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

Anesth Analg. 2019 Nov;129(5):e150-e154. doi: 10.1213/ANE.0000000000004179.


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 in 5 patients ≥60 years of age who developed postoperative cognitive dysfunction and 5 matched controls who did not. We detected 12,654 ± 4895 cells/10 mL of CSF sample (mean ± SD). Patients who developed postoperative cognitive dysfunction showed an increased CSF monocyte/lymphocyte ratio and monocyte chemoattractant protein 1 receptor downregulation on CSF monocytes 24 hours after surgery. These pilot data demonstrate that CSF flow cytometry can be used to study mechanisms of postoperative neurocognitive dysfunction.

Trial registration: ClinicalTrials.gov NCT03273335.

MeSH terms

  • Cerebrospinal Fluid / cytology
  • Flow Cytometry / methods*
  • GPI-Linked Proteins / analysis
  • Humans
  • Lipopolysaccharide Receptors / analysis
  • Monocytes / immunology*
  • Pilot Projects
  • Postoperative Cognitive Complications / cerebrospinal fluid*
  • Postoperative Cognitive Complications / etiology
  • Receptors, IgG / analysis


  • CD14 protein, human
  • FCGR3B protein, human
  • GPI-Linked Proteins
  • Lipopolysaccharide Receptors
  • Receptors, IgG

Associated data

  • ClinicalTrials.gov/NCT03273335