# Blood-Brain Barrier Disruption as a Biomarker for Perioperative Neurocognitive Disorder:Cognitive Recovery after Elective Surgery

> **NIH NIH R01** · RHODE ISLAND HOSPITAL · 2020 · $741,596

## Abstract

Despite decades of research, little is known about how to effectively prevent postoperative delirium or postoperative
cognitive dysfunction; however, emerging perspectives on the role of the blood-brain barrier (BBB) in health and
disease suggest that increased permeability (BBB dysfunction) may be associated with the development of
postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). Up to half of all older adults develop
POD, and POCD is reported in 5-20% of surgical patients over 65 years; at present, neither condition can be
effectively prevented nor treated and both are associated with decreased quality of life and survival, as well as
numerous other negative outcomes. Our long-term goal is to advance knowledge of the effects of surgical stress on
the aging brain, ultimately leading to effective strategies to improve the cognitive safety of surgery. The objective of
this research is to investigate the extent to which an innovative brain imaging technique, water exchange index MRI
(WEI-MRI) evidence of BBB dysfunction predicts the incidence of POD and POCD, in a longitudinal study of older
adults undergoing major elective non-cardiac surgeries. Our central hypothesis is that in the aging brain, BBB
dysfunction is a biomarker for brain vulnerability that predicts increased risk for POD, POCD, and progressive
cognitive decline. We will test this hypothesis by accomplishing the following specific aims: 1) Evaluate
associations between BBB permeability and the incidence of POD; 2) Evaluate associations between BBB
permeability and the incidence of POCD; and 3) Identify changes in markers of endothelial injury and
inflammation in peripheral blood that predict POD and POCD. This approach is innovative because it employs a
noninvasive technology to precisely measure BBB permeability and pinpoint the area(s) of the brain in which it
occurs. The proposed research is significant in that it will lay essential groundwork for development of future
interventions to improve the cognitive safety of major elective surgeries in the aging population. Recognition of BBB
dysfunction may be of critical prognostic importance in determining brain susceptibility to surgical stress.

## Key facts

- **NIH application ID:** 9920656
- **Project number:** 5R01AG058648-02
- **Recipient organization:** RHODE ISLAND HOSPITAL
- **Principal Investigator:** lori A daiello
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $741,596
- **Award type:** 5
- **Project period:** 2019-05-01 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9920656

## Citation

> US National Institutes of Health, RePORTER application 9920656, Blood-Brain Barrier Disruption as a Biomarker for Perioperative Neurocognitive Disorder:Cognitive Recovery after Elective Surgery (5R01AG058648-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9920656. Licensed CC0.

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