Cited by Optical Neuroimaging in Delirium

Regional cerebral hypometabolism on 18F‐FDG PET/CT scan in delirium is independent of acute illness and dementia DOI

Anita Nitchingham, Jarett Vanz‐Brian Pereira, Eva A. Wegner

et al.

Alzheimer s & Dementia, Journal Year: 2022, Volume and Issue: 19(1), P. 97 - 106

Published: March 15, 2022

Delirium is associated with new onset dementia and accelerated cognitive decline; however, its pathophysiology remains unknown. Cerebral glucose metabolism previously seen in delirium may have been attributable to acute illness and/or dementia. We aimed statistically map cerebral delirium.We assessed using 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) sick, older patients without delirium, all clinical (N = 20). Strict exclusion criteria were adopted minimize the effect of established confounders on FDG-PET.Patients demonstrated hypometabolism bilateral thalami right superior frontal, posterior cingulate, infero-lateral anterior temporal, left parietal cortices. Regional correlated severity performance neuropsychological testing.In but dementia, accompanied by regional hypometabolism. While some hypometabolic regions represent preclinical Alzheimer's disease (AD), thalamic atypical AD consistent features that are unique delirium.

Language: Английский

Citations

Impaired glucose utilization in the brain of patients with delirium following hip fracture DOI

Irit Titlestad, Leiv Otto Watne, Gideon A. Caplan

et al.

Brain, Journal Year: 2023, Volume and Issue: 147(1), P. 215 - 223

Published: Sept. 2, 2023

Abstract Alterations in brain energy metabolism have long been proposed as one of several neurobiological processes contributing to delirium. This is supported by previous findings altered CSF lactate and neuron-specific enolase concentrations decreased glucose uptake on brain-PET patients with Despite this, there are limited data metabolic alterations found samples, targeted profiling metabolites involved has not performed. The aim the study was investigate whether related serum hip fracture associated cohort included 406 a mean age 81 years (standard deviation 10 years), acutely admitted hospital for surgical repair fracture. Delirium assessed daily until fifth postoperative day. collected from all participants at onset spinal anaesthesia, samples were drawn concurrently 213 participants. Glucose measured using amperometry, whereas plasma clinical laboratory enzymatic photometry. Serum branched-chain amino acids, 3-hydroxyisobutyric acid, acetoacetate β-hydroxybutyrate gas chromatography-tandem mass spectrometry (GC-MS/MS). In total, 224 (55%) developed delirium pre- or postoperatively. Ketone body (acetoacetate, β-hydroxybutyrate) acids significantly elevated but among delirium, despite no group differences concentrations. level acid both serum. An elevation during explained comorbidity. Our suggest that utilization shift ketone occurs

Language: Английский

Citations

Delirium is associated with loss of feedback cortical connectivity DOI

Klevest Gjini,

Cameron Casey, David Kunkel

et al.

Alzheimer s & Dementia, Journal Year: 2023, Volume and Issue: 20(1), P. 511 - 524

Published: Sept. 11, 2023

Abstract INTRODUCTION Post‐operative delirium (POD) is associated with increased morbidity and mortality but bereft of treatments, largely due to our limited understanding the underlying pathophysiology. We hypothesized that reflects a disturbance in cortical connectivity leads altered predictions sensory environment. METHODS High‐density electroencephalogram recordings during an oddball auditory roving paradigm were collected from 131 patients. Dynamic causal modeling (DCM) analysis facilitated inference about neuronal inhibition–excitation dynamics auditory‐evoked responses. RESULTS Mismatch negativity amplitudes smaller patients POD. DCM showed was decreased left‐sided superior temporal gyrus (l‐STG) cortex feedback connectivity. Feedback also negatively correlated severity systemic inflammation. Increased inhibition l‐STG, consequent decreases feed‐forward feed‐back connectivity, occurred for tones delirium. DISCUSSION Delirium possibly resulting intrinsic inhibitory tone. Highlights amplitude reduced Patients postoperative had feedforward before surgery. diminished left‐side left primary area inversely inflammation severity.

Language: Английский

Citations

Predilection for Perplexion: Preoperative microstructural damage is linked to postoperative delirium DOI

Tyler Reekes,

Vinith R. Upadhya,

Jenna L. Merenstein

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 9, 2025

Postoperative delirium is the most common postsurgical complication in older adults and associated with an increased risk of long-term cognitive decline Alzheimer's disease (AD) related dementias (ADRD). However, neurological basis this risk- whether postoperative unmasks latent preoperative pathology or leads to AD-relevant after perioperative brain injury-remains unclear. Recent advancements neuroimaging techniques now enable detection subtle features damage that may underlie clinical symptoms. Among these, Neurite Orientation Dispersion Density Imaging (NODDI) can help identify microstructural damage, even absence visible macro-anatomical abnormalities. To investigate potential abnormalities function, we analyzed pre- post-operative diffusion MRI data from 111 patients aged ≥60 years who underwent non-cardiac/non-intracranial surgery. Specifically, investigated variation metrics within posterior cingulate cortex (PCC), a region which prior work has identified glucose metabolism alterations delirious brain, key early accumulation amyloid beta (Aβ) preclinical AD. We also examined relationship PCC NODDI function. Compared did not develop (n=99), found free water (FISO) neurite density index (NDI) decreased orientation dispersion (ODI) dorsal before surgery among those later developed (n=12). These FISO differences remained present at six weeks postoperatively, while these NDI ODI not. Preoperative values were positively attention/concentration performance, independent age, education level, global atrophy. Yet, correlated cerebrospinal fluid Aβ positivity levels. results suggest susceptibility delirium, AD-related (i.e., Aβ) neuropathology. Furthermore, linked deficits attention/concentration, core feature delirium. Our findings highlight vulnerability PCC, default mode network, as neuroanatomic locus explain link between vulnerable surgical patients.

Language: Английский

Citations

Intranasal Insulin Diminishes Postoperative Delirium and Elevated Osteocalcin and Brain Derived Neurotrophic Factor in Older Patients Undergoing Joint Replacement: A Randomized, Double-Blind, Placebo-Controlled Trial DOI

Yang Mi, Lei Zhou,

Ge Long

et al.

Drug Design Development and Therapy, Journal Year: 2025, Volume and Issue: Volume 19, P. 759 - 769

Published: Feb. 1, 2025

Background: Brain energy metabolism disorders, including glucose utilization disorders and abnormal insulin sensitivity, are linked to the pathogenesis of postoperative delirium. Intranasal has shown significant benefits in improving metabolism, sensitivity cognitive function. However, its impact on delirium biomarkers remains unknown. Aim: This randomized, double-blind, placebo-controlled trial was evaluate whether intranasal reduces incidence severity (POD) older patients undergoing joint replacement, effect sensitivity-related biomarkers. Methods: 212 (≥ 65 years) were randomly assigned receive either 40 IU (n=106) or a placebo for 8 days. The primary objective determine POD within 5 days after surgery, estimated using Confusion Assessment Method (CAM) Delirium Rating Scale (DRS)-98. secondary which assessed homeostasis model Insulin Resistance (HOMA-IR) biomarkers, total osteocalcin (tOC), uncarboxylated (ucOC), brain-derived neurotrophic factor (BDNF). Main Results: Compared placebo, significantly reduced surgery (8 [8.33%] vs 23 [23.23%], P = 0.004, odds ratio [OR] 3.33 [95% CI 1.41– 7.88]) (P< 0.001). elevated levels tOC, ucOC, BDNF CSF D 0 (all P< 0.001) tOC plasma , 1 3 It ucOC group but not administration HOMA-IR (P=0.002). Conclusion: notably may be related elevation levels. Trial Registry Numbers: Chinese Clinical (ChiCTR2300068073). Keywords: insulin, osteocalcin, delirium, brain derived factor, patient

Language: Английский

Citations

Clinical biomarkers of perioperative neurocognitive disorder: initiation and recommendation DOI

Jianhui Liu, Cheng Li, Junyan Yao

et al.

Science China Life Sciences, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 22, 2025

Language: Английский

Citations

Brain Structural and Functional Changes Associated With Postoperative Neurocognitive Disorders: Research Update DOI

Huimin Wu,

Yaseen Ahammed,

Shouyuan Tian

et al.

Anesthesia & Analgesia, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 19, 2025

Postoperative neurocognitive disorders (PNDs) are frequent and serious perioperative complications in the elderly, associated with increased morbidity mortality, length of hospital stay, need for long-term care. At present, pathogenesis PND is not completely clear, there various risk factors including surgical trauma stress mediating systemic inflammation towards neuroinflammation development which causes brain structural functional changes namely PND. For elderly patients, neurological monitoring may provide insights into function status. Monitoring also help clinicians identify potential risks would ultimately allow timely effective intervention better safety prognosis patients. In this review, we summarize mechanisms PND, discuss preliminary evidence regarding application electroencephalography, near-infrared spectroscopy, magnetic resonance, positron emission tomography imaging central nervous system during postoperative period.

Language: Английский

Citations

Delirium in the ICU: Pathophysiology, Diagnosis and Management DOI

Neil J. Glassford,

R. E. Olver,

Yahya Shehabi

et al.

Published: Jan. 1, 2025

Language: Английский

Citations

Modernizing Medicine Through a Proof of Concept that Studies the Intersection of Robotic Exoskeletons, Computational Capacities and Dementia Care DOI

Ritwik Raj Saxena, Arshia Khan

Communications in computer and information science, Journal Year: 2025, Volume and Issue: unknown, P. 373 - 391

Published: Jan. 1, 2025

Language: Английский

Citations

Diffuse optical tomography for mapping cerebral hemodynamics and functional connectivity in delirium DOI

Shixie Jiang,

Jingyu Huang,

Hao Yang

et al.

Alzheimer s & Dementia, Journal Year: 2024, Volume and Issue: 20(6), P. 4032 - 4042

Published: May 3, 2024

Abstract INTRODUCTION Delirium is associated with mortality and new onset dementia, yet the underlying pathophysiology remains poorly understood. Development of imaging biomarkers has been difficult given challenging nature delirious patients. Diffuse optical tomography (DOT) offers a promising approach for investigating delirium its portability three‐dimensional capabilities. METHODS Twenty‐five matched non‐delirious patients ( n = 50) were examined using DOT, comparing cerebral oxygenation functional connectivity in prefrontal cortex during after an episode delirium. RESULTS Total hemoglobin values significantly decreased group, even resolution. Functional between dorsolateral dorsomedial was strengthened post‐resolution compared to episode; however, this relationship still weaker controls. DISCUSSION These findings highlight DOT's potential as biomarker measure impaired dysconnectivity Future studies should focus on role pathogenesis exploring etiological link dementias. Highlights We developed portable diffuse system bedside neuroimaging study hospital. implemented novel DOT task‐focused seed‐based correlation analysis. revealed strength resolution

Language: Английский

Citations