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. 2014 Dec;51(4):376-382.
doi: 10.5152/npa.2014.6999. Epub 2014 Dec 1.

Role of CRP, TNF-a, and IGF-1 in Delirium Pathophysiology

Mehmet Alper Çinar  1 , Adem Balikçi  2 , Erdim Sertoğlu  3 , A K Mehmet  2 , Muhittin A Serdar  4 , Kamil Nahit Özmenler  2
Affiliations

Role of CRP, TNF-a, and IGF-1 in Delirium Pathophysiology

Mehmet Alper Çinar et al. Noro Psikiyatr Ars. 2014 Dec.

Abstract

Introduction: Delirium is a common and life-threatening neuropsychiatric syndrome. Diagnosing delirium can be challenging, which increases mortality and mortality rates and health care costs. The biologic model of delirium is not definite yet, but evidence supports a cholinergic deficiency model. Delirium may be the result of processes and drugs that trespass a compromised blood-brain barrier. We aimed to evaluate the possible diagnostic utilization and the role of certain biomarkers, such as C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and insulin like growth factor-1 (IGF-1), in delirium etiology.

Methods: A total of 93 inpatients that planned to undergo cardiovascular surgery were informed; 35 of them completed the study. Medical history and current cognitive status were evaluated pre-operatively. Participants were followed using Delirium Rating Scale-Revised-98 Turkish (DRS-R98-T) for delirium symptoms, and blood samples were collected post-operatively.

Results: Delirium was developed more in participants who had worse pre-operative cognitive status. Also, low pre-operative IGF-1 levels were detected in the delirium group. Pre-operative CRP and TNF-α levels were not different between groups.

Conclusion: Low IGF-1 levels can be used to predict delirium after surgery. However, the complex nature of cytokines and delirium itself make it difficult to utilize cytokines to predict delirium instead of psychometric tools.

Keywords: CRP; DRS-R98-T; Delirium; IGF-1; TNF-α.

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Conflict of interest statement

Conflict of Interest: The authors reported no conflict of interest related to this article.

Figures

Figure 1
Figure 1
IGF-1 values in controls and patients with delirium.
See this image and copyright information in PMC

References

    1. Trzepacz PT, Bourne R, Zhang S. Designing clinical trials for the treatment of delirium. J Psychosom Res. 2008;65:299–307. http://dx.doi.org/10.1016/j.jpsychores.2008.06.001. - DOI - PubMed
    1. Trzepacz PT, Meagher DJ. Neuropsychiatric aspects of delirium. In: Yudofsky SC, Hales RE, editors. American Psyhiatric Publishing Textbook of Neuropsychiatry and Clinical Neurosciences içinde. 5 Baskı. Washington DC: American Psychiatric Publishing; 2007. pp. 445–517.
    1. Laurila JV, Pitkala KH, Strandberg TE, Tilvis RS. Confusion assessment method in the diagnostics of delirium among aged hospital patients: would it serve better in screening than as a diagnostic instrument? Int J Geriatr Psychiatry. 2002;17:1112–1119. http://dx.doi.org/10.1002/gps.753. - DOI - PubMed
    1. O’Keeffe ST, Gosney MA. Assessing attentiveness in older hospital patients: global assessment versus tests of attention. J Am Geriatr Soc. 1997;45:470–473. - PubMed
    1. Agbayewa MO. Recognition of organic mental disorders by physicians. CMAJ. 1983;128:927–928. - PMC - PubMed

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