Predisposition for delirium and EEG characteristics

Abstract

Objective: Delirium is associated with increased electroencephalography (EEG) delta activity, decreased connectivity strength and decreased network integration. To improve our understanding of development of delirium, we studied whether non-delirious individuals with a predisposition for delirium also show these EEG abnormalities.

Methods: Elderly subjects (N = 206) underwent resting-state EEG measurements and were assessed on predisposing delirium risk factors, i.e. older age, alcohol misuse, cognitive impairment, depression, functional impairment, history of stroke and physical status. Delirium-related EEG characteristics of interest were relative delta power, alpha connectivity strength (phase lag index) and network integration (minimum spanning tree leaf fraction). Linear regression analyses were used to investigate the relation between predisposing delirium risk factors and EEG characteristics that are associated with delirium, adjusting for confounding and multiple testing.

Results: Functional impairment was related to a decrease in connectivity strength (adjusted R² = 0.071, β = 0.201, p < 0.05). None of the other risk factors had significant influence on EEG delta power, connectivity strength or network integration.

Conclusions: Functional impairment seems to be associated with decreased alpha connectivity strength. Other predisposing risk factors for delirium had no effect on the studied EEG characteristics.

Significance: Predisposition for delirium is not consistently related to EEG characteristics that can be found during delirium.

Trial registration: ClinicalTrials.gov NCT02265263.

Keywords: Delirium; EEG; Functional connectivity; Functional impairment; Graph analysis; Risk factors.