title: Neurodevelopment of children exposed to anesthesia: design of the Mayo Anesthesia Safety in Kids (MASK) study.
abstract: There is increasing evidence that exposure of developing brains in animals, including nonhuman primates, to commonly-utilized anesthetic agents may cause adverse effects on cognition and behavior. In this paper, we summarize our methodology for a population-based, propensity-matched study to evaluate possible anesthesia-related sequelae in preschool children when evaluated in elementary or high school. A cohort of all children born in Olmsted County, Minnesota between the years 1994 and 2007 who are currently local residents has been identified. Existing medical records are being used to identify all episodes of exposure to general anesthesia prior to the age of 3 years (i.e., prior to their 3rd birthday). Children with multiple, single, and no anesthesia exposure are sampled for testing between the ages of 8 and 12 years or 15 and 19 years during the period 2012-2016. To match children in different exposure groups as closely as possible, sampling is guided by propensity-matching for the likelihood of receiving anesthesia. Selected children are invited to participate in a single 4-hour session of neuropsychological testing, including the National Center for Toxicological Research-Operant Test Battery, which has been used to study anesthetic neurotoxicity in nonhuman primates. The results of this testing will be compared among children with different anesthetic exposure histories. The expected products of this research will be a detailed phenotype of possible anesthetic-associated neurotoxicity in humans, utilizing a robust patient database and neuropsychological testing battery, and the first comparison of effects of anesthetic exposure in children and nonhuman primates performing nearly identical behavioral tasks.
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gleich
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Randall
authors.initials: R
authors.lastname: Flick
authors.affiliation: Mayo Graduate School, Mayo Clinic, Rochester, MN, United States.
authors.forename: Danqing
authors.initials: D
authors.lastname: Hu
authors.affiliation: Department of Psychology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Zaccariello
authors.affiliation: Department of Psychology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Colligan
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States.
authors.forename: Slavica K
authors.initials: SK
authors.lastname: Katusic
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States.
authors.forename: Darrell R
authors.initials: DR
authors.lastname: Schroeder
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hanson
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Shonie
authors.initials: S
authors.lastname: Buenvenida
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Wilder
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Juraj
authors.initials: J
authors.lastname: Sprung
authors.affiliation: Department of Pediatric Medicine, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Voigt
authors.affiliation: National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR, United States.
authors.forename: Merle G
authors.initials: MG
authors.lastname: Paule
authors.affiliation: National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR, United States.
authors.forename: John J
authors.initials: JJ
authors.lastname: Chelonis
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States. Electronic address: warner.david@mayo.edu.
authors.forename: David O
authors.initials: DO
authors.lastname: Warner
mesh_terms: D000293:Adolescent; D000768:Anesthesia, General / Q000706:statistics & numerical data*; D001288:Attention; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D015331:Cohort Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D007223:Infant; D007802:Language; D008297:Male; D008568:Memory; D008910:Minnesota / Q000453:epidemiology; D009048:Motor Skills; D065886:Neurodevelopmental Disorders / Q000453:epidemiology*; D009483:Neuropsychological Tests; D057216:Propensity Score
keywords: Anesthesia; Neurotoxicity; Operant Test Battery; Population study; Propensity-match design