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A Decrease in the Volume of Gray Matter as a Risk Factor for Postoperative Delirium Revealed by an Atlas-based Method
- Source :
- The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 24(7)
- Publication Year :
- 2015
-
Abstract
- Objective Delirium is a common syndrome in older patients after surgery. Although an atrophic change in the whole brain may be a potential risk factor for postoperative delirium, the anatomically specific change related to the vulnerability still remains a significant issue. Design Prospective study. Setting University hospital. Participants 116 consecutive patients who underwent elective cardiac operations. Measurements Before the surgery, magnetic resonance imaging (MRI) was evaluated. The MRI data were processed to calculate the absolute volumes of the predefined region of interest using Statistical Parametrical Mapping 8 with an atlas-based method. The evaluated volume was expressed as the fraction (%) of the total intracranial volume. Postoperative delirium was diagnosed according to the DSM-IV criteria for delirium. Results Delirium developed in 19 of 116 patients (16.4%) with an age range from 58 to 84 years. Based on a comparison with the age-controlled non-delirium patients (over 57 years; n = 65), a statistically significant reduction in the gray matter volume of the delirium patients was observed in the defined gyri of the temporal and limbic lobes. Moreover, a moderate value (>0.8) of area under the curve to predict postoperative delirium was revealed by receiver operating characteristic curve analysis of the gyri of temporal lobe. Conclusions The decreased volume of gray matter could be associated with the vulnerability to delirium after surgery. The atlas-based method would be a potential tool to pre-screen the brain structure of individual patients for the prediction of postoperative delirium.
- Subjects :
- Male
behavioral disciplines and activities
Temporal lobe
Hospitals, University
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Japan
Region of interest
Risk Factors
mental disorders
medicine
Humans
Prospective Studies
Risk factor
Cardiac Surgical Procedures
Gray Matter
Prospective cohort study
Aged
Aged, 80 and over
030214 geriatrics
Receiver operating characteristic
medicine.diagnostic_test
Area under the curve
Delirium
Magnetic resonance imaging
Middle Aged
Magnetic Resonance Imaging
Temporal Lobe
nervous system diseases
Diagnostic and Statistical Manual of Mental Disorders
Psychiatry and Mental health
Logistic Models
ROC Curve
Anesthesia
Case-Control Studies
Multivariate Analysis
Female
Geriatrics and Gerontology
medicine.symptom
Atrophy
Psychology
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15457214
- Volume :
- 24
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
- Accession number :
- edsair.doi.dedup.....983d5e42e6183c9e16fce454e4cbc2fc