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Characterizing the relationship between electroencephalographic burst-suppression and postoperative delirium in the context of corticothalamic function.

Award Number: K23AG095373
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 07/01/2026
PERIOD OF PERFORMANCE END DATE: 04/30/2031

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Characterizing the relationship between electroencephalographic burst-suppression and postoperative delirium in the context of corticothalamic function. - PROJECT SUMMARY As an anesthesiologist physician-scientist, my primary career aspiration is to investigate ways to protect vulnerable patients from cognitive insults experienced during surgery and anesthesia. A critical step toward this goal is identifying candidate biomarkers of neurocognitive vulnerability that can be assessed perioperatively. To this end, my direct research goal is to identify biomarkers for postoperative delirium (POD), a common neurocognitive disturbance conferring significant morbidity and mortality for older patients and those with pre- existing cognitive impairments, including Alzheimer's Disease and Related Dementias. Among candidate biomarkers, those with clinical relevance will have a neurophysiological basis, will logically and predictably relate to patient outcomes, and will be clinically actionable. Such an identification requires a hypothesis-driven approach combining analytical neuroscience techniques with biostatistical models. Without this knowledge, the potential for relevant biomarkers that could modify treatment and improve outcomes would remain unrealized. Previously, the phenomenon of electroencephalographic burst-suppression (EEG BSP), an alternating period of EEG activity and electrical silence representing global neuronal downregulation, has been evaluated as a biomarker for development of POD. Both BSP presence and duration have been associated with POD in human experimental trials and meta-analyses, but not consistently associated in major randomized clinical trials. I will test the hypothesis that corticothalamic (CT) dysregulation confers an increased risk of POD, and that BSP in the setting of CT dysregulation further modifies POD risk. Normal CT function is necessary for normal resting EEG activity and can be assessed via the frequency content of the EEG signal. Using a large (n=646) prospective intraoperative EEG dataset in patients with variable rates of BSP and POD, I have designed several analyses to assess EEG metrics of CT function and evaluate the role of BSP in POD with regards to the level of CT function. In Aim 1, I will quantify the relationship between EEG measures of CT function and development of POD in the context of aging. I expect that EEG metrics of CT dysfunction will be associated with POD independent of chronological age, and BSP will further increase POD likelihood in patients with CT dysfunction. In Aim 2, I will identify the BSP burst spectral features and dynamics associated with development of POD. I expect that the BSP features most consistent with CT dysfunction will best discriminate the likelihood of developing POD. My activities for career development will be instrumental for the success of my research plan and my continued progress toward independence as a translational neuroscientist. I have constructed a plan to 1) enhance my knowledge of delirium and relevant issues in geriatrics, 2) build computational tools for large-scale analyses, 3) learn advanced biostatistical techniques, 4) acquire a fundamental understanding of clinical trials design, and 5) develop the complement of skills needed for a successful academic career.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $172,260 )
2026	2026	WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY	575 LEXINGTON AVE FL 9	NEW YORK	NY	10022	NEW YORK	USA	Aging Research	000	1	7/1/2026	NEW	$172,260
														Subtotal = $172,260

Grand Total All Awards = $172,260

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Characterizing the relationship between electroencephalographic burst-suppression and postoperative delirium in the context of corticothalamic function.

Award Number: K23AG095373

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 07/01/2026

PERIOD OF PERFORMANCE END DATE: 04/30/2031

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