Flow Cytometry Characterization of Cerebrospinal Fluid Monocytes in Patients With Postoperative Cognitive Dysfunction: A Pilot Study

• Published in: Anesthesia and analgesia Vol. 129; no. 5; pp. e150 - e154
• Main Authors: Berger, Miles, Murdoch, David M., Staats, Janet S., Chan, Cliburn, Thomas, Jake P., Garrigues, Grant E., Browndyke, Jeffrey N., Cooter, Mary, Quinones, Quintin J., Mathew, Joseph P., Weinhold, Kent J.
• Format: Journal Article
• Language: English
• Published: United States International Anesthesia Research Society 01-11-2019
• Subjects: Cerebrospinal Fluid - cytology; Flow Cytometry - methods; GPI-Linked Proteins - analysis; Humans; Lipopolysaccharide Receptors - analysis; Monocytes - immunology; Pilot Projects; Postoperative Cognitive Complications - cerebrospinal fluid; Postoperative Cognitive Complications - etiology; Receptors, IgG - analysis
• ISSN: 0003-2999; 1526-7598; 1526-7598
• DOI: 10.1213/ANE.0000000000004179

Animal models suggest postoperative cognitive dysfunction may be caused by brain monocyte influx. To study this in humans, we developed a flow cytometry panel to profile cerebrospinal fluid (CSF) samples collected before and after major noncardiac surgery in 5 patients ≥60 years of age who developed postoperative cognitive dysfunction and 5 matched controls who did not. We detected 12,654 ± 4895 cells/10 mL of CSF sample (mean ± SD). Patients who developed postoperative cognitive dysfunction showed an increased CSF monocyte/lymphocyte ratio and monocyte chemoattractant protein 1 receptor downregulation on CSF monocytes 24 hours after surgery. These pilot data demonstrate that CSF flow cytometry can be used to study mechanisms of postoperative neurocognitive dysfunction.