Permutation Entropy Does Not Track the Electroencephalogram-Related Manifestations of Paradoxical Excitation During Propofol-Induced Loss of Responsiveness: Results From a Prospective Observational Cohort Study DOI
Julian Ostertag, Robert Zanner, Gerhard Schneider

et al.

Anesthesia & Analgesia, Journal Year: 2024, Volume and Issue: unknown

Published: Feb. 27, 2024

During the anesthetic-induced loss of responsiveness (LOR), a "paradoxical excitation" with activation β-frequencies in electroencephalogram (EEG) can be observed. Thus, spectral parameters-as widely used commercial anesthesia monitoring devices-may mistakenly indicate that patients are awake when they actually losing responsiveness. Nonlinear time-domain parameters such as permutation entropy (PeEn) may analyze additional EEG information and appropriately reflect change cognitive state during transition. Determining which correctly track level is essential for designing algorithms but also give valuable insight regarding signal characteristics transitions.

Language: Английский

Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients DOI Creative Commons
César Aldecoa,

Gabriella Bettelli,

Federico Bilotta

et al.

European Journal of Anaesthesiology, Journal Year: 2023, Volume and Issue: unknown

Published: Aug. 21, 2023

Postoperative delirium (POD) remains a common, dangerous and resource-consuming adverse event but is often preventable. The whole peri-operative team can play key role in its management. This update to the 2017 ESAIC Guideline on prevention of POD evidence-based consensus-based considers literature between 01 April 2015, 28 February 2022. search terms broad were identical those used first version guideline published 2017. was defined accordance with DSM-5 criteria. had be measured validated screening tool, at least once per day for 3 days starting recovery room or postanaesthesia care unit surgery or, latest, postoperative 1. Recent confirmed pathogenic surgery-induced inflammation, this concept reinforces positive multicomponent strategies aimed reduce surgical stress response. Although some putative precipitating risk factors are not modifiable (length surgery, site), others (such as depth anaesthesia, appropriate analgesia haemodynamic stability) under control anaesthesiologists. Multicomponent preoperative, intra-operative preventive measures showed potential incidence duration POD, confirming pivotal comprehensive team-based approach improve patients’ clinical functional status.

Language: Английский

Citations

74
Association between plasma tau and postoperative delirium incidence and severity: a prospective observational study DOI Creative Commons

Tyler Ballweg,

Marissa White,

Margaret Parker

et al.

British Journal of Anaesthesia, Journal Year: 2020, Volume and Issue: 126(2), P. 458 - 466

Published: Nov. 20, 2020

Language: Английский

Citations

103
Susceptibility to acute cognitive dysfunction in aged mice is underpinned by reduced white matter integrity and microgliosis DOI Creative Commons
Dáire Healy, Carol Murray,

C. McAdams

et al.

Communications Biology, Journal Year: 2024, Volume and Issue: 7(1)

Published: Jan. 16, 2024

Abstract Age is a significant but heterogeneous risk factor for acute neuropsychiatric disturbances such as delirium. Neuroinflammation increases with aging the determinants of underlying dysfunction upon systemic inflammation are not clear. We hypothesised that, advancing age, mice would become progressively more vulnerable to cognitive and that neuroinflammation neuronal integrity might predict heterogeneity in vulnerability. Here we show region-dependent differential expression microglial transcripts, ubiquitously observed primed signature: chronic Clec7a exaggerated Il1b responses bacterial LPS. Cognitive frailty (vulnerability disruption under stressors LPS double stranded RNA; poly I:C) was increased aged animals showed significantly correlated reduced myelin density, synaptic loss severity white matter microgliosis. The data indicate may be key substrates progressive delirium individuals.

Language: Английский

Citations

10
Clinical and intracranial electrophysiological signatures of post-operative and post-ictal delirium DOI
Matthew I. Banks,

Emily R. Dappen,

Elie Matar

et al.

Clinical Neurophysiology, Journal Year: 2025, Volume and Issue: 171, P. 38 - 50

Published: Jan. 20, 2025

Language: Английский

Citations

1
Inflammation Disrupts the Brain Network of Executive Function after Cardiac Surgery DOI
Yangzi Zhu,

Meiyan Zhou,

Xiuqin Jia

et al.

Annals of Surgery, Journal Year: 2021, Volume and Issue: 277(3), P. e689 - e698

Published: July 2, 2021

To investigate postoperative functional connectivity (FC) alterations across impaired cognitive domains and their causal relationships with systemic inflammation.Postoperative dysfunction commonly occurs after cardiac surgery, both neuroinflammation may trigger its development. Whether FC underlying deficits in specific surgery are affected by inflammation remains unclear.Seventeen patients, who underwent valve replacement, completed a neuropsychological test battery brain MRI scan before on days 7 30 compared to age-matched healthy controls. Blood samples were taken for tumor necrosis factor-a interleukin-6 measurements. Seed-to-voxel of the left dorsolateral prefrontal cortex (DLPFC) was examined. Bivariate correlation linear regression models used determine among function, alterations, cytokines.Executive function significantly surgery. At day follow-up, surgical controls, demonstrated decreased DLPFC superior parietal lobe attenuated negative default mode network, including angular gyrus posterior cingulate cortex. The enhanced right cortex, all which related increased executive up surgery.The control network anticorrelation contribute Systemic these transient changes impairments.

Language: Английский

Citations

42
Electroencephalography in delirium assessment: a scoping review DOI Creative Commons
Tim L. T. Wiegand, Jan Rémi, Konstantinos Dimitriadis

et al.

BMC Neurology, Journal Year: 2022, Volume and Issue: 22(1)

Published: March 11, 2022

Abstract Background Delirium is a common disorder affecting around 31% of patients in the intensive care unit (ICU). assessment scores such as Confusion Assessment Method (CAM) are time-consuming, they cannot differentiate between different types delirium and their etiologies, may have low sensitivities clinical setting. While today, electroencephalography (EEG) increasingly being applied to delirious ICU, lack clear cut EEG signs, leads inconsistent assessments. Methods We therefore conducted scoping review on findings delirium. One thousand two hundred thirty-six articles identified through database search PubMed Embase were reviewed. Finally, 33 original included synthesis. Results seems offer manifold possibilities diagnosing All studies showed certain degree qualitative or quantitative alterations Thus, normal routine (rEEG) continuous (cEEG) make presence very unlikely. used research protocols at least some extent. These include differences time points, duration, conditions, recording methods EEG, well patient populations, diagnostic for synthesis recommendations so far elusive. Conclusion Future should compare evaluation identify robust parameters everyday use. Evidence bi-electrode detection based increased relative delta power decreased beta growing be further pursued. Additionally, evolution including outcomes needed.

Language: Английский

Citations

35
Efficacy of transcranial direct current stimulation on postoperative delirium in elderly patients undergoing lower limb major arthroplasty: A randomized controlled trial DOI Creative Commons

Mingshu Tao,

Song Zhang, Yuan Han

et al.

Brain stimulation, Journal Year: 2023, Volume and Issue: 16(1), P. 88 - 96

Published: Jan. 1, 2023

BackgroundPostoperative delirium (POD) is a common and severe postoperative complication in elderly patients undergoing major surgery linked to increased morbidity mortality. It reported that transcranial direct current stimulation (tDCS) effectively enhances cognitive function improves impaired consciousness.ObjectiveThis study aimed evaluate the efficacy of tDCS on POD lower limb arthroplasty, including total hip arthroplasty (THA) or knee (TKA).MethodsPatients aged ≥65 years scheduled for THA TKA were randomly assigned receive 2 mA 20 min active-tDCS (n = 61) sham-tDCS 61). The primary outcome was incidence during first 3 days.ResultsAll 122 (median age, 70 years; 80 women [65.6%]) completed trial. incident risk 4.9% 3) vs. 19.7% 12) groups, respectively (relative risk, 0.250; 95% CI, 0.074 0.842; P 0.013). Compared group, anxiety depression scores group at h one day after (P < 0.001 each), pain three days 0.05).ConclusionOne session anodal over left dorsolateral prefrontal cortex may decrease arthroplasty.

Language: Английский

Citations

21
Preclinical and translational models for delirium: Recommendations for future research from the NIDUS delirium network DOI Creative Commons
Sarinnapha M. Vasunilashorn, Nadia Lunardi, John C. Newman

et al.

Alzheimer s & Dementia, Journal Year: 2023, Volume and Issue: 19(5), P. 2150 - 2174

Published: Feb. 17, 2023

Abstract Delirium is a common, morbid, and costly syndrome that closely linked to Alzheimer's disease (AD) AD‐related dementias (ADRD) as risk factor outcome. Human studies of delirium have advanced our knowledge incidence prevalence, factors, biomarkers, outcomes, prevention, management. However, understanding neurobiology remains limited. Preclinical translational models for delirium, while challenging develop, could advance inform the development new prevention treatment approaches. We discuss use preclinical animal in focusing on (1) review current models, (2) challenges strategies replicating elements human animals, (3) utility biofluid, neurophysiology, neuroimaging markers animals. conclude with recommendations validation goal advancing awareness this important field.

Language: Английский

Citations

18
Prevalence of clinical electroencephalography findings in stroke patients with delirium DOI
Noa Mintz,

N.L. Andrews,

Kelly Pan

et al.

Clinical Neurophysiology, Journal Year: 2024, Volume and Issue: 162, P. 229 - 234

Published: March 16, 2024

Language: Английский

Citations

6
Regional cerebral hypometabolism on 18F‐FDG PET/CT scan in delirium is independent of acute illness and dementia DOI Creative Commons
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

26