The underlying structural correlates of predisposition to postoperative delirium remain largely unknown. A combined analysis of preoperative brain magnetic resonance imaging (MRI) markers could improve our understanding of the pathophysiology of delirium. Therefore, we aimed to identify different MRI brain phenotypes in older patients scheduled for major elective surgery, and to assess the relation between these phenotypes and postoperative delirium. Markers of neurodegenerative and neurovascular brain changes were determined from MRI brain scans in older patients (n = 161, mean age 71, standard deviation 5 years), of whom 24 (15%) developed delirium. A hierarchical cluster analysis was performed. We found six distinct groups of patients with different MRI brain phenotypes. Logistic regression analysis showed a higher odds of developing postoperative delirium in individuals with multi-burden pathology (n = 15 (9%), odds ratio (95% confidence interval): 3.8 (1.1-13.0)). In conclusion, these results indicate that different MRI brain phenotypes are related to a different risk of developing delirium after major elective surgery. MRI brain phenotypes could assist in an improved understanding of the structural correlates of predisposition to postoperative delirium.

Copyright © 2021. Published by Elsevier Inc.

Overview publication

TitlePreoperative MRI brain phenotypes are related to postoperative delirium in older individuals.
DateMay 1st, 2021
Issue nameNeurobiology of aging
Issue numberv101:247-255
DOI10.1016/j.neurobiolaging.2021.01.033
PubMed33647523
AuthorsKant IMJ, Slooter AJC, Jaarsma-Coes M, van Montfort SJT, Witkamp TD, Pasma W, Hendrikse J & de Bresser J
KeywordsBrain phenotypes, Delirium, Encephalopathy, MRI
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