Preoperative MRI brain phenotypes are related to postoperative delirium in older individuals

NEUROBIOLOGY OF AGING

卷:101

Article

Kant, Ilse M. J.¹  Slooter, Arjen J. C.¹  Jaarsma-Coes, Myriam²  van Montfort, Simone J. T.¹  Witkamp, Theo D.³  Pasma, Wietze¹  Hendrikse, Jeroen³  de Bresser, Jeroen² 

[1] Univ Utrecht, Univ Med Ctr Utrecht, Brain Ctr, Dept Intens Care Med, Heidelberglaan 100, Utrecht, Netherlands

[2] Leiden Univ, Med Ctr, Dept Radiol, Leiden, Netherlands

[3] Univ Utrecht, Univ Med Ctr Utrecht, Brain Ctr, Dept Radiol, Utrecht, Netherlands

关键词: Delirium;    Encephalopathy;    Brain phenotypes;    MRI;   

DOI  :  10.1016/j.neurobiolaging.2021.01.033

来源: Elsevier

【 摘 要 】

The underlying structural correlates of predisposition to postoperative delirium remain largely unknown. A combined analysis of preoperative brain magnetic resonance imaging (MRI) markers could improve our understanding of the pathophysiology of delirium. Therefore, we aimed to identify different MRI brain phenotypes in older patients scheduled for major elective surgery, and to assess the relation be-tween these phenotypes and postoperative delirium. Markers of neurodegenerative and neurovascular brain changes were determined from MRI brain scans in older patients (n = 161, mean age 71, standard deviation 5 years), of whom 24 (15%) developed delirium. A hierarchical cluster analysis was performed. We found six distinct groups of patients with different MRI brain phenotypes. Logistic regression analysis showed a higher odds of developing postoperative delirium in individuals with multi-burden pathology (n = 15 (9%), odds ratio (95% confidence interval): 3.8 (1.1-13.0)). In conclusion, these results indicate that different MRI brain phenotypes are related to a different risk of developing delirium after major elective surgery. MRI brain phenotypes could assist in an improved understanding of the structural correlates of predisposition to postoperative delirium. (c) 2021 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )

【 授权许可】

Free