{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:40:59Z","timestamp":1790278859092,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,23]],"date-time":"2019-01-23T00:00:00Z","timestamp":1548201600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005831","name":"Foundation for Anesthesia Education and Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005831","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002553"],"award-info":[{"award-number":["UL1TR002553"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["1K76AG057022"],"award-info":[{"award-number":["1K76AG057022"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["UH2AG056925"],"award-info":[{"award-number":["UH2AG056925"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DA043241"],"award-info":[{"award-number":["R01DA043241"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND\/OBJECTIVES<\/jats:title>\n                    <jats:p>Every year, up to 40% of the more than 16 million older Americans who undergo anesthesia\/surgery develop postoperative cognitive dysfunction (POCD) or delirium. Each of these distinct syndromes is associated with decreased quality of life, increased mortality, and a possible increased risk of Alzheimer's disease. One pathologic process hypothesized to underlie both delirium and POCD is neuroinflammation. The INTUIT study described here will determine the extent to which postoperative increases in cerebrospinal fluid (CSF) monocyte chemoattractant protein 1 (MCP\u20101) levels and monocyte numbers are associated with delirium and\/or POCD and their underlying brain connectivity changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Observational prospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>Duke University Medical Center, Duke Regional Hospital, and Duke Raleigh Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>Patients 60 years of age or older (N = 200) undergoing noncardiac\/nonneurologic surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>Participants will undergo cognitive testing before, 6 weeks, and 1 year after surgery. Delirium screening will be performed on postoperative days 1 to 5. Blood and CSF samples are obtained before surgery, and 24 hours, 6 weeks, and 1 year after surgery. CSF MCP\u20101 levels are measured by enzyme\u2010linked immunosorbent assay, and CSF monocytes are assessed by flow cytometry. Half the patients will also undergo pre\u2010 and postoperative functional magnetic resonance imaging scans. 32\u2010channel intraoperative electroencephalogram (EEG) recordings will be performed to identify intraoperative EEG correlates of neuroinflammation and\/or postoperative cognitive resilience. Eighty patients will also undergo home sleep apnea testing to determine the relationships between sleep apnea severity, neuroinflammation, and impaired postoperative cognition. Additional assessments will help evaluate relationships between delirium, POCD, and other geriatric syndromes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>INTUIT will use a transdisciplinary approach to study the role of neuroinflammation in postoperative delirium and cognitive dysfunction and their associated functional brain connectivity changes, and it may identify novel targets for treating and\/or preventing delirium and POCD and their sequelae. J Am Geriatr Soc 67:794\u2013798, 2019.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15770","type":"journal-article","created":{"date-parts":[[2019,1,24]],"date-time":"2019-01-24T14:12:47Z","timestamp":1548339167000},"page":"794-798","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":70,"title":["The INTUIT Study: Investigating Neuroinflammation Underlying Postoperative Cognitive Dysfunction"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2386-5061","authenticated-orcid":false,"given":"Miles","family":"Berger","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center  Durham North Carolina"},{"name":"Center for the Study of Aging and Human Development Duke University Medical Center  Durham North Carolina"},{"name":"Center for Cognitive Neuroscience Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4142-7505","authenticated-orcid":false,"given":"Deborah","family":"Oyeyemi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center  Durham North Carolina"},{"name":"Department of Medicine Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mobolaji O.","family":"Olurinde","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Thomas Jefferson University Hospital  Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather E.","family":"Whitson","sequence":"additional","affiliation":[{"name":"Center for the Study of Aging and Human Development Duke University Medical Center  Durham North Carolina"},{"name":"Department of Medicine Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent J.","family":"Weinhold","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marty G.","family":"Woldorff","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University Medical Center  Durham North Carolina"},{"name":"Department of Psychology and Neuroscience Duke University  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis A.","family":"Lipsitz","sequence":"additional","affiliation":[{"name":"Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife  Boston Massachusetts"},{"name":"Division of Gerontology Beth Israel Deaconess Medical Center  Boston Massachusetts"},{"name":"Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Moretti","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles M.","family":"Giattino","sequence":"additional","affiliation":[{"name":"Center for Cognitive Neuroscience Duke University Medical Center  Durham North Carolina"},{"name":"Department of Psychology and Neuroscience Duke University  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth C.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Center for Cognitive Neuroscience Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife  Boston Massachusetts"},{"name":"Division of Gerontology Beth Israel Deaconess Medical Center  Boston Massachusetts"},{"name":"Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Bunning","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ferrandino","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall P.","family":"Scheri","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Cooter","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cliburn","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Cabeza","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University Medical Center  Durham North Carolina"},{"name":"Department of Psychology and Neuroscience Duke University  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey N.","family":"Browndyke","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Murdoch","sequence":"additional","affiliation":[{"name":"Department of Medicine Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3906-6421","authenticated-orcid":false,"given":"Michael J.","family":"Devinney","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie M.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Pennsylvania  Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvey Jay","family":"Cohen","sequence":"additional","affiliation":[{"name":"Center for the Study of Aging and Human Development Duke University Medical Center  Durham North Carolina"},{"name":"Department of Medicine Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the INTUIT Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,23]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"1","article-title":"Ambulatory surgery in the United States","volume":"2009","author":"Cullen KA","year":"2006","journal-title":"Natl Health Stat Rep."},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2015.05.008"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200102083440601"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60688-1"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2017.11.087"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/hs1201.099803"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.anes.0000296071.19434.1e"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2014.04.014"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4720"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12974-016-0681-9"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2014.06.014"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbr.2016.08.027"},{"key":"e_1_2_5_14_1","article-title":"An optimized polychromatic flow cytometry panel for detecting cerebrospinal fluid cell types in patients before and after surgery","author":"Berger M","year":"2019","journal-title":"Anesth Analg"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.01528"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a1aafe"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2015.11.010"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.20160"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2012.11060976"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14534"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0030525"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-2010-100702"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-013-1156-0"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002703"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1991.tb01616.x"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638289809166077"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(01)00349-3"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.21.2703"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-015-3514-0"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnsys.2017.00024"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-151190"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjgs.15770","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.15770","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.15770","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.15770","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T17:42:01Z","timestamp":1762191721000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.15770"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,23]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1111\/jgs.15770"],"URL":"https:\/\/doi.org\/10.1111\/jgs.15770","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,23]]},"assertion":[{"value":"2018-11-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}