PIPages
Labs

Charles Brown

Stanford University, CA·Medicine & Clinical Research

Confusion, inattention and memory loss after major surgery are common and often lasting. Delirium — a sudden, fluctuating state of confusion — affects a large share of surgical patients, and many go on to experience declines in thinking and daily function in the year that follows, including dementia.

Fields

Medicine & Clinical Research

Neuroscience

Public Health & Epidemiology

Topics

postoperative delirium

cognitive decline

cerebral autoregulation

Grants
2 known grants, through Mar 2030

What they work on

  1. Test whether cerebrospinal fluid markers of blood-brain barrier leak, inflammation, and neuron and astrocyte injury — including the CSF/blood albumin ratio, cytokines, neurofilament light and glial fibrillary acidic protein — are associated with delirium after aortic surgery in 180 patients with CSF drains.
  2. Determine whether the same serial CSF markers, together with baseline Alzheimer's-related measures such as β-amyloid and phosphorylated tau, predict cognitive decline in the year after open or endovascular aortic surgery.
  3. Compare blood-based versions of these markers against paired CSF samples to assess how well a simple blood draw could identify patients at high risk of postoperative brain dysfunction.
  4. Test whether time spent with mean arterial pressure outside each patient's own limits of cerebral autoregulation in the cardiac surgery ICU is associated with postoperative delirium.
  5. Examine whether impaired cerebral autoregulation in the ICU predicts cognitive change from baseline at 1 and 12 months after cardiac surgery.
  6. Explore whether perioperative brain injury measured by blood biomarkers mediates, or baseline neurodegeneration moderates, the link between cerebral blood-flow regulation and delirium or cognitive decline.

More about the research

Why this happens is still unclear. Two projects take complementary approaches to the same question: one measures molecules in fluid around the brain and in blood to trace what is injured and when, and the other measures whether the brain receives the right amount of blood during intensive care. Both aim to turn surgery into a window onto how brain injury and later cognitive decline begin.

Why it matters

Delirium and cognitive decline after surgery affect large numbers of older patients and are linked to later dementia, yet clinicians have few ways to tell who is at risk or what to do differently. Blood-based markers could flag vulnerable patients before or during an operation, and individualized blood-pressure targets in the intensive care unit offer a concrete, testable way to protect the brain using monitoring already compatible with routine cardiac and aortic surgery care.

Known grants

From NIH and NSF research grants. Labs often have other funding we can't see.

Examining CSF and Blood Biomarkers to Gain Insight into Postoperative Delirium and Neurocognitive Dysfunction

NIH · Apr 2025 – Mar 2030

Cerebral Autoregulation in the Cardiac Surgery Intensive Care Unit: Associations with Postoperative Delirium, Cognitive Change, and Biomarkers of Brain Injury

NIH · May 2021 – Apr 2027

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Lauren Jantzie

Johns Hopkins University, MD·Medicine & Clinical Research

Determine whether perioperative serum levels of cyclohexanone, a solvent used to bond plastic medical devices, are associated with morbidity, mortality and neurodevelopmental outcomes in infants undergoing cardiac surgery.

The school

Stanford University: 87 labs on PI Pages, $1.6B a year on research, 739 research doctorates a year.

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