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Non-neurological surgery and cerebrospinal fluid biomarkers for neuronal and astroglial integrity
Anckarsäter R, Anckarsäter H, Bromander S, Blennow K, Wass C, Zetterberg H.. Journal of neural transmission (Vienna, Austria : 1996), 2014-01-14
Topic: Brain proteins, microglia and lab models
Non-neurological surgery has both acute and long-term effects on the brain. Markers for Alzheimer pathology may be used to study surgically induced neurological changes relevant for postoperative confusion, asthenia or cognitive decline. Inflammatory biomarkers, total tau (T-tau) and phosphorylated tau (P-tau) were recently shown to increase progressively in the cerebrospinal fluid (CSF) during surgery for nasal CSF leak, suggesting a neuroinflammatory response with signs of neuronal damage. We used a study group of 35 patients, undergoing knee arthroplasty with a spinal blockade and propofol sedation, to replicate this finding. Five CSF biomarkers were analyzed before, 3 h after and on the morning after the interventions: T-tau and P-tau for cortical axonal integrity and tangle pathology, respectively, the 42 amino acids form of amyloid β (Aβ42) for plaque formation, neurofilament light (NFL) for the integrity of large-caliber myelinated axons and glial fibrillary acidic protein (GFAp) for astroglial cell integrity. CSF T-tau concentrations increased significantly during and after surgery (p = 0.028) and were significantly correlated with the administered doses of bupivacaine. P-tau, Aβ42 and NFL remained unchanged, while the mean GFAp concentration increased with a large standard deviation. CSF T-tau and P-tau correlated significantly with the CSF/serum albumin ratios as an indicator of blood-brain barrier permeability. Findings from earlier studies showing a significant increase in biomarkers for Alzheimer's pathology during surgery were partly replicated, as neurochemical signs of impaired cortical axonal integrity during non-neurological surgery were detected. Bupivacaine may be involved in these reactions.
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APA 7th
Anckarsäter, R., Anckarsäter, H., Bromander, S., Blennow, K., Wass, C., & Zetterberg, H. (2014). Non-neurological surgery and cerebrospinal fluid biomarkers for neuronal and astroglial integrity. Journal of neural transmission (Vienna, Austria : 1996). https://doi.org/10.1007/s00702-013-1156-0
Vancouver
Anckarsäter R, Anckarsäter H, Bromander S, Blennow K, Wass C, Zetterberg H. Non-neurological surgery and cerebrospinal fluid biomarkers for neuronal and astroglial integrity. Journal of neural transmission (Vienna, Austria : 1996). 2014. doi:10.1007/s00702-013-1156-0. PMID: 24420082.
BibTeX
@article{anckarsater2014-24420082,
author = {Anckarsäter, R. and Anckarsäter, H. and Bromander, S. and Blennow, K. and Wass, C. and Zetterberg, H.},
title = {{Non-neurological surgery and cerebrospinal fluid biomarkers for neuronal and astroglial integrity}},
journal = {Journal of neural transmission (Vienna, Austria : 1996)},
year = {2014},
doi = {10.1007/s00702-013-1156-0},
pmid = {24420082},
url = {https://doi.org/10.1007/s00702-013-1156-0}
}
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Key findings
- CSF T-tau concentrations increased significantly during and after surgery (p = 0.028) and were significantly correlated with the administered doses of bupivacaine.
- CSF T-tau and P-tau correlated significantly with the CSF/serum albumin ratios as an indicator of blood-brain barrier permeability.
- Findings from earlier studies showing a significant increase in biomarkers for Alzheimer's pathology during surgery were partly replicated, as neurochemical signs of impaired cortical axonal integrity during non-neurological surgery were detected.
Why it matters
In 35 patients undergoing knee arthroplasty, cerebrospinal fluid total tau increased significantly during and after surgery and correlated with bupivacaine dose, while phosphorylated tau, amyloid-beta 42 and neurofilament light remained unchanged. This concerns effects of non-neurological surgery on biomarkers and does not test a treatment, cure or prevention of Alzheimer disease.
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Study details
- Participants35
- Evidence strengthLow
How this study scored 42/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of neural transmission (Vienna, Austria : 1996)) |
| Journal's citation record | 2 / 4 | Journal of Neural Transmission: journal h-index 167 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2014 — within 20 year(s) of the newest study here |
| Sample size | 1 / 4 | 35 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 21 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.5 citations a year over 14 year(s) since 2014 |
| Impact for its field and year | 1 / 6 | Cited 0.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Henrik Zetterberg: h-index 196 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 24420082) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 42 / 100 | — |
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