Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 30;5(1):fcad013.
doi: 10.1093/braincomms/fcad013. eCollection 2023.

Postoperative delirium is associated with grey matter brain volume loss

Ilse M J Kant  1   2 , Jeroen de Bresser  3 , Simone J T van Montfort  1 , Theodoor D Witkamp  4 , Bob Walraad  1 , Claudia D Spies  5 , Jeroen Hendrikse  4 , Edwin van Dellen  1   6 , Arjen J C Slooter  1   6   7 ; BioCog consortium
Collaborators, Affiliations

Postoperative delirium is associated with grey matter brain volume loss

Ilse M J Kant et al. Brain Commun. .

Abstract

Delirium is associated with long-term cognitive dysfunction and with increased brain atrophy. However, it is unclear whether these problems result from or predisposes to delirium. We aimed to investigate preoperative to postoperative brain changes, as well as the role of delirium in these changes over time. We investigated the effects of surgery and postoperative delirium with brain MRIs made before and 3 months after major elective surgery in 299 elderly patients, and an MRI with a 3 months follow-up MRI in 48 non-surgical control participants. To study the effects of surgery and delirium, we compared brain volumes, white matter hyperintensities and brain infarcts between baseline and follow-up MRIs, using multiple regression analyses adjusting for possible confounders. Within the patients group, 37 persons (12%) developed postoperative delirium. Surgical patients showed a greater decrease in grey matter volume than non-surgical control participants [linear regression: B (95% confidence interval) = -0.65% of intracranial volume (-1.01 to -0.29, P < 0.005)]. Within the surgery group, delirium was associated with a greater decrease in grey matter volume [B (95% confidence interval): -0.44% of intracranial volume (-0.82 to -0.06, P = 0.02)]. Furthermore, within the patients, delirium was associated with a non-significantly increased risk of a new postoperative brain infarct [logistic regression: odds ratio (95% confidence interval): 2.8 (0.7-11.1), P = 0.14]. Our study was the first to investigate the association between delirium and preoperative to postoperative brain volume changes, suggesting that delirium is associated with increased progression of grey matter volume loss.

Keywords: brain infarcts; brain volume; delirium; encephalopathy; grey matter.

PubMed Disclaimer

Figures

Graphical abstract
Graphical abstract
See this image and copyright information in PMC

References

    1. Slooter AJC, Otte WM, Devlin JW, et al. Updated nomenclature of delirium and acute encephalopathy: Statement of ten societies. Intensive Care Med. 2020;46:1020‐11022. - PMC - PubMed
    1. Wilson JE, Mart MF, Cunningham C, et al. Delirium. Nat Rev Dis Prim. 2020;6(1):90. - PMC - PubMed
    1. Sprung J, Roberts RO, Weingarten TN, et al. Postoperative delirium in elderly patients is associated with subsequent cognitive impairment. Br J Anaesth. 2017;119(2):316–323. - PubMed
    1. Saczynski JS, Marcantonio ER, Quach L, et al. Cognitive trajectories after postoperative delirium. N Engl J Med. 2012;367(1):30–39. - PMC - PubMed
    1. Soiza RL, Sharma V, Ferguson K, Shenkin SD, Seymour DG, MacLullich AMJ. Neuroimaging studies of delirium: A systematic review. J Psychosom Res. 2008;65(3):239–248. - PubMed