Skip to main content

Michael Devinney

Assistant Professor of Anesthesiology
Anesthesiology, Critical Care Medicine
5684 Hafs Building, Box 0049, Durham, NC 27710

Selected Publications


Cognitive and Cerebrospinal Fluid Alzheimer's Disease-related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls.

Conference Anesthesiology · May 1, 2024 BACKGROUND: Anesthesia and/or surgery accelerate Alzheimer's disease pathology and cause memory deficits in animal models, yet there is a lack of prospective data comparing cerebrospinal fluid (CSF) Alzheimer's disease-related biomarker and cognitive traje ... 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

The role of Advance Directives and Living Wills in Anesthesia Practice

Journal Article Anesthesiology Clinics · January 1, 2024 Full text Cite

Role of Blood-Brain Barrier Dysfunction in Delirium following Non-cardiac Surgery in Older Adults.

Journal Article Ann Neurol · December 2023 OBJECTIVE: Although animal models suggest a role for blood-brain barrier dysfunction in postoperative delirium-like behavior, its role in postoperative delirium and postoperative recovery in humans is unclear. Thus, we evaluated the role of blood-brain bar ... 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

Amyloid beta and postoperative delirium: partners in crime or strangers in the dark?

Journal Article Br J Anaesth · August 2023 Postoperative delirium is a particularly debilitating complication of surgery and perioperative care. Although the aetiology of postoperative delirium is not entirely understood, recent evidence suggests that Alzheimer's disease and related dementias patho ... Full text Link to item Cite

A Role for Blood-brain Barrier Dysfunction in Delirium following Non-Cardiac Surgery in Older adults.

Journal Article medRxiv · May 10, 2023 OBJECTIVE: Although animal models suggest a role for blood-brain barrier dysfunction in postoperative delirium-like behavior, its role in postoperative delirium and postoperative recovery in humans is unclear. Thus, we evaluated the role of blood-brain bar ... 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

The potential link between obstructive sleep apnea and postoperative neurocognitive disorders: current knowledge and possible mechanisms.

Journal Article Canadian journal of anaesthesia = Journal canadien d'anesthesie · October 2022 PurposeThis narrative review examines the current evidence on whether obstructive sleep apnea (OSA) is associated with postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). The mechanisms that could predispose OSA patients t ... Full text Open Access 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

Relationship Between Depression/Anxiety and Cognitive Function Before and 6 Weeks After Major Non-Cardiac Surgery in Older Adults.

Journal Article Journal of geriatric psychiatry and neurology · January 2022 ObjectiveTo determine the relationship between affective measures and cognition before and after non-cardiac surgery in older adults.MethodsObservational prospective cohort study in 103 surgical patients age ≥ 60 years old. All par ... Full text Cite

Geriatric Preoperative Optimization: A Review.

Journal Article Am J Med · January 2022 This review summarizes best practices for the perioperative care of older adults as recommended by the American Geriatrics Society, American Society of Anesthesiologists, and American College of Surgeons, with practical implementation strategies that can b ... Full text Link to item Cite

Cognitive and Cerebrospinal Fluid Alzheimer's Disease-related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls.

Conference Anesthesiology · May 1, 2024 BACKGROUND: Anesthesia and/or surgery accelerate Alzheimer's disease pathology and cause memory deficits in animal models, yet there is a lack of prospective data comparing cerebrospinal fluid (CSF) Alzheimer's disease-related biomarker and cognitive traje ... 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

The role of Advance Directives and Living Wills in Anesthesia Practice

Journal Article Anesthesiology Clinics · January 1, 2024 Full text Cite

Role of Blood-Brain Barrier Dysfunction in Delirium following Non-cardiac Surgery in Older Adults.

Journal Article Ann Neurol · December 2023 OBJECTIVE: Although animal models suggest a role for blood-brain barrier dysfunction in postoperative delirium-like behavior, its role in postoperative delirium and postoperative recovery in humans is unclear. Thus, we evaluated the role of blood-brain bar ... 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

Amyloid beta and postoperative delirium: partners in crime or strangers in the dark?

Journal Article Br J Anaesth · August 2023 Postoperative delirium is a particularly debilitating complication of surgery and perioperative care. Although the aetiology of postoperative delirium is not entirely understood, recent evidence suggests that Alzheimer's disease and related dementias patho ... Full text Link to item Cite

A Role for Blood-brain Barrier Dysfunction in Delirium following Non-Cardiac Surgery in Older adults.

Journal Article medRxiv · May 10, 2023 OBJECTIVE: Although animal models suggest a role for blood-brain barrier dysfunction in postoperative delirium-like behavior, its role in postoperative delirium and postoperative recovery in humans is unclear. Thus, we evaluated the role of blood-brain bar ... 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

The potential link between obstructive sleep apnea and postoperative neurocognitive disorders: current knowledge and possible mechanisms.

Journal Article Canadian journal of anaesthesia = Journal canadien d'anesthesie · October 2022 PurposeThis narrative review examines the current evidence on whether obstructive sleep apnea (OSA) is associated with postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). The mechanisms that could predispose OSA patients t ... Full text Open Access 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

Relationship Between Depression/Anxiety and Cognitive Function Before and 6 Weeks After Major Non-Cardiac Surgery in Older Adults.

Journal Article Journal of geriatric psychiatry and neurology · January 2022 ObjectiveTo determine the relationship between affective measures and cognition before and after non-cardiac surgery in older adults.MethodsObservational prospective cohort study in 103 surgical patients age ≥ 60 years old. All par ... Full text Cite

Geriatric Preoperative Optimization: A Review.

Journal Article Am J Med · January 2022 This review summarizes best practices for the perioperative care of older adults as recommended by the American Geriatrics Society, American Society of Anesthesiologists, and American College of Surgeons, with practical implementation strategies that can b ... Full text Link to item Cite

Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study.

Journal Article British journal of anaesthesia · December 2021 BackgroundCognitive dysfunction after surgery is a major issue in older adults. Here, we determined the effect of APOE4 on perioperative neurocognitive function in older patients.MethodsWe enrolled 140 English-speaking patients ≥60 yr old ... Full text Open Access Cite

Immunomodulatory lipid mediator profiling of cerebrospinal fluid following surgery in older adults.

Journal Article Scientific reports · February 2021 Arachidonic acid (AA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) derived lipids play key roles in initiating and resolving inflammation. Neuro-inflammation is thought to play a causal role in perioperative neurocognitive disorders, yet th ... Full text Open Access Cite

APOE4 Copy Number-Dependent Proteomic Changes in the Cerebrospinal Fluid.

Journal Article J Alzheimers Dis · 2021 BACKGROUND: APOE4 has been hypothesized to increase Alzheimer's disease risk by increasing neuroinflammation, though the specific neuroinflammatory pathways involved are unclear. OBJECTIVE: Characterize cerebrospinal fluid (CSF) proteomic changes related t ... Full text Link to item Cite

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

Journal Article Journal of Alzheimer's disease : JAD · January 2021 BackgroundPostoperative 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 neuroinflam ... Full text Open Access 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

A New Severity Scoring Scale for the 3-Minute Confusion Assessment Method (3D-CAM).

Journal Article J Am Geriatr Soc · August 2020 Featured Publication Full text Link to item Cite

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.

Journal Article J Neurol · July 2020 OBJECTIVE: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort st ... Full text Link to item Cite

The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2020 BACKGROUND: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the A ... Full text Open Access Link to item Cite

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

Journal Article Anesth Analg · November 2019 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 ... Full text Open Access Link to item Cite

The INTUIT Study: Investigating Neuroinflammation Underlying Postoperative Cognitive Dysfunction.

Journal Article J Am Geriatr Soc · April 2019 BACKGROUND/OBJECTIVES: 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 ... Full text Open Access Link to item Cite

The Association of Obstructive Sleep Apnea Risk with Postoperative Cognitive Decline

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2019 Link to item Cite

Spinal activation of protein kinase C elicits phrenic motor facilitation.

Journal Article Respir Physiol Neurobiol · October 2018 The protein kinase C family regulates many cellular functions, including multiple forms of neuroplasticity. The novel PKCθ and atypical PKCζ isoforms have been implicated in distinct forms of spinal, respiratory motor plasticity, including phrenic motor fa ... Full text Link to item Cite

Intermittent but not sustained moderate hypoxia elicits long-term facilitation of hypoglossal motor output.

Journal Article Respir Physiol Neurobiol · October 2018 Phrenic long-term facilitation (pLTF) is a form of serotonin-dependent respiratory motor plasticity induced by moderate acute intermittent hypoxia (AIH), but not by moderate acute sustained hypoxia (ASH) of similar cumulative duration. Thus, moderate AIH-i ... Full text Link to item Cite

Comparing CAM-ICU and 3D-CAM as early postoperative delirium screening tools

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2018 Link to item Cite

Phrenic motor neuron TrkB expression is necessary for acute intermittent hypoxia-induced phrenic long-term facilitation.

Journal Article Exp Neurol · January 2017 Phrenic long-term facilitation (pLTF) is a form of hypoxia-induced spinal respiratory motor plasticity that requires new synthesis of brain derived neurotrophic factor (BDNF) and activation of its high-affinity receptor, tropomyosin receptor kinase B (TrkB ... Full text Link to item Cite

Sustained Hypoxia Elicits Competing Spinal Mechanisms of Phrenic Motor Facilitation.

Journal Article J Neurosci · July 27, 2016 UNLABELLED: Acute intermittent hypoxia (AIH) induces phrenic long-term facilitation (pLTF), a form of spinal motor plasticity. Competing mechanisms give rise to phrenic motor facilitation (pMF; a general term including pLTF) depending on the severity of hy ... Full text Link to item Cite

Phrenic long-term facilitation requires PKCθ activity within phrenic motor neurons.

Journal Article J Neurosci · May 27, 2015 Acute intermittent hypoxia (AIH) induces a form of spinal motor plasticity known as phrenic long-term facilitation (pLTF); pLTF is a prolonged increase in phrenic motor output after AIH has ended. In anesthetized rats, we demonstrate that pLTF requires act ... Full text Link to item Cite

Hypoxia-induced phrenic long-term facilitation: emergent properties.

Journal Article Ann N Y Acad Sci · March 2013 As in other neural systems, plasticity is a hallmark of the neural system controlling breathing. One spinal mechanism of respiratory plasticity is phrenic long-term facilitation (pLTF) following acute intermittent hypoxia. Although cellular mechanisms givi ... Full text Link to item Cite

A comparison of Zn2+- and Ca2+-triggered depolarization of liver mitochondria reveals no evidence of Zn2+-induced permeability transition.

Journal Article Cell Calcium · May 2009 Intracellular Zn(2+) toxicity is associated with mitochondrial dysfunction. Zn(2+) depolarizes mitochondria in assays using isolated organelles as well as cultured cells. Some reports suggest that Zn(2+)-induced depolarization results from the opening of t ... Full text Link to item Cite

The interaction of biological and noxious transition metals with the zinc probes FluoZin-3 and Newport Green.

Journal Article Anal Biochem · January 1, 2009 Zinc-sensitive fluorescent probes have become increasingly important in the investigation of the cellular roles of zinc. There is, however, little information on how the other transition metals in cells may influence the measurement of zinc. We have charac ... Full text Link to item Cite

Glutamate mobilizes [Zn2+] through Ca2+ -dependent reactive oxygen species accumulation.

Journal Article J Neurochem · September 2008 Liberation of zinc from intracellular stores contributes to oxidant-induced neuronal injury. However, little is known regarding how endogenous oxidant systems regulate intracellular free zinc ([Zn(2+)](i)). Here we simultaneously imaged [Ca(2+)](i) and [Zn ... Full text Link to item Cite

Simultaneous detection of intracellular free calcium and zinc using fura-2FF and FluoZin-3.

Journal Article Cell Calcium · March 2005 Elevation of intracellular free zinc ([Zn2+]i) probably contributes to cell death in injury paradigms involving calcium deregulation and oxidative stress such as glutamate excitotoxicity. However, it is difficult to monitor both ions simultaneously in live ... Full text Link to item Cite