Predisposition for delirium and EEG characteristics

S J T van Montfort; E van Dellen; L L Wattel; I M J Kant; T Numan; C J Stam; A J C Slooter

doi:10.1016/j.clinph.2020.01.023

Predisposition for delirium and EEG characteristics

Clin Neurophysiol. 2020 May;131(5):1051-1058. doi: 10.1016/j.clinph.2020.01.023. Epub 2020 Feb 21.

Authors

S J T van Montfort¹, E van Dellen², L L Wattel³, I M J Kant⁴, T Numan⁵, C J Stam⁶, A J C Slooter⁴

Affiliations

¹ Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands. Electronic address: s.j.t.vanmontfort-2@umcutrecht.nl.
² Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands; Department of Psychiatry and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands.
³ Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands; Faculty of Science, University of Amsterdam, the Netherlands.
⁴ Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands.
⁵ Department of Anatomy and Neurosciences, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.
⁶ Department of Clinical Neurophysiology and MEG Center, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.

PMID: 32199395
DOI: 10.1016/j.clinph.2020.01.023

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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Brain / physiopathology*
Cross-Sectional Studies
Delirium / diagnosis*
Delirium / physiopathology*
Delirium / psychology
Electrocardiography / methods
Electroencephalography / methods*
Female
Humans
Male
Nerve Net / physiopathology*

Associated data

ClinicalTrials.gov/NCT02265263