Scholars@Duke
Leah Acker

Leah Acker

Assistant Professor in Anesthesiology
Anesthesiology, Neuroanesthesia
leah.acker@duke.edu
136 Sands Building, Durham, NC 27710

Selected Publications

The brain-heart-immune axis: a vago-centric framework for predicting and enhancing resilient recovery in older surgery patients.

Journal Article Bioelectron Med · September 2, 2024 Nearly all geriatric surgical complications are studied in the context of a single organ system, e.g., cardiac complications and the heart; delirium and the brain; infections and the immune system. Yet, we know that advanced age, physiological stress, and ... Full text Link to item Cite

Preoperative electroencephalographic alpha-power changes with eyes opening are associated with postoperative attention impairment and inattention-related delirium severity.

Journal Article Br J Anaesth · January 2024 BACKGROUND: In the eyes-closed, awake condition, EEG oscillatory power in the alpha band (7-13 Hz) dominates human spectral activity. With eyes open, however, EEG alpha power substantially decreases. Less alpha attenuation with eyes opening has been associ ... Full text Link to item Cite

Perioperative changes in neurocognitive and Alzheimer's disease-related cerebrospinal fluid biomarkers in older patients randomised to isoflurane or propofol for anaesthetic maintenance.

Journal Article Br J Anaesth · August 2023 BACKGROUND: Animal studies have shown that isoflurane and propofol have differential effects on Alzheimer's disease (AD) pathology and memory, although it is unclear whether this occurs in humans. METHODS: This was a nested randomised controlled trial with ... Full text Link to item Cite

Preclinical and translational models for delirium: Recommendations for future research from the NIDUS delirium network.

Journal Article Alzheimers Dement · May 2023 Delirium is a common, morbid, and costly syndrome that is closely linked to Alzheimer's disease (AD) and AD-related dementias (ADRD) as a risk factor and outcome. Human studies of delirium have advanced our knowledge of delirium incidence and prevalence, r ... Full text Link to item Cite

EEG pre-burst suppression: characterization and inverse association with preoperative cognitive function in older adults.

Journal Article Front Aging Neurosci · 2023 The most common complication in older surgical patients is postoperative delirium (POD). POD is associated with preoperative cognitive impairment and longer durations of intraoperative burst suppression (BSup) - electroencephalography (EEG) with repeated p ... Full text Link to item Cite

Conserved YKL-40 changes in mice and humans after postoperative delirium.

Journal Article Brain Behav Immun Health · December 2022 Delirium is a common postoperative neurologic complication among older adults. Despite its prevalence (14%-50%) and likely association with inflammation, the exact mechanisms that underpin postoperative delirium are unclear. This project aimed to character ... Full text Link to item Cite

Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.

Journal Article Ann Clin Transl Neurol · February 2022 OBJECTIVE: Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cereb ... Full text Open Access Link to item Cite

Perioperative Management of Flecainide: A Problem-Based Learning Discussion.

Journal Article A A Pract · April 1, 2021 Flecainide is a first-line antiarrhythmic drug used to treat atrial arrhythmias and/or supraventricular tachycardia in those without coronary artery disease or structural heart disease. Even though it is an older antiarrhythmic, flecainide accounted for 1. ... Full text Link to item Cite

Cerebrospinal Fluid Proteome Changes in Older Non-Cardiac Surgical Patients with Postoperative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2021 BACKGROUND: Postoperative cognitive dysfunction (POCD), a syndrome of cognitive deficits occurring 1-12 months after surgery primarily in older patients, is associated with poor postoperative outcomes. POCD is hypothesized to result from neuroinflammation; ... Full text Open Access Link to item Cite

Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction.

Journal Article Front Syst Neurosci · 2021 Physiologic signals such as the electroencephalogram (EEG) demonstrate irregular behaviors due to the interaction of multiple control processes operating over different time scales. The complexity of this behavior can be quantified using multi-scale entrop ... Full text Link to item Cite

An Open Resource for Non-human Primate Optogenetics.

Journal Article Neuron · December 23, 2020 Optogenetics has revolutionized neuroscience in small laboratory animals, but its effect on animal models more closely related to humans, such as non-human primates (NHPs), has been mixed. To make evidence-based decisions in primate optogenetics, the scien ... Full text Link to item Cite

Nonhuman Primate Optogenetics: Recent Advances and Future Directions.

Journal Article J Neurosci · November 8, 2017 Optogenetics is the use of genetically coded, light-gated ion channels or pumps (opsins) for millisecond resolution control of neural activity. By targeting opsin expression to specific cell types and neuronal pathways, optogenetics can expand our understa ... Full text Link to item Cite

Large Volume, Behaviorally-relevant Illumination for Optogenetics in Non-human Primates.

Journal Article J Vis Exp · October 3, 2017 This protocol describes a large-volume illuminator, which was developed for optogenetic manipulations in the non-human primate brain. The illuminator is a modified plastic optical fiber with etched tip, such that the light emitting surface area is > 100x t ... Full text Link to item Cite

FEF inactivation with improved optogenetic methods.

Journal Article Proc Natl Acad Sci U S A · November 15, 2016 Optogenetic methods have been highly effective for suppressing neural activity and modulating behavior in rodents, but effects have been much smaller in primates, which have much larger brains. Here, we present a suite of technologies to use optogenetics e ... Full text Link to item Cite

Noninvasive optical inhibition with a red-shifted microbial rhodopsin.

Journal Article Nat Neurosci · August 2014 Optogenetic inhibition of the electrical activity of neurons enables the causal assessment of their contributions to brain functions. Red light penetrates deeper into tissue than other visible wavelengths. We present a red-shifted cruxhalorhodopsin, Jaws, ... Full text Link to item Cite

Semiautomatic vessel wall detection and quantification of wall thickness in computed tomography images of human abdominal aortic aneurysms

Journal Article Medical Physics · February 2010 Purpose:Quantitative measurements of wall thickness in human abdominal aortic aneurysms (AAAs) may lead to more accurate methods for the evaluation of their biomechanical environment. ... Full text Cite

Software-defined radio for undergraduate projects

Journal Article ACM SIGCSE Bulletin · March 7, 2007 Software-defined radio (SDR) is a self-contained, embedded software system with hardware components and real-time constraints. SDR is the basis for many of today's wireless communications systems. Because SDR combines basic digital signal processin ... Full text Cite