Michael, et al. “The SANDMAN Study: Sleep Apnea, Neuroinflammation, and Cognitive Dysfunction Manifesting After Non-cardiac surgery.” Anesthesia and Analgesia, vol. 130, 2020, pp. 514–15.
VanDusen, Keith W., et al. “The MARBLE Study: Modulating ApoE signaling to Reduce Brain inflammation, deLirium, and postopErative Cognitive Dysfunction.” Anesthesia and Analgesia, vol. 130, 2020, pp. 432–33.
Eleswarpu, Sarada, et al. “Developing a Real-time EEG-guided Anesthesia Management curriculum for Educating Residents (DREAMER): A randomized controlled trial.” Anesthesia and Analgesia, vol. 130, 2020, pp. 413–413.
Ha, C., et al. “Postoperative Resilience in Older People: An EEG Complexity Measure Predicts Postoperative Attention Deficits.” Journal of the American Geriatrics Society, vol. 68, WILEY, 2020, pp. S179–S179.
Devinney, Michael, et al. “METABOLIPIDOMIC ANALYSIS OF CEREBROSPINAL FLUID REVEALS INCREASED ARACHIDONIC ACID-DERIVED LIPIDS AND SPECIALIZED PRO-RESOLVING MEDIATORS 24 HRS AND 6-WEEKS FOLLOWING SURGERY AND ANESTHESIA.” Anesthesia and Analgesia, vol. 128, 2019, pp. 485–86.