Tarja Stenberg

TOPIC: Sleep and its Regulation


Docent, M.D., PhD, Research Director

Sleep Team Helsinki, Institute of Biomedicine, University of Helsinki

www.svha.org.au| www.cognition.org.au



Dr. Stenberg (Porkka-Heiskanen) gained her MD and PhD degrees at the University of Helsinki. She moved to Northwestern University, Evanston, IL for a postdoctoral fellowship 1990 – 1992 and to Harvard Medical School as associate professor 1995-1997. She is presently a senior researcher at the University of Helsinki, Finland, leading a sleep research team. Her research has concentrated on the mechanisms of recovery sleep, leading to the finding that adenosine and nitric oxide increase in the basal forebrain during sleep deprivation and induce increase in sleep (recovery sleep). She has also studied the effects of prolonged wakefulness in humans and the connection between sleep and depression using animal models. Dr. Stenberg has been coordinating two European Union funded research consortia, which studied the effects of prolonged wakefulness on health and psychosocial functions. She is the past Secretary of the European Sleep Research Society and past President of the Brain Research Society of Finland.


Porkka-Heiskanen, T., Strecker,R.E., Bjorkum, A.A., Thakkar, M., Greene,R.W., McCarley, R.W., Adenosine: A mediator of the sleep-inducing effects of prolonged wakefulness. Science 276: 1265-1268, 1997

Zant JC, Rozov S, Wigren H-K, Pertti Panula P, and Porkka-Heiskanen T, Histamine release in the basal forebrain mediates cortical activation through cholinergic neurons. J Neurosci 19;32(38):13244-54, 2012

Rytkönen, K-M., Wigren, H-K., Kostin, A., Porkka-Heiskanen, T, Kalinchuk, A., Nitric oxide mediated recovery sleep is attenuated with aging. Neurobiol Aging, 31 (11): 2011 – 2019, 2010

Wigren, H-K, Rytkönen, K-M, Porkka-Heiskanen, T, Aging attenuates basal forebrain lactate release and promotion of cortical arousal during prolonged       wakefulness J Neurosci, 16;29(37):11698-707, 2009

Kalinchuk, A., McCarley RW, Porkka-Heiskanen, T., Basheer, R., Sleep deprivation triggers inducible nitric oxide – dependent nitric oxide production in wake-active basal forebrain neurons. J Neurosci  30 (40): 13254-13264, 2010

Ollila HM, Kronholm E, Kettunen J, Silander K, Perola M, Porkka-Heiskanen T, Salomaa V, Paunio T, Insomnia does not mediate or modify the association between MTNR1B risk variant rs10830963 and glucose levels. Diabetologia. 2016 May;59(5):1070-2.

Aho V, Ollila HM, Kronholm E, Bondia-Pons I, Soininen P, Kangas AJ, Hilvo M, Seppälä I, Kettunen J, Oikonen M, Raitoharju E, Hyötyläinen T, Kähönen M, Viikari JSA, Härmä M, Sallinen M, Olkkonen VM, Alenius H, Jauhiainen M, Paunio T, Lehtimäki T, Salomaa V, Orešič M, Raitakari OT, Ala-Korpela M, Porkka-Heiskanen T. Prolonged sleep restriction induces changes in pathways involved in cholesterol metabolism and inflammatory responses. Scientific Reports, 2016

Stacie Deiner

TOPIC: Cognitive Dysfunction – Can we agree to speak the same language?


Associate Professor Anesthesiology, Neurosurgery, Geriatrics and Palliative Care, The Mount Sinai Hospital, New York



I am a neurosurgical anesthesiologist with research interests that focus on ways in which anesthesiologists can optimize their anesthetic to decrease the burden of postoperative cognitive decline and improve recovery in the elderly. I am a current Beeson K23 scholar; my project focuses on the use of intraoperative EEG and whether intraoperative anesthetic depth affects postoperative cognitive dysfunction. I was previously a GEMMSTAR/Jahnigen scholar (2011-2013) and completed a project entitled: “The geriatric patient; anesthetics, stress, and functional outcomes”. I have also served as a co-investigator on an R01 funded randomized trial of the use of Dexmedetomidine. I am an active member several national and international groups. These include: the American Society of Anesthesiology (Brain Health Initiative Panel, chair of the abstract review committee for geriatrics), the American College of Surgery Coalition for Quality in Geriatric Surgical Care, Society for Neuroanesthesia (scientific planning committee), and the International Neurotoxicity Group.


Risk and complications in the elderly surgical patient

  • Phillips AT, Deiner S, Mo Lin H, Andreopoulos E, Silverstein J, Levin MA. Propofol Use in the Elderly Population: Prevalence of Overdose and Association with 30-Day Mortality. Clin Ther. 2015 Dec 1;37(12):2676-85.
  • Amrock LG, Neuman MD, Lin HM, Deiner S. Can Routine Preoperative Data Predict Adverse Outcomes in the Elderly? Development and Validation of a Simple Risk Model Incorporating a Chart-Derived Frailty Score. J Am Coll Surg. 2014 Jun 3. pii: S1072-7515(14)00439-6.
  • Deiner S, Westlake B, Dutton RP. Patterns of surgical care and Complications in the Elderly. J Am Geriatr Soc. 2014 May; 62(5) 829-35.

Cognition and the elderly

  • Brallier JW, Dalal PJ, McCormick PJ, Lin HM, Deiner SG. Elevated Intraoperative Serum Lactate During Craniotomy Is Associated With New Neurological Deficit and Longer Length of Stay. In press.
  • Deiner S, Lin HM, Bodansky D, Silverstein J, Sano M. Do stress markers and anesthetic technique predict       delirium in the elderly? Dement Geriatr Cogn Disord. 2014;38(5-6):366-74
  • Deiner S, Luo X, Silverstein JH, Sano M. Can Intraoperative Processed EEG Predict Postoperative             Cognitive Dysfunction in the Elderly? Clin Ther. 2015 Dec 1;37(12):2700-5.
  • Deiner S, Chu I, Mahanian M, Lin HM, Hecht AC, Silverstein JH. Prone position is associated with mild cerebral oxygen desaturation in elderly surgical patients.PLoS One. 2014 Sep 12;9(9)

Michael Avidan

TOPIC: Unresolved Controversies in Consciousness, Awareness, and Memory


    Seymour & Rose T. Brown Professor of Anesthesiology
  • Director, Institute of Quality Improvement, Research & Informatics (INQUIRI)
  • Chief, Division of Cardiothoracic Anesthesiology

Washington University School of Medicine, St. Louis, MO

Barnes-Jewish Hospital, St. Louis, MO


Michael Avidan, He is the Division Chief of Cardiothoracic Anesthesiology and is the Director of the Institute of Quality Improvement, Research and Informatics (INQUIRI). His current research interests include: intraoperative awareness, postoperative cognitive alteration, brain monitoring, and postoperative intermediate term outcomes.

Maria Fitzgerald

TOPIC: Cortical pain processing in awake and anesthetised infants


  • PhD FMedSci FRS
  • Professor of Developmental Neurobiology
  • Neuroscience, Physiology & Pharmacology,

University College London,



Maria Fitzgerald studies the developmental neurobiology of pain. She is Professor of Developmental Neurobiology in the Department of Neuroscience, Physiology & Pharmacology at University College London (UCL). The Fitzgerald lab at UCL is internationally recognized for pioneering translational work in infant and childhood pain. She uses advanced biological and neurophysiological techniques in animal models and human infants to understand the mechanisms underlying the immediate and long term effects of early life pain. Maria was elected as a Fellow of the Academy of Medical Sciences in 2000 and was awarded the Jeffery Lawson Award for Advocacy in Children’s Pain Relief by the American Pain Society in 2010. She was elected a Fellow of the Royal Society of Anaesthetists (Pain Faculty) in 2013 for services to pain medicine and in 2016 she was elected a Fellow of the Royal Society for her work in the science of pain.   She currently serves on the Council of the British Pain Society and of the International Association for the Study of Pain (IASP) Pain in Children Group.


  • Chang P, Fabrizi L, Olhede S, Fitzgerald M. The Development of Nociceptive Network Activity in the Somatosensory Cortex of Freely Moving Rat Pups. Cereb Cortex. 2016 Dec;26(12):4513-4523.
  • Verriotis M, Chang P, Fitzgerald M, Fabrizi L. The development of the nociceptive brain. Neuroscience. 2016 Dec 3;338:207-219.
  • Fabrizi L, Verriotis M, Williams G, Lee A, Meek J, Olhede S, Fitzgerald M. Encoding of mechanical nociception differs in the adult and infant brain. Sci Rep. 2016 Jun 27;6:28642.
  • Verriotis M, Fabrizi L, Lee A, Cooper RJ, Fitzgerald M, Meek J Mapping Cortical Responses to Somatosensory Stimuli in Human Infants with Simultaneous Near-Infrared Spectroscopy and Event-Related Potential Recording. eNeuro. 2016 May 13;3(2).
  • Chang PS, Walker SM, Fitzgerald M. Differential Suppression of Spontaneous and Noxious-evoked Somatosensory Cortical Activity by Isoflurane in the Neonatal Rat. Anesthesiology. 2016 Apr;124(4):885-98..
  • Fitzgerald M. What do we really know about newborn infant pain? Exp Physiol. 2015 Dec;100(12):1451-7.
  • Williams, G., Fabrizi, L., Meek, J., Jackson, D., Tracey, I., Robertson, N., Slater, R., Fitzgerald, M. (2015). Functional magnetic resonance imaging can be used to explore tactile and nociceptive processing in the infant brain. Acta Paediatr 104, 158-66.
  • Pillai Riddell R, Fitzgerald M, Slater R, Stevens B, Johnston C, Campbell-Yeo M. Using only behaviours to assess infant pain: a painful compromise? Pain. 2016 Aug;157(8):1579-80.
  • Fitzgerald M, McKelvey R. Nerve injury and neuropathic pain – A question of age. Exp Neurol. 2016 Jan;275 Pt 2:296-302.

Jackie Andrade

TOPIC: How to reduce the psychological impact of AAGA


Professor of Psychology, University of Plymouth, UK

Website: https://www.plymouth.ac.uk/staff/jackie-andrade


Jackie Andrade is Professor of Psychology at the University of Plymouth. She was a member of the steering panel of the RCoA/AAGBI 5th National Audit Project on Accidental Awareness during General Anaesthesia (NAP5). She has worked on memory and awareness in anaesthesia for over 20 years, using anaesthetics to address psychological questions and psychology to increase the rigour of anaesthesia research and practice. Her team was one of the first to show that memory function persists during clinically adequate anaesthesia, and the first to conduct a large-scale study of wakefulness and memory priming during general anaesthesia in children using the isolated forearm technique.


  • Andrade, J. (1995). Learning during anaesthesia: A review. British Journal of Psychology, 86(4), 479-506.
  • Andrade, J. (1996). Investigations of hypesthesia: Using anesthetics to explore relationships between consciousness, learning and memory. Consciousness and Cognition, 5, 562-580.
  • Andrade, J., Deeprose, C. & Barker, I. (2008). Incidence of awareness and memory priming in paediatric surgery with general anaesthesia, British Journal of Anaesthesia, 100(3), 389-396. DOI 10.1093/bja/aem378
  • Andrade, J., Englert, L., Harper, C. & Edwards, N. (2001) Comparing the effects of stimulation and propofol infusion rate on implicit and explicit memory formation, British Journal of Anaesthesia, 86(2), 189-195.
  • Andrade, J., Sapsford, D., Jeevaratnum, R. D., Pickworth, A. J., & Jones, J. G. (1996). The coherent frequency in the EEG as an objective measure of cognitive function during propofol sedation. Anesthesia and Analgesia, 83, 1279-1284.
  • Cook TM, Andrade J, Bogod DG, et al. (2014). The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: patient experiences, human factors, sedation, consent and medicolegal issues. British Journal of Anaesthesia. doi: aeu314.
  • Deeprose, C., Andrade, J., Harrison, D. & Edwards, N. E. (2005). Unconscious memory priming during anaesthesia: A replication. British Journal of Anaesthesia, 94(1), 57-62.

Suellen Walker

TOPIC: Pain Memory: How Early Pain Modulates Nociception and Perception


  • Dr Suellen Walker1,2
  • Reader and Consultant in Paediatric Anaesthesia and Pain Medicine
  • Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK.
  • Department of Anaesthesia and Pain Medicine, Great Ormond St Hospital for Children, London, UK.


Dr Walker held Consultant posts in paediatric anaesthesia and pain medicine in Melbourne and Sydney, completed a Masters in Pain Medicine at University of Sydney, and was a Foundation Fellow of the Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists when it formed in 1999. Suellen subsequently moved to London to pursue developmental pain research, completing an MSc in Neuroscience at UCL, followed by a PhD.

Dr Walker’s current post includes clinical practice in paediatric anaesthesia and pain medicine. Her clinical and translational laboratory research relates to the developmental neurobiology of pain, developmental pharmacodynamics of analgesics, and long-term effects of neonatal pain. Her research is currently funded by the Great Ormond Street Hospital Children’s Charity, Medical Research Council UK and Royal College of Anaesthetists/British Journal of Anaesthesia UK. She has received the IASP Bonica Fellowship, IASP Pain in Children New Investigator Award and was the Macintosh Professor, Royal College of Anaesthetists UK in 2012. She is currently Chair of the Scientific Committee, Association of Paediatric Anaesthetists of UK and Ireland and Member of the Scientific Council, National Institute of Academic Anaesthesia, UK. 



  • Walker SM, Beggs S, Baccei M. Persistent changes in peripheral and spinal nociceptive processing after early tissue injury. Experimental Neurol 275(2):253-60; 2016
  • Chang P, Walker SM, Fitzgerald M. Differential suppression of spontaneous and noxious-evoked somatosensory cortical activity by isoflurane in the neonatal rat. Anesthesiology 124:885-98; 2016
  • Walker SM, Fitzgerald M, Hathway G. Surgical injury in the neonatal rat alters the adult pattern of descending modulation from the rostroventral medulla Anesthesiology 122: 1391-400; 2015
  • Schwaller F, Beggs S, Walker SM. Targeting p38 mitogen-activated protein kinase to reduce the impact of neonatal microglial priming on incision-induced hyperalgesia in the adult rat. Anesthesiology 122: 1377-90; 2015
  • Hamurtekin E, Fitzsimmons BL, Shubayev VI, Grafe M, Deumens R, Yaksh TL, Walker SM. Evaluation of spinal toxicity and long-term spinal reflex function following intrathecal levobupivacaine in the neonatal rat. Anesthesiology 119(1):142-155; 2013
  • Walker SM, Grafe M, Yaksh TL. Intrathecal clonidine in the neonatal rat: dose-dependent analgesia and evaluation of spinal apoptosis and toxicity. Anesth Analg 115:450-460; 2012
  • Beggs S, Currie G, Salter MW, Fitzgerald M, Walker SM. Priming of adult pain responses by neonatal pain experience: maintenance by central neuroimmune activity. Brain 135:404-17; 2012
  • Walker SM. Pain after surgery in children: clinical recommendations. Curr Opin Anaesthesiol 28:570-576; 2015
  • McGrath P, Stevens B, Walker S, Zempsky W (eds). Oxford Textbook of Paediatric Pain. Oxford University Press pp 1-688; 2014

Nick Franks

TOPIC:  Overlapping mechanisms of sleep and anaesthesia


  • Professor
  • FRSB
  • FRCA
  • FMedSci
  • FRS is Professor of Biophysics and Anaesthetics at Imperial College London where he is in the Department of Life Sciences.


After a PhD with Nobel laureate Maurice Wilkins at King’s College London Nick Franks moved to Imperial College as one of the founding members of the Biophysics Section. Throughout his career, Nick Franks has been interested in how general anaesthetics act and he has demonstrated that the traditional view that general anaesthetics acted on lipid bilayers was incorrect. He has shown that, despite their chemical diversity, anaesthetics act by directly and selectively binding to a small number of protein targets in the central nervous system, a paradigm that is now widely accepted. He identified a key target for the inert gas xenon that has led to interest in its possible use as a neuroprotectant. For the past few years his focus is on identifying the neuronal pathways responsible for anaesthetic-induced loss of consciousness, and the extent to which anaesthetics act on the neuronal pathways responsible for natural sleep.


  • Neuronal ensembles sufficient for recovery sleep and the sedative actions of a2 adrenergic agonists Z Zhang et al. Nature Neuroscience 18, 553-561 (2015)
  • Altered activity in the central medial thalamus precedes changes in the neocortex during transitions into both sleep and propofol anesthesia R Baker et al. J. Neurosci. 34, 13326-13335 (2014)
  • A propofol binding site on mammalian GABAA receptors identified by photolabeling GMS Yip et al. Nature Chemical Biology 9, 715-720 (2013)
  • An unexpected role for TASK-3 potassium channels in network oscillations with implications for sleep mechanisms and anesthetic action DSJ Pang et al. PNAS 106, 17546-17551 (2009)
  • The involvement of hypothalamic sleep pathways in general anesthesia: testing the hypothesis using the GABAA receptor β3N265M knock-in mouse AY Zecharia et al. J. Neurosci. 29, 2177-2187 (2009)
  • General anaesthesia: from molecular targets to neuronal pathways of sleep and arousal NP Franks Nature Rev. Neuroscience 9, 370-386 (2008)
  • Competitive Inhibition at the Glycine Site of the N-Methyl-d-aspartate Receptor by the Anesthetics Xenon and IsofluraneEvidence from Molecular Modeling and Electrophysiology R Dickinson et al. Anesthesiology 107, 756-767 (2007)
  • The sedative component of anesthesia is mediated by GABAA receptors in an endogenous sleep pathway LE Nelson et al. Nature Neuroscience 5, 979-984 (2002)
  • Effects of xenon on in vitro and in vivo models of neuronal injury S Wilhelm et al. Anesthesiology 96, 1485-1491 (2002)
  • How does xenon produce anaesthesia? NP Franks et al. Nature 396, 324-325 (1998)
  • Crystal structure of human serum albumin complexed with fatty acid reveals an asymmetric distribution of binding sites S Curry et al. Nature Structural Biology 5, 827-835 (1998)
  • Molecular and cellular mechanisms of general anaesthesia NP Franks, WR Lieb Nature 367, 607-614 (1994)
  • Stereospecific effects of inhalational general anesthetic optical isomers on nerve ion channels NP Franks, WR Lieb Science 254, 427-430 (1991)
  • Volatile general anaesthetics activate a novel neuronal K+ current NP Franks, WR Lieb Nature 333, 662-664 (1988)
  • Partitioning of long-chain alcohols into lipid bilayers: implications for mechanisms of general anesthesia NP Franks, WR Lieb PNAS 83, 5116-5120 (1986)
  • Mapping of general anaesthetic target sites provides a molecular basis for cutoff effects. NP Franks, WR Lieb Nature 316, 349-351 (1985)
  • Do general anaesthetics act by competitive binding to specific receptors NP Franks, WR Lieb Nature 310, 599-601 (1984)
  • Molecular mechanisms of general anaesthesia NP Franks, WR Lieb Nature 300, 487-493 (1982)
  • Is membrane expansion relevant to anaesthesia? NP Franks, WR Lieb Nature 292, 248-251 (1981)
  • The structure of lipid bilayers and the effects of general anaesthetics: an x-ray and neutron diffraction study NP Franks, WR Lieb Journal of molecular biology 133, 469-500 (1979)
  • A direct method for determination of membrane electron density profiles on an absolute scale NP Franks et al. Nature 276, 530-532 (1978)
  • Where do general anaesthetics act? NP Franks, WR Lieb Nature 274, 339-342 (1978)