Michael Devinney | Scholars@Duke

Michael Devinney
Assistant Professor of Anesthesiology

Delirium and cognitive dysfunction following surgery are associated with significant long-term risk for dementia, diminished quality of life, and increased mortality. Yet, few interventions exist to prevent these neurocognitive disorders, in part due to our poor understanding of their pathophysiologic underpinnings and risk factors. One possible risk factor is obstructive sleep apnea (OSA), a disorder characterized by repeated breathing interruptions during sleep that is highly prevalent yet frequently undiagnosed in older adults. One way that OSA could increase risk of postoperative neurocognitive disorders is through increased neuroinflammation. To better understand the relationship between OSA, postoperative neurocognitive disorders and neuroinflammation, we are carrying out a prospective observational cohort study called Sleep Apnea, Neuroinflammation, and cognitive Dysfunction Manifesting After Non-cardiac surgery (SANDMAN). In SANDMAN, patients undergo preoperative home sleep apnea testing in addition to pre- and postoperative cognitive testing, delirium screening, and cerebrospinal fluid sampling. This work has the potential to shed insight into crucial mechanisms of brain injury in OSA patients that could increase risk for postoperative delirium and cognitive dysfunction.

Current Appointments & Affiliations

Assistant Professor of Anesthesiology, Anesthesiology, Critical Care Medicine, Anesthesiology 2021

Contact Information

5684 Hafs Building, Box 0049, Durham, NC 27710
michael.devinney@duke.edu (919) 668-6266

Background
Education, Training, & Certifications
- Anesthesiology, American Board of Anesthesiology 2021 - 2031
- Critical Care Medicine, American Board of Anesthesiology 2021 - 2031
- Fellowship. Critical Care, Duke University 2019 - 2020
- Resident, Anesthesiology, Duke University 2015 - 2019
- M.D., University of Wisconsin - Madison 2015
- Ph.D., University of Wisconsin - Madison 2014
Medical Licensure
- 210578. North Carolina. 2020
Previous Appointments & Affiliations
- Assistant Professor of Anesthesiology, Anesthesiology, Critical Care Medicine, Anesthesiology 2020
Expertise
Subject Headings
Research
Selected Grants
- The Association of Blood-brain Barrier Breakdown with Sleep Apnea and Postoperative Delirium awarded by Foundation for Anesthesia Education and Research 2021 - 2023
- The Association of Blood-Brain Barrier Breakdown with Sleep Apnea and Postoperative Delirium awarded by National Institutes of Health 2021 - 2023
- The Association of Blood-Brain Barrier Breakdown with Sleep Apnea and Postoperative Delirium awarded by Society for Neuroscience in Anesthesiology and Critical Care 2020 - 2021
- The Role of Obstructive Sleep Apnea in Neuroinflammation and Postoperative Cognitive Dysfunction awarded by Foundation for Anesthesia Education and Research 2019 - 2021
External Relationships
- Attindas Hygiene Partners
Publications & Artistic Works
Selected Publications
- Academic Articles
  - David-Bercholz, Jennifer, Leah Acker, Ana I. Caceres, Pau Yen Wu, Saanvi Goenka, Nathan O. Franklin, Ramona M. Rodriguiz, et al. “Conserved YKL-40 changes in mice and humans after postoperative delirium.” Brain Behav Immun Health 26 (December 2022): 100555. https://doi.org/10.1016/j.bbih.2022.100555.
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  - Devinney, Michael J., Keith W. VanDusen, Jad M. Kfouri, Pallavi Avasarala, Andrew R. Spector, Joseph P. Mathew, and Miles Berger. “The potential link between obstructive sleep apnea and postoperative neurocognitive disorders: current knowledge and possible mechanisms.” Can J Anaesth 69, no. 10 (October 2022): 1272–87. https://doi.org/10.1007/s12630-022-02302-4.
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  - Nobuhara, Chloe, Michael Devinney, and Miles Berger. “Regional vs General Anesthesia and Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery.” Jama 327, no. 17 (May 3, 2022): 1707–8. https://doi.org/10.1001/jama.2022.3538.
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  - Uzoigwe, Chika Edward, and Frederick Campbell-Jones. “Regional vs General Anesthesia and Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery.” Jama 327, no. 17 (May 3, 2022): 1707. https://doi.org/10.1001/jama.2022.3535.
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  - Berger, Miles, Jeffrey N. Browndyke, Mary Cooter Wright, Chloe Nobuhara, Melody Reese, Leah Acker, W Michael Bullock, et al. “Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.” Ann Clin Transl Neurol 9, no. 2 (February 2022): 155–70. https://doi.org/10.1002/acn3.51499.
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  - Berger, Miles, Mary Cooter, Alexander S. Roesler, Stacey Chunga, John Park, Jennifer L. Modliszewski, Keith W. VanDusen, et al. “Erratum to: APOE4 Copy Number-Dependent Proteomic Changes in the Cerebrospinal Fluid.” J Alzheimers Dis 90, no. 3 (2022): 1339–40. https://doi.org/10.3233/JAD-229018.
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  - Oyeyemi, Deborah M., Mary Cooter, Stacey Chung, Heather E. Whitson, Jeffrey N. Browndyke, Michael J. Devinney, Patrick J. Smith, et al. “Relationship Between Depression/Anxiety and Cognitive Function Before and 6 Weeks After Major Non-Cardiac Surgery in Older Adults.” J Geriatr Psychiatry Neurol 35, no. 1 (January 2022): 145–54. https://doi.org/10.1177/0891988720978791.
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  - Zietlow, Kahli E., Serena Wong, Mitchell T. Heflin, Shelley R. McDonald, Robert Sickeler, Michael Devinney, Jeanna Blitz, Sandhya Lagoo-Deenadayalan, and Miles Berger. “Geriatric Preoperative Optimization: A Review.” Am J Med 135, no. 1 (January 2022): 39–48. https://doi.org/10.1016/j.amjmed.2021.07.028.
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  - Browndyke, Jeffrey N., Mary C. Wright, Rosa Yang, Ayesha Syed, John Park, Ashley Hall, Katherine Martucci, et al. “Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study.” Br J Anaesth 127, no. 6 (December 2021): 917–28. https://doi.org/10.1016/j.bja.2021.08.012.
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  - Devinney, Michael J., and Miles Berger. “Goldilocks and propofol dosage in older adults: Too much, too little, or just right?” J Am Geriatr Soc 69, no. 8 (August 2021): 2106–9. https://doi.org/10.1111/jgs.17221.
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  - Terrando, Niccolò, John J. Park, Michael Devinney, Cliburn Chan, Mary Cooter, Pallavi Avasarala, Joseph P. Mathew, et al. “Immunomodulatory lipid mediator profiling of cerebrospinal fluid following surgery in older adults.” Sci Rep 11, no. 1 (February 4, 2021): 3047. https://doi.org/10.1038/s41598-021-82606-5.
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  - Acker, Leah, Christine Ha, Junhong Zhou, Brad Manor, Charles M. Giattino, Ken Roberts, Miles Berger, et al. “Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction.” Front Syst Neurosci 15 (2021): 718769. https://doi.org/10.3389/fnsys.2021.718769.
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  - Berger, Miles, Mary Cooter, Alexander S. Roesler, Stacey Chung, John Park, Jennifer L. Modliszewski, Keith W. VanDusen, et al. “APOE4 Copy Number-Dependent Proteomic Changes in the Cerebrospinal Fluid.” J Alzheimers Dis 79, no. 2 (2021): 511–30. https://doi.org/10.3233/JAD-200747.
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  - VanDusen, Keith W., Yi-Ju Li, Victor Cai, Ashley Hall, Sarah Hiles, J Will Thompson, M Arthur Moseley, et al. “Cerebrospinal Fluid Proteome Changes in Older Non-Cardiac Surgical Patients with Postoperative Cognitive Dysfunction.” J Alzheimers Dis 80, no. 3 (2021): 1281–97. https://doi.org/10.3233/JAD-201544.
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  - Vasunilashorn, Sarinnapha M., Michael J. Devinney, Leah Acker, Yoojin Jung, Long Ngo, Mary Cooter, Richard Huang, Edward R. Marcantonio, and Miles Berger. “A New Severity Scoring Scale for the 3-Minute Confusion Assessment Method (3D-CAM).” J Am Geriatr Soc 68, no. 8 (August 2020): 1874–76. https://doi.org/10.1111/jgs.16538.
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  - Nobuhara, Chloe K., W Michael Bullock, Thomas Bunning, Brian Colin, Mary Cooter, Michael J. Devinney, Michael N. Ferrandino, et al. “A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.” J Neurol 267, no. 7 (July 2020): 2002–6. https://doi.org/10.1007/s00415-020-09797-1.
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  - Podgoreanu, Mihai V., Michael J. Devinney, and Joseph P. Mathew. “Oxidative Stress Response and Delirium after Cardiac Surgery: Can Circulating Biomarkers Refine New Therapeutic Paradigms?” Anesthesiology 132, no. 3 (March 2020): 418–20. https://doi.org/10.1097/ALN.0000000000003097.
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  - VanDusen, Keith W., Sarada Eleswarpu, Eugene W. Moretti, Michael J. Devinney, Donna M. Crabtree, Daniel T. Laskowitz, Marty G. Woldorff, et al. “The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.” J Alzheimers Dis 75, no. 4 (2020): 1319–28. https://doi.org/10.3233/JAD-191185.
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  - Berger, Miles, David M. Murdoch, Janet S. Staats, Cliburn Chan, Jake P. Thomas, Grant E. Garrigues, Jeffrey N. Browndyke, et al. “Flow Cytometry Characterization of Cerebrospinal Fluid Monocytes in Patients With Postoperative Cognitive Dysfunction: A Pilot Study.” Anesth Analg 129, no. 5 (November 2019): e150–54. https://doi.org/10.1213/ANE.0000000000004179.
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  - Browndyke, Jeffrey N., Michael Devinney, and Joseph P. Mathew. “The Devil Is in the Details: Comparison of Postoperative Delirium and Neurocognitive Dysfunction.” Anesthesiology 131, no. 3 (September 2019): 456–58. https://doi.org/10.1097/aln.0000000000002823.
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  - Berger, Miles, Deborah Oyeyemi, Mobolaji O. Olurinde, Heather E. Whitson, Kent J. Weinhold, Marty G. Woldorff, Lewis A. Lipsitz, et al. “The INTUIT Study: Investigating Neuroinflammation Underlying Postoperative Cognitive Dysfunction.” J Am Geriatr Soc 67, no. 4 (April 2019): 794–98. https://doi.org/10.1111/jgs.15770.
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  - Devinney, Michael J., and Gordon S. Mitchell. “Spinal activation of protein kinase C elicits phrenic motor facilitation.” Respir Physiol Neurobiol 256 (October 2018): 36–42. https://doi.org/10.1016/j.resp.2017.10.007.
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  - Wilkerson, Julia E. R., Michael Devinney, and Gordon S. Mitchell. “Intermittent but not sustained moderate hypoxia elicits long-term facilitation of hypoglossal motor output.” Respir Physiol Neurobiol 256 (October 2018): 15–20. https://doi.org/10.1016/j.resp.2017.10.005.
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  - Devinney, Michael J., Joseph P. Mathew, and Miles Berger. “Postoperative Delirium and Postoperative Cognitive Dysfunction: Two Sides of the Same Coin?” Anesthesiology 129, no. 3 (September 2018): 389–91. https://doi.org/10.1097/ALN.0000000000002338.
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  - Dale, Erica A., Daryl P. Fields, Michael J. Devinney, and Gordon S. Mitchell. “Phrenic motor neuron TrkB expression is necessary for acute intermittent hypoxia-induced phrenic long-term facilitation.” Exp Neurol 287, no. Pt 2 (January 2017): 130–36. https://doi.org/10.1016/j.expneurol.2016.05.012.
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  - Devinney, Michael J., Nicole L. Nichols, and Gordon S. Mitchell. “Sustained Hypoxia Elicits Competing Spinal Mechanisms of Phrenic Motor Facilitation.” J Neurosci 36, no. 30 (July 27, 2016): 7877–85. https://doi.org/10.1523/JNEUROSCI.4122-15.2016.
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  - Devinney, M. J., R. M. Bauer, and R. D. Sanders. “Climbing the delirium mountain: is alpine anaesthesia the perioperative cause?” Br J Anaesth 115, no. 3 (September 2015): 342–44. https://doi.org/10.1093/bja/aev144.
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  - Devinney, Michael J., Daryl P. Fields, Adrianne G. Huxtable, Timothy J. Peterson, Erica A. Dale, and Gordon S. Mitchell. “Phrenic long-term facilitation requires PKCθ activity within phrenic motor neurons.” J Neurosci 35, no. 21 (May 27, 2015): 8107–17. https://doi.org/10.1523/JNEUROSCI.5086-14.2015.
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  - Devinney, Michael J., Adrianne G. Huxtable, Nicole L. Nichols, and Gordon S. Mitchell. “Hypoxia-induced phrenic long-term facilitation: emergent properties.” Ann N Y Acad Sci 1279 (March 2013): 143–53. https://doi.org/10.1111/nyas.12085.
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  - Devinney, Michael J., Latha M. Malaiyandi, Olga Vergun, Donald B. DeFranco, Teresa G. Hastings, and Kirk E. Dineley. “A comparison of Zn2+- and Ca2+-triggered depolarization of liver mitochondria reveals no evidence of Zn2+-induced permeability transition.” Cell Calcium 45, no. 5 (May 2009): 447–55. https://doi.org/10.1016/j.ceca.2009.03.002.
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  - Zhao, Jinfu, Bryan A. Bertoglio, Michael J. Devinney, Kirk E. Dineley, and Alan R. Kay. “The interaction of biological and noxious transition metals with the zinc probes FluoZin-3 and Newport Green.” Anal Biochem 384, no. 1 (January 1, 2009): 34–41. https://doi.org/10.1016/j.ab.2008.09.019.
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  - Dineley, Kirk E., Michael J. Devinney, Jennifer A. Zeak, Gordon L. Rintoul, and Ian J. Reynolds. “Glutamate mobilizes [Zn2+] through Ca2+ -dependent reactive oxygen species accumulation.” J Neurochem 106, no. 5 (September 2008): 2184–93. https://doi.org/10.1111/j.1471-4159.2008.05536.x.
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  - Devinney, Michael J., Ian J. Reynolds, and Kirk E. Dineley. “Simultaneous detection of intracellular free calcium and zinc using fura-2FF and FluoZin-3.” Cell Calcium 37, no. 3 (March 2005): 225–32. https://doi.org/10.1016/j.ceca.2004.10.003.
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- Conference Papers
  - Ha, C., C. Giattino, J. Zhou, M. Cooter, K. Roberts, D. Crabtree, D. Oyeyemi, et al. “Postoperative Resilience in Older People: An EEG Complexity Measure Predicts Postoperative Attention Deficits.” In Journal of the American Geriatrics Society, 68:S179–S179. WILEY, 2020.
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  - Devinney, Michael, Andrew R. Spector, Jeffrey N. Browndyke, Patrick J. Smith, Jennifer Dominguez, Anesthesio M. Dominguez, Mary Cooter, et al. “The SANDMAN Study: Sleep Apnea, Neuroinflammation, and Cognitive Dysfunction Manifesting After Non-cardiac surgery.” In Anesthesia and Analgesia, 130:514–15, 2020.
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  - Ha, Christine, Vanessa Cheong, Mary Cooter, Jeffrey N. Browndyke, Eugene Moretti, W. M. Bullock, Brian J. Colin, et al. “Cognitive and Cerebrospinal fluid Alzheimer's Disease biomarker changes over time in older surgical patients and matched nonsurgical controls.” In Anesthesia and Analgesia, 130:502–502, 2020.
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  - VanDusen, Keith W., Sarada Eleswarpu, Eugene Moretti, Michael Devinney, Ken Roberts, Mary Cooter, Daniel T. Laskowitz, Frank W. Rockhold, and Miles Berger. “The MARBLE Study: Modulating ApoE signaling to Reduce Brain inflammation, deLirium, and postopErative Cognitive Dysfunction.” In Anesthesia and Analgesia, 130:432–33, 2020.
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  - Devinney, M. J., P. J. Smith, A. R. Spector, Y. Cheong, V. A. Wickenheisser, J. N. Browndyke, M. Cooter, J. P. Mathew, and M. Berger. “The Association of Obstructive Sleep Apnea Risk with Postoperative Cognitive Decline.” In Journal of the American Geriatrics Society, 67:S178–S178. WILEY, 2019.
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  - Bunning, Thomas, Heather E. Whitson, Kent Weinhold, Marty G. Woldorff, Eugene Moretti, Deborah Oyeyemi, Mary Cooter, et al. “THE INTUIT STUDY: INVESTIGATING NEUROINFLAMMATION UNDERLYING POSTOPERATIVE NEUROCOGNITIVE DYSFUNCTION AND DELIRIUM IN OLDER ADULTS.” In Anesthesia and Analgesia, 128:432–432, 2019.
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  - Devinney, Michael, Andrew R. Spector, Jeffrey N. Browndyke, Patrick J. Smith, Jennifer Dominguez, Thomas Bunning, Mary Cooter, Joseph P. Mathew, and Miles Berger. “THE SANDMAN STUDY: SLEEP APNEA, NEUROINFLAMMATION, AND COGNITIVE DYSFUNCTION MANIFESTING AFTER NON-CARDIAC SURGERY.” In Anesthesia and Analgesia, 128:918–918, 2019.
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  - Devinney, Michael, Krishna Rao Maddipati, Cliburn Chan, Joseph P. Mathew, Mary Cooter, Niccolo Terrando, and Miles Berger. “METABOLIPIDOMIC ANALYSIS OF CEREBROSPINAL FLUID REVEALS INCREASED ARACHIDONIC ACID-DERIVED LIPIDS AND SPECIALIZED PRO-RESOLVING MEDIATORS 24 HRS AND 6-WEEKS FOLLOWING SURGERY AND ANESTHESIA.” In Anesthesia and Analgesia, 128:485–86, 2019.
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  - Devinney, M. J., M. Mclawhorn, B. Taicher, J. Hunting, and M. Berger. “Comparing CAM-ICU and 3D-CAM as early postoperative delirium screening tools.” In Journal of the American Geriatrics Society, 66:S172–73. WILEY, 2018.
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  - Devinney, Michael, Yee Ching Vanessa Cheong, Victoria Wickenheisser, Mary Cooter, Jennifer Dominguez, and Miles Berger. “IS OBSTRUCTIVE SLEEP APNEA ASSOCIATED WITH POSTOPERATIVE DELIRIUM AND COGNITIVE DECLINE?” In Anesthesia and Analgesia, 126:704–5. LIPPINCOTT WILLIAMS & WILKINS, 2018.
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Teaching & Mentoring
Recent Courses
Scholarly, Clinical, & Service Activities
Clinical Activities
- I am an intensivist at the Duke Regional Critical Care Unit and an anesthesiologist in the Duke University Hospital and Duke Medical Pavilion operating rooms.

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Education, Training, & Certifications

Medical Licensure

Previous Appointments & Affiliations

Subject Headings

Selected Grants

External Relationships

Selected Publications

Academic Articles

Conference Papers

Recent Courses

Clinical Activities