Optical Neuroimaging in Delirium DOI Creative Commons
Shixie Jiang, Philip A. Efron, Esther S. Oh

et al.

Photonics, Journal Year: 2023, Volume and Issue: 10(12), P. 1334 - 1334

Published: Dec. 1, 2023

Delirium persists as the most common neuropsychiatric syndrome among medically ill hospitalized patients, yet its neural mechanisms remain poorly understood. The development of neuroimaging biomarkers has been difficult primarily due to complexities imaging patients experiencing delirium. Optical techniques, including near-infrared spectroscopy (NIRS) and diffuse optical tomography (DOT), offer promising avenues for investigating delirium’s pathophysiology. These modalities uniquely stand out delirium exploration their blend spatiotemporal resolution, bedside applicability, cost-effectiveness, potential real-time monitoring. In this review, we examine emergence pioneering utility in research. With further investment research efforts, they will become instrumental our understanding pathophysiology preventive, predictive, therapeutic strategies.

Language: Английский

Aptamer-Based Proteomics Measuring Preoperative Cerebrospinal Fluid Protein Alterations Associated with Postoperative Delirium DOI Creative Commons
Simon T. Dillon, Sarinnapha M. Vasunilashorn, Hasan H. Otu

et al.

Biomolecules, Journal Year: 2023, Volume and Issue: 13(9), P. 1395 - 1395

Published: Sept. 15, 2023

Delirium is a common postoperative complication among older patients with many adverse outcomes. Due to lack of validated biomarkers, prediction and monitoring delirium by biological testing not currently feasible. Circulating proteins in cerebrospinal fluid (CSF) may reflect processes causing delirium. Our goal was discover investigate candidate protein biomarkers preoperative CSF that were associated the development surgical patients. We employed nested case–control study design coupled high multiplex affinity proteomics analysis measure 1305 CSF. Twenty-four matched cases non-delirium controls selected from Healthier Postoperative Recovery (HiPOR) cohort, associations between levels assessed using t-test statistics further systems biology elucidate pathophysiology. Proteomics identified 32 significantly associate (t-test p < 0.05). limited sample size, these did remain significant multiple hypothesis Benjamini–Hochberg correction q-value method. Three algorithms applied separate controls. Hierarchical clustering classified 40/48 samples correctly, principal components separated 43/48. The receiver operating characteristic curve yielded an area under [95% confidence interval] 0.91 [0.80–0.97]. Systems several key pathways risk delirium: inflammation, immune cell migration, apoptosis, angiogenesis, synaptic depression neuronal death. might discriminate individuals who subsequently develop control samples. These are potential for play role its

Language: Английский

Citations

7
Association Between 18F-FDG PET Activity and HER2 Status in Breast Cancer Brain Metastases DOI Creative Commons
Jonathan R. Young, Julie A. Ressler, Joanne Mortimer

et al.

Nuclear Medicine and Molecular Imaging, Journal Year: 2024, Volume and Issue: 58(3), P. 113 - 119

Published: Feb. 1, 2024

Abstract Purpose The objective of this study was to evaluate whether uptake on 18 F-fluorodeoxyglucose ( F-FDG) PET could help differentiate HER2-positive from HER2-negative breast cancer brain metastases. Methods In retrospective, cross-sectional a cohort 14 histologically proven metastases, we analyzed both preoperative F-FDG PET/CT and HER2 status the resected/biopsied specimens. maximum standardized values (SUVmax) lesions were normalized contralateral normal white matter compared using Mann–Whitney U tests. Results comprised 12 women with mean age 59 years (range: 43–76 years) total distinct metastatic lesions. SUVmax ratio metastases significantly greater than that (3.98 vs 1.79, = 38.00, p 0.008). Conclusion may identify if validated prospectively.

Language: Английский

Citations

2
Structural disconnectivity in postoperative delirium: A perioperative two‐center cohort study in older patients DOI Creative Commons
Marinus Fislage, Stefan Winzeck, Rebecca Woodrow

et al.

Alzheimer s & Dementia, Journal Year: 2024, Volume and Issue: 20(4), P. 2861 - 2872

Published: March 7, 2024

Abstract BACKGROUND Structural disconnectivity was found to precede dementia. Global white matter abnormalities might also be associated with postoperative delirium (POD). METHODS We recruited older patients (≥65 years) without dementia that were scheduled for major surgery. Diffusion kurtosis imaging metrics obtained preoperatively, after 3 and 12 months postoperatively. calculated fractional anisotropy (FA), mean diffusivity (MD), (MK), free water (FW). A structured validated assessment performed twice daily. RESULTS Of 325 patients, 53 developed POD (16.3%). Preoperative global MD (standardized beta 0.27 [95% confidence interval [CI] 0.21–0.32] p < 0.001) higher in POD. MK (−0.07 CI −0.11 (−0.04)] FA (0.07 −0.10 lower. When correcting baseline diffusion, lower (0.05 −0.08 (−0.03)] 0.001; n = 183) (0.28 0.20–0.35] 45) among DISCUSSION structural lead depletion

Language: Английский

Citations

2
Association between preoperative persistent hyperglycemia and postoperative delirium in geriatric hip fracture patients DOI Creative Commons
Wei Wang, Yingqi Zhang,

Wei Yao

et al.

BMC Geriatrics, Journal Year: 2024, Volume and Issue: 24(1)

Published: July 8, 2024

Abstract Background The management of preoperative blood glucose levels in reducing the incidence postoperative delirium (POD) remains controversial. This study aims to investigate impact persistent hyperglycemia on POD geriatric patients with hip fractures. Methods retrospective cohort analyzed medical records who underwent fracture surgery at a tertiary institution between January 2013 and November 2023. Patients were categorized based (hyperglycemia defined as ≥ 6.1mmol/L), clinical classification hyperglycemia, percentile thresholds. Multivariate logistic regression propensity score matching analysis (PSM) employed assess association different POD. Subgroup was conducted explore potential interactions. Results A total 1440 included this study, an rate 19.1% (275/1440). Utilizing multiple analysis, we found that had 1.65-fold increased risk experiencing compared those normal (95% CI: 1.17–2.32). Moreover, significant upward trend discerned both strength predicted probability higher levels. PSM did not alter trend, even after meticulous adjustments for confounding factors. Additionally, when treating continuous variable, observed 6% increase 1-12%) each 1mmol/L elevation Conclusions There exists clear linear dose-response relationship Higher associated greater Clinical trial number NCT06473324.

Language: Английский

Citations

2
Successful aging after elective surgery II: Study design and methods DOI
Tammy T. Hshieh,

Eva M. Schmitt,

Tamara G. Fong

et al.

Journal of the American Geriatrics Society, Journal Year: 2022, Volume and Issue: 71(1), P. 46 - 61

Published: Oct. 10, 2022

Abstract Background The Successful Aging after Elective Surgery (SAGES) II study was designed to increase knowledge of the pathophysiology and linkages between delirium dementia. We examine novel biomarkers potentially associated with delirium, including inflammation, Alzheimer's disease (AD) pathology neurodegeneration, neuroimaging markers, neurophysiologic markers. goal this paper is describe design methods for SAGES study. Methods a 5‐year prospective observational 400–420 community dwelling persons, aged 65 years older, assessed prior scheduled surgery followed daily throughout hospitalization observe development other clinical outcomes. Delirium measured Confusion Assessment Method (CAM), long form, cognitive testing. Cognitive function detailed neuropsychologic test battery, summarized as weighted composite, General Performance (GCP) score. Other key measures include magnetic resonance imaging (MRI), transcranial stimulation (TMS)/electroencephalography (EEG), Amyloid positron emission tomography (PET) imaging. eligibility criteria, enrollment flow, timing assessments, variables collected at baseline during repeated assessments 1, 2, 6, 12, 18 months. Results This describes hospital surgery‐related variables, long‐term decline, outcomes, biomarkers. In inter‐rater reliability CAM ratings (weighted kappa = 0.91, 95% confidence interval, CI 0.74–1.0) in 50 paired GCP 0.99, 0.94–1.0) 25 assessments. procedures data quality assurance Covid‐19 adaptations. Conclusions complex presents an innovative effort advance our understanding inter‐relationship dementia via biomarkers, context major older adults. Strengths integration MRI, TMS/EEG, PET modalities, high‐quality longitudinal data.

Language: Английский

Citations

5
Identification of 18F-FDG PET/CT Parameters Associated with Weight Loss in Patients with Esophageal Cancer DOI Open Access
Thierry Galvez,

Ikrame Berkane,

Simon Thézenas

et al.

Nutrients, Journal Year: 2023, Volume and Issue: 15(13), P. 3042 - 3042

Published: July 5, 2023

18F-FDG PET-CT is routinely performed as part of the initial staging numerous cancers. Other than having descriptive, predictive and prognostic values for tumors, provides full-body data, which could inform on concurrent pathophysiological processes such malnutrition. To test this hypothesis, we measured uptake in several organs evaluated their association with weight loss patients at diagnosis esophageal cancer. Forty-eight were included retrospective monocentric study. quantification was brain, liver, spleen, bone marrow, muscle tumor itself compared between different amounts loss. We found that Total Lesion Glycolysis (TLG) peak Standardized Uptake Values (SUVpeak) brain correlated amount loss: TLG was, average, higher who had lost more 5% usual weight, whereas SUVpeak were, lower 10% weight. Higher associated worse OS univariate analysis. This study reports a new significant

Language: Английский

Citations

2
The Thalamus in Perioperative Neurocognitive Disorders DOI
Marinus Fislage, Norman Zacharias, Insa Feinkohl

et al.

Neuropsychology Review, Journal Year: 2023, Volume and Issue: 34(3), P. 850 - 859

Published: Sept. 22, 2023

Language: Английский

Citations

2
A Molecular Framework for Delirium DOI
Kyle A. Lyman

The Neurohospitalist, Journal Year: 2023, Volume and Issue: 14(2), P. 147 - 156

Published: Nov. 10, 2023

Over 2.6 million adults over the age of 65 develop delirium each year in United States (US). Delirium is associated with a significant increase mortality and US health care costs are estimated at $164 billion annually. Despite prevalence condition, molecular pathophysiology remains unexplained, limiting development pharmacotherapies. Delirious patients can be identified by prominent impairments attention working memory (WM), two cognitive domains that localize to dorsolateral prefrontal cortex (dlPFC). The dlPFC also key site for Alzheimer's disease (AD) pathology, given high risk AD patients, suggests efforts understanding might focus on as final common endpoint changes. Preclinical studies reproduce many pharmacological observations made delirious including sensitivity anticholinergics an 'inverted U' pattern dependence monoaminergic input, diminished performance outside narrow range signaling. Medications like guanfacine, which influence context attention-deficit/hyperactivity disorder (ADHD), have emerged therapies motivate detailed α-2 agonists WM. In this review, I will discuss neural circuitry mechanisms underlying WM function dlPFC. Localizing deficits commonly seen may help identify new targets highly prevalent disease.

Language: Английский

Citations

2
Sigmoid Micro-Perforation and Pelvic Abscess Masquerading as Hyperactive Delirium DOI Open Access
Samer Alkhuja,

Susheer Dilbagh Gandotra,

Hirenkumar Faldu

et al.

Case Reports in Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(08), P. 315 - 320

Published: Jan. 1, 2024

Language: Английский

Citations

0
The Relationship between Delirium and Dementia DOI
Mfon Umoh,

Dennis Fitzgerald,

Sarinnapha M. Vasunilashorn

et al.

Seminars in Neurology, Journal Year: 2024, Volume and Issue: 44(06), P. 732 - 751

Published: Oct. 11, 2024

Delirium and dementia are common causes of cognitive impairment in older adults. They distinct but interrelated. Delirium, an acute confusional state, has been linked to the chronic progressive loss ability seen dementia. Individuals with at higher risk for delirium, delirium itself is a factor incident Additionally, individuals can hasten underlying decline. In this review, we summarize recent literature linking these conditions, including epidemiological, clinicopathological, neuroimaging, biomarker, experimental evidence supporting intersection between conditions. Strategies evaluation diagnosis that focus on distinguishing from clinical settings recommendations prevention interventions patients presented. We also discuss studies provide may be modifiable consider impact long-term outcomes.

Language: Английский

Citations

0