The Impact of Anesthesiologist Dr. Miles Berger

Josh Pirtle
|
Sep 17, 2020

Dr. Miles Berger MD is an anesthesiologist focused on understanding the causes of postoperative cognitive dysfunction and delirium, and is working to find links to Alzheimer’s disease pathways. He is board-certified through the American Board of Anesthesiology, General Anesthesiology. Through his years of research and clinical trials, the medical community is improving long term outcomes for patients over 60 who go under anesthesia. 

Education and Early Career

Dr. Berger’s education began in biochemistry at Columbia University in the City of New York, where he obtained his Bachelor of Arts (B.A.) in the field of Biochemistry. Dr. Berger received his medical degree at the University of California San Francisco (USCSF) with a focus in neuroendocrinology and underwent internship and residency at Duke University School of Medicine in 2009. 

His research focus is on nueroanesthesia and hones in on elder care, and memory loss after surgery led to groundbreaking research projects. Graduate work for Dr. Miles Berger entailed understanding the job of serotonin receptors and other G-protein coupled receptors in pancreatic islet improvement.

In 2013, Dr. Miles Berger MD became an Assistant Professor of Anesthesiology with Duke. In 2017, he became an Associate of the Duke Initiative for Science & Society, as well as a faculty network member of the Duke Institute for Brain Sciences.

One of his earliest publications covers the link between perioperative care and cognitive function. He outlined the details of his study in this video. He hoped to uncover the links of POCD and dementia after coronary bypass surgery in order to lessen these effects for future patients. Dr. Berger states that, “Patients who have a cognitive deficit early after surgery, at approximately six weeks, are still impaired approximately five years later.” 

Research into cognitive function after anesthesia has been in development since a paper was published in The Lancet in 1955, and Dr. Berger’s continued research is expounding on early findings to find a solution. 

Miles Berger’s notes on POCD and dementia from early research:

  • Anesthesia drugs have a number of mechanisms through which they can act on Alzheimer’s disease pathways.
  • Inhaling anesthesia medications can increase the clumping of a protein called Amyloid Beta that is involved in Alzheimer’s disease. 
  • Alzheimer’s markers increased after anesthesia in patients – tested through CSF.
  • By measuring synaptic functions, immunologic response, and cholesterol metabolism pathways in CSF of surgical patients that have developed cognitive dysfunction after surgery will help find which pathways are affected.
  • Compare the results of patients who develop cognitive dysfunction with patients who do not develop cognitive dysfunction to find a way to prevent dementia and Alzheimer’s from occurring after surgery.

In an article published in the British Journal of Anesthesia – “Age-Dependent Decrease in Minimum Alveolar Concentration of Inhaled Anesthetics: A Systematic Search of Published Studies and Meta-Regression Analysis” Dr. Berger collaborates with a team of great minds within the neurological and anesthetic health community. The study and related article looked to research started in 1996 and aimed to update the previous study. The combined studies correlated evidence of MAC (minimum alveolar concentration) of inhaling anesthetics decreased by roughly 6% every ten years after the age of 40.

Current Research and Clinical Trials

Dr. Berger’s research continues to expand into new areas of nueroanasthesia, and its relation to cognitive impairment. He has seen great progress with identifying markers of Alzheimer’s in relation to anesthesia and is working on trials for a new drug in hopes of preventing cognitive impairment for persons who undergo anesthesia. 

MARBLE

Miles Berger MD’s latest clinical trial is an ongoing study of the effectiveness of administering CN-105 to mitigate and prevent cognitive decline after surgery in patients over 60 years of age. The study began on January 14, 2019, and was last updated in April of 2019. The brief title of the study is MARBLE – Modulating ApoE4 Signaling to Reduce Brain Inflammation, Delirium, and Postoperative Cognitive Dysfunction. 

Contingent upon when patients join this investigation, members will get either a placebo or a logically higher portion of CN-105 until the most secure and best-endured portion is come to. The study drug (CN-105) is given by means of IV infusion in the medical facility. Infusions are given up to four days after surgery. The aim is to see if CN-105 can block signaling from the ApoE4 gene, which is most commonly associated with late in life Alzheimer’s disease patients.

CN-105 is still an investigational drug, and Dr. Berger hopes his research can bring approval from the U.S. Food and Drug Administration. If the trials prove sufficient, this drug hopes to make breakthroughs to battle Alzheimer’s and dementia both for patients who’ve undergone anesthesia during surgery, and in the future for all elderly patients as a preventative measure.

INTUIT

Dr. Miles Berger MD is currently involved in the INTUIT study researching the relationship between sleep apnea severity, postoperative cognition, and neuroinflammation. Continued assessments and studies through this research trial will help assess connections between delirium, POCD, and other geriatric disorders.

Social Media Presence

His contributions to publications such as the Journal of the American Geriatrics Society received a wide reach on social media platforms. Sharing his research findings online connects the medical world, and he got health care professionals talking about solutions to problems in new ways.

His publication in the Journal of the American Geriatrics Society, which reached wide social media attention, studies the relation of age-related disease rather than age itself to cognitive dysfunction. The article discusses the rise of dementia and other age-related memory issues can be tracked with warning signs, and help individuals impaired with cognitive dysfunctions. 

Awards and Grants Received:

  • William H. Young Award Neuroscience Research - The Society for Neuroscience in Anesthesiology and Critical Care (SNACC)
  • Jahnigen Scholar Award - American Geriatrics Society and the Foundation for Anesthesia Education and Research
  • Awarded NIH Grant
  • Butler-Williams Scholar Award - National Institute on Aging (NIA)
  • NIA Beeson K76 Scholar Award
  • 2nd Place Resident Research Award Winner – American Association of Anesthesiologists 2012

Thank you, Dr. Miles Berger, MD for your continued work in nueroanesthesia, and commitment to improving the outcomes for patients who undergo anesthesia. Through his research, facilities understand how to provide better perioperative care to patients. H1 looks forward to seeing the results of your current studies, and your future breakthroughs surrounding cognitive function in relation to anesthetics.