Miles Berger DCGS Profile

Miles Berger

What is your specific area of interest in geriatric surgery?

My research team focuses on understanding the cause of postoperative cognitive dysfunction (POCD) and delirium, and whether these disorders are caused by perioperative changes in Alzheimer's disease pathways and/or neuro-inflammation. We are also interested in whether delirium or POCD are associated with an increased long term risk of developing Alzheimer's disease. Towards these ends, we use a transdisciplinary approach including cognitive testing and delirium screening, CSF and blood sampling, perioperative EEG recordings, functional neuroimaging, rigorous biochemical assays and polychromatic flow cytometry. This work has the potential to improve long term outcomes for the more than 16 million Americans over age 60 who undergo anesthesia and surgery each year.

What is an example of your best work in geriatric research?

Berger M, Schenning KJ, Brown CH 4th, Deiner SG, Whittington RA, Eckenhoff RG, Angst MS, Avramescu S, Bekker A, Brzezinski M, Crosby G, Culley DJ, Eckenhoff M, Eriksson LI, Evered L, Ibinson J, Kline RP, Kofke A, Ma D, Mathew JP, Maze M, Orser BA, Price CC, Scott DA, Silbert B, Su D, Terrando N, Wang DS, Wei H, Xie Z, Zuo Z; Perioperative Neurotoxicity Working Group. Best Practices for Postoperative Brain Health: Recommendations From the Fifth International Perioperative Neurotoxicity Working Group. Anesth Analg. 2018 Oct 9. doi: 10.1213/ANE.0000000000003841. [Epub ahead of print] PMID:30303868

In your opinion, what is an important health services research question that needs to be answered in the field of geriatric surgery?

How to best promote postoperative neurocognitive function for older adults.

What are your most relevant geriatric surgery publications?

Mathew JP, White WD, Schinderle DB, Podgoreanu MV, Berger M, Milano CA, Laskowitz DT, Stafford-Smith M, Blumenthal JA, Newman MF; Neurologic Outcome Research Group (NORG); Intraoperative magnesium administration does not improve neurocognitive function after cardiac surgery. Stroke. 2013 Dec; 44(12):3407-13.

Ishida K, Berger M, Nadler J, Warner DS. Anesthetic Neuroprotection: Antecedents and an Appraisal of preclinical and clinical Data Quality. Curr Pharm Des. 2014; 20(36):5751-65.
McDonagh DL, Berger M, Mathew JP, Graffagnino C, Milano CA, Newman MF. Neurologic Complications after Cardiac Surgery. Lancet Neurol. 2014 May;13(5):490-502. doi: 10.1016/S1474-4422(14)70004-3. 2014 Apr 2. Review.

Hussain M, Berger M, Eckenhoff R, Sietz DL. General anesthetic and the risk of dementia in elderly patients: current insights. Clinic Intervent Aging, 2014 September, 2014(9): 1619-1628.

Berger M, Burke J, Eckenhoff R, Mathew JP. Alzheimers Disease, Anesthesia and Surgery: A Clinically Focused Review. Journal of Cardiothoracic and Vascular Anesthesia, 2014 Dec 28. pii: S1053-0770(14)00172-4. doi: 10.1053/j.jvca.2014.04.014. Review.

Berger M, Nadler J, Browndyke J, Terrando N, Whitson HE, Cohen HJ, Mathew JP. Postoperative Cognitive Dysfunction: Minding the Gaps in our Knowledge of A Common Postoperative Complication in the Elderly. Anesthesiology Clinics, 2015 Sep;33(3):517-50. doi: 10.1016/j.anclin.2015.05.008. Review.

Berger M, Nadler JW, Friedman A, McDonagh DL, Bennett ER, Cooter M, Qi W, Laskowitz DL Ponnusamy V, Newman, MF, Shaw LM, Warner DS, Mathew JP, James ML for the MAD-PIA investigators. The Effect of Propofol vs. Isoflurane Anesthesia on Human CSF Markers of Alzheimer’s Disease: Results of a Randomized Trial. J Alz Disease, 2016 Apr 15;52(4):1299-310. doi: 10.3233/JAD-151190.

Berger M, Garcia PS. Anesthetic Suppression of Thalamic High-Frequency Oscillations: Evidence that The Thalamus: More than a Gateway to Consciousness?  Anesthesia and Analgesia, 2016 Jun;122(6):1737-9. doi:10.1213/ANE.0000000000001207

Klinger RY, Cooter M, Berger M, Podgoreanu MV, M. Stafford-Smith M, Welsby I, Levy JH, Newman MF, Mathew JP. Effect of Intravenous Lidocaine on the Transcerebral Inflammatory Response During Cardiac Surgery: a randomized controlled trial. Canadian Journal of Anesthesia, 2016 Nov;63(11):1223-32. doi: 10.1007/s12630-016-0704-0. Epub 2016 Jul 28.

Browndyke JN, Berger M, Harshbarger TB, Smith PJ, White W, Bisanar TL, Alexander JH, Gaca JG, Welsh-Bohmer K, Newman MF, Mathew JP. Resting-State Functional Connectivity and Cognition after Major Cardia Surgery in Older Adults without Preoperative Cognitive Impairment: Preliminary Findings. J American Geriatrics Society, 2017 Jan;65(1): e6-e12.Epub 2016 Nov 17.

Giattino CM, Gardner CM, Sbahi FM, Roberts KC, Cooter M, Moretti E, Browndyke JN, Mathew JP, Woldorff MG, Berger M. Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults. Front. Syst. Neurosci. | doi: 10.3389/fnsys.2017.00024 Epub 4/2017.

Berger M, Ponnusamy V, Greene N, Cooter M, Nadler J, Friedman A, McDonagh DL, Laskowitz DT, Newman MF, Shaw LM, Warner DS, Mathew JP, and James ML for the MAD-PIA Investigators. The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial. Front. Immunology. 2017 Nov 13

Browndyke JN*, Berger M*, Smith PJ, Harshbarger TB, Monge ZA, Panchal V, Bisanar TL, Glower DD, Alexander JH, Cabeza R, Welsh-Bohmer K, Newman MF, Mathew JP; Duke Neurologic Outcomes Research Group (NORG). Task-related changes in degree centrality and local coherence of the posterior cingulate cortex after major cardiac surgery in older adults. Hum Brain Mapp. 2017 Nov 21. doi: 10.1002/hbm.23898. *Co-first authors.

Evered L, Silbert B, Knopman DS, Scott DA, DeKosky ST, Rasmussen LS, Oh ES, Crosby G, Berger M, Eckenhoff RG. Recommendations for the Nomenclature of Cognitive Change Associated with Anaesthesia and Surgery. Br J Anaesth, Anesthesiology, Can J Anesth, Anesth Analg, J Alz Dis, acta scandinavica anaesthesiologica (Joint Publication) 2018; Accepted, In Press.

Klinger RY, James OG, Borges-Neto S, Bisanar T, Li YJ, Qi W, Berger M, Terrando N, Newman MF, Doraiswamy PM, Mathew JP; Alzheimer’s Disease Neuroimaging Initiative (ADNI) Study Group; Neurologic Outcomes Research Group (NORG).18F-florbetapir Positron Emission Tomography-determined Cerebral β-Amyloid Deposition and Neurocognitive Performance after Cardiac Surgery. Anesthesiology. 2018 Feb 1. doi: 10.1097/ALN.0000000000002103. [Epub ahead of print]

Brinkley TE, Berger M, Callahan KE, Fieo RA, Jennings LA, Morris JK, Wilkins HM, Kritchevsky SB. Workshop on Synergies Between Alzheimer’s Research and Clinical Gerontology and Geriatrics: Current Status and Future Directions. The Journals of Gerontology: Series A, gly041,, 21 March 2018

Cobb MIH, Crowison M, Mintz-Cole R, Husain AM, Berger M, Jang D, Codd P. Transnasal Transphenoidal Elevation of Optic Chiasm in Secondary Empty Sella Syndrome following Prolactinoma Treatment. World Neurosurg. 2018 Apr; 112:250-253. doi:10.1016/j.wneu.2018.01.202. Epub 2018 Feb 6.

Smith P, Browndyke JN, Monge Z, Harshbarger T, Gaca J, Berger M, Newman MF, Mathew JP. Longitudinal Changes in Regional Cerebral Perfusion and Cognition Following Cardiac Surgery. The Annals of Thoracic Surgery, 2018 Sep 22. pii: S0003-4975(18)31301-8. doi: 10.1016/j.athoracsur.2018.07.056. [Epub ahead of print]

Berger M, Terrando N, Smith SK, Browndyke JN, Newman MF, Mathew JP. Neurocognitive Function after Cardiac Surgery: From Phenotypes to Mechanisms, Anesthesiology, 2018 Oct; 129(4): 829-851. Doi: 10.1097/ALN.0000000000002194.

Ni K, Cooter M, Gupta DK, Thomas J, Hopkins TJ, Miller T, James ML, Kertai MD, Berger M. A Paradox of Age: Older Patients receive higher age-adjusted end-tidal MAC fractions, yet display higher BIS values. Results from a Retrospective Single Centre Study. British J Anaesthesiology, Accepted, 2018.

Berger M, Schenning KJ, Brown CH, Deiner S, Whittington R, Eckenhoff R. Best Practices for Postoperative Brain Health: Recommendations from the 5th International Perioperative Neurotoxicity Working Group, Anesthesia & Analgesia, Accepted, 2018.

What is a fun fact about you?

I used to play guitar and sing in a band some over 20 years ago.