Association of postoperative delirium with markers of neurodegeneration and brain amyloidosis

a pilot study

Elena Rolandi, Enrica Cavedo, Michela Pievani, Samantha Galluzzi, Federica Ribaldi, Christopher Buckley, Colm Cunningham, Ugo Paolo Guerra, Monica Musarra, Sabrina Morzenti, Silvia Magnaldi, Mirko Patassini, Flavio Terragnoli, Luca Matascioli, Simone Franzoni, Giorgio Annoni, Lucio Carnevali, Giuseppe Bellelli, Giovanni B Frisoni

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The aim of the study was to investigate the association between postoperative delirium (POD) and in vivo markers of Alzheimer's disease pathology in nondemented hip fracture surgery patients. POD was assessed with the Confusion Assessment Method. Amyloid load was quantified on 18F-Flutemetamol positron emission tomography images as standardized uptake value ratio. Secondary outcome measures were gray matter volumes, white matter integrity, and functional connectivity at rest. All the patients with POD (POD+, N = 5) were amyloid negative (standardized uptake value ratio <0.59), whereas 6 out of 11 patients without POD (POD-) showed brain amyloid positivity. POD+ compared to POD- displayed: lower gray matter volumes in the amygdala (p = 0.003), in the middle temporal gyrus and in the anterior cingulate cortex (p < 0.001), increased diffusivity in the genu of the corpus callosum and in the anterior corona radiata (p < 0.05), and higher functional connectivity within the default mode network (p < 0.001). POD patients showed altered gray and white matter integrity in the fronto-limbic regions in absence of brain amyloidosis. Based on this preliminary investigation, delirium pathophysiology might be independent of Alzheimer's disease. Future studies on larger samples are needed to confirm this hypothesis.

Original languageEnglish
Number of pages9
JournalNeurobiology of Aging
Volume61
DOIs
Publication statusE-pub ahead of print - 2017

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Delirium
Amyloidosis
Brain
Amyloid
Alzheimer Disease
Confusion
Corpus Callosum
Gyrus Cinguli
Hip Fractures
Temporal Lobe
Amygdala
Positron-Emission Tomography
Outcome Assessment (Health Care)
Pathology

Keywords

  • Journal Article

Cite this

Association of postoperative delirium with markers of neurodegeneration and brain amyloidosis : a pilot study. / Rolandi, Elena; Cavedo, Enrica; Pievani, Michela; Galluzzi, Samantha; Ribaldi, Federica; Buckley, Christopher; Cunningham, Colm; Guerra, Ugo Paolo; Musarra, Monica; Morzenti, Sabrina; Magnaldi, Silvia; Patassini, Mirko; Terragnoli, Flavio; Matascioli, Luca; Franzoni, Simone; Annoni, Giorgio; Carnevali, Lucio; Bellelli, Giuseppe; Frisoni, Giovanni B.

In: Neurobiology of Aging, Vol. 61, 2017.

Research output: Contribution to journalArticle

Rolandi, E, Cavedo, E, Pievani, M, Galluzzi, S, Ribaldi, F, Buckley, C, Cunningham, C, Guerra, UP, Musarra, M, Morzenti, S, Magnaldi, S, Patassini, M, Terragnoli, F, Matascioli, L, Franzoni, S, Annoni, G, Carnevali, L, Bellelli, G & Frisoni, GB 2017, 'Association of postoperative delirium with markers of neurodegeneration and brain amyloidosis: a pilot study', Neurobiology of Aging, vol. 61. https://doi.org/10.1016/j.neurobiolaging.2017.09.020
Rolandi, Elena ; Cavedo, Enrica ; Pievani, Michela ; Galluzzi, Samantha ; Ribaldi, Federica ; Buckley, Christopher ; Cunningham, Colm ; Guerra, Ugo Paolo ; Musarra, Monica ; Morzenti, Sabrina ; Magnaldi, Silvia ; Patassini, Mirko ; Terragnoli, Flavio ; Matascioli, Luca ; Franzoni, Simone ; Annoni, Giorgio ; Carnevali, Lucio ; Bellelli, Giuseppe ; Frisoni, Giovanni B. / Association of postoperative delirium with markers of neurodegeneration and brain amyloidosis : a pilot study. In: Neurobiology of Aging. 2017 ; Vol. 61.
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abstract = "The aim of the study was to investigate the association between postoperative delirium (POD) and in vivo markers of Alzheimer's disease pathology in nondemented hip fracture surgery patients. POD was assessed with the Confusion Assessment Method. Amyloid load was quantified on 18F-Flutemetamol positron emission tomography images as standardized uptake value ratio. Secondary outcome measures were gray matter volumes, white matter integrity, and functional connectivity at rest. All the patients with POD (POD+, N = 5) were amyloid negative (standardized uptake value ratio <0.59), whereas 6 out of 11 patients without POD (POD-) showed brain amyloid positivity. POD+ compared to POD- displayed: lower gray matter volumes in the amygdala (p = 0.003), in the middle temporal gyrus and in the anterior cingulate cortex (p < 0.001), increased diffusivity in the genu of the corpus callosum and in the anterior corona radiata (p < 0.05), and higher functional connectivity within the default mode network (p < 0.001). POD patients showed altered gray and white matter integrity in the fronto-limbic regions in absence of brain amyloidosis. Based on this preliminary investigation, delirium pathophysiology might be independent of Alzheimer's disease. Future studies on larger samples are needed to confirm this hypothesis.",
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T1 - Association of postoperative delirium with markers of neurodegeneration and brain amyloidosis

T2 - a pilot study

AU - Rolandi, Elena

AU - Cavedo, Enrica

AU - Pievani, Michela

AU - Galluzzi, Samantha

AU - Ribaldi, Federica

AU - Buckley, Christopher

AU - Cunningham, Colm

AU - Guerra, Ugo Paolo

AU - Musarra, Monica

AU - Morzenti, Sabrina

AU - Magnaldi, Silvia

AU - Patassini, Mirko

AU - Terragnoli, Flavio

AU - Matascioli, Luca

AU - Franzoni, Simone

AU - Annoni, Giorgio

AU - Carnevali, Lucio

AU - Bellelli, Giuseppe

AU - Frisoni, Giovanni B

N1 - Copyright © 2017 Elsevier Inc. All rights reserved.

PY - 2017

Y1 - 2017

N2 - The aim of the study was to investigate the association between postoperative delirium (POD) and in vivo markers of Alzheimer's disease pathology in nondemented hip fracture surgery patients. POD was assessed with the Confusion Assessment Method. Amyloid load was quantified on 18F-Flutemetamol positron emission tomography images as standardized uptake value ratio. Secondary outcome measures were gray matter volumes, white matter integrity, and functional connectivity at rest. All the patients with POD (POD+, N = 5) were amyloid negative (standardized uptake value ratio <0.59), whereas 6 out of 11 patients without POD (POD-) showed brain amyloid positivity. POD+ compared to POD- displayed: lower gray matter volumes in the amygdala (p = 0.003), in the middle temporal gyrus and in the anterior cingulate cortex (p < 0.001), increased diffusivity in the genu of the corpus callosum and in the anterior corona radiata (p < 0.05), and higher functional connectivity within the default mode network (p < 0.001). POD patients showed altered gray and white matter integrity in the fronto-limbic regions in absence of brain amyloidosis. Based on this preliminary investigation, delirium pathophysiology might be independent of Alzheimer's disease. Future studies on larger samples are needed to confirm this hypothesis.

AB - The aim of the study was to investigate the association between postoperative delirium (POD) and in vivo markers of Alzheimer's disease pathology in nondemented hip fracture surgery patients. POD was assessed with the Confusion Assessment Method. Amyloid load was quantified on 18F-Flutemetamol positron emission tomography images as standardized uptake value ratio. Secondary outcome measures were gray matter volumes, white matter integrity, and functional connectivity at rest. All the patients with POD (POD+, N = 5) were amyloid negative (standardized uptake value ratio <0.59), whereas 6 out of 11 patients without POD (POD-) showed brain amyloid positivity. POD+ compared to POD- displayed: lower gray matter volumes in the amygdala (p = 0.003), in the middle temporal gyrus and in the anterior cingulate cortex (p < 0.001), increased diffusivity in the genu of the corpus callosum and in the anterior corona radiata (p < 0.05), and higher functional connectivity within the default mode network (p < 0.001). POD patients showed altered gray and white matter integrity in the fronto-limbic regions in absence of brain amyloidosis. Based on this preliminary investigation, delirium pathophysiology might be independent of Alzheimer's disease. Future studies on larger samples are needed to confirm this hypothesis.

KW - Journal Article

U2 - 10.1016/j.neurobiolaging.2017.09.020

DO - 10.1016/j.neurobiolaging.2017.09.020

M3 - Article

VL - 61

JO - Neurobiology of Aging

JF - Neurobiology of Aging

SN - 0197-4580

ER -