Resting-state fMRI reveals network disintegration during delirium

Simone J.T. van Montfort, Edwin van Dellen, Aletta M.R. van den Bosch, Willem M. Otte, Maya J.L. Schutte, Soo Hee Choi, Tae Sub Chung, Sunghyon Kyeong, Arjen J.C. Slooter, Jae-Jin Kim

Research output: Contribution to journalArticle

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Abstract

Delirium is characterized by inattention and other cognitive deficits, symptoms that have been associated with disturbed interactions between remote brain regions. Recent EEG studies confirm that disturbed global network topology may underlie the syndrome, but lack an anatomical basis. The aim of this study was to increase our understanding of the global organization of functional connectivity during delirium and to localize possible alterations. Resting-state fMRI data from 44 subjects were analyzed, and motion-free data were available in nine delirious patients, seven post delirium patients and thirteen non-delirious clinical controls. We focused on the functional network backbones using the minimum spanning tree, which allows unbiased network comparisons. During delirium a longer diameter (mean (M) = 0.30, standard deviation (SD) = 0.05, P =.024) and a lower leaf fraction (M = 0.32, SD = 0.03, P =.027) was found compared to the control group (M = 0.28, SD = 0.04 respectively M = 0.35, SD = 0.03), suggesting reduced functional network integration and efficiency. Delirium duration was strongly related to loss of network hierarchy (rho = −0.92, P =.001). Connectivity strength was decreased in the post delirium group (M = 0.16, SD = 0.01) compared to the delirium group (M = 0.17, SD = 0.03, P =.024) and the control group (M = 0.19, SD = 0.02, P =.001). Permutation tests revealed a decreased degree of the right posterior cingulate cortex during delirium and complex regional alterations after delirium. These findings indicate that delirium reflects disintegration of functional interactions between remote brain areas and suggest long-term impact after the syndrome resolves.

Original languageEnglish
Pages (from-to)35-41
Number of pages7
JournalNeuroImage: Clinical
Volume20
DOIs
Publication statusPublished - 2018 Jan 1

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Delirium
Magnetic Resonance Imaging
Neurobehavioral Manifestations
Control Groups
Gyrus Cinguli
Brain
Electroencephalography

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Clinical Neurology
  • Cognitive Neuroscience

Cite this

van Montfort, S. J. T., van Dellen, E., van den Bosch, A. M. R., Otte, W. M., Schutte, M. J. L., Choi, S. H., ... Kim, J-J. (2018). Resting-state fMRI reveals network disintegration during delirium. NeuroImage: Clinical, 20, 35-41. https://doi.org/10.1016/j.nicl.2018.06.024
van Montfort, Simone J.T. ; van Dellen, Edwin ; van den Bosch, Aletta M.R. ; Otte, Willem M. ; Schutte, Maya J.L. ; Choi, Soo Hee ; Chung, Tae Sub ; Kyeong, Sunghyon ; Slooter, Arjen J.C. ; Kim, Jae-Jin. / Resting-state fMRI reveals network disintegration during delirium. In: NeuroImage: Clinical. 2018 ; Vol. 20. pp. 35-41.
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van Montfort, SJT, van Dellen, E, van den Bosch, AMR, Otte, WM, Schutte, MJL, Choi, SH, Chung, TS, Kyeong, S, Slooter, AJC & Kim, J-J 2018, 'Resting-state fMRI reveals network disintegration during delirium', NeuroImage: Clinical, vol. 20, pp. 35-41. https://doi.org/10.1016/j.nicl.2018.06.024

Resting-state fMRI reveals network disintegration during delirium. / van Montfort, Simone J.T.; van Dellen, Edwin; van den Bosch, Aletta M.R.; Otte, Willem M.; Schutte, Maya J.L.; Choi, Soo Hee; Chung, Tae Sub; Kyeong, Sunghyon; Slooter, Arjen J.C.; Kim, Jae-Jin.

In: NeuroImage: Clinical, Vol. 20, 01.01.2018, p. 35-41.

Research output: Contribution to journalArticle

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T1 - Resting-state fMRI reveals network disintegration during delirium

AU - van Montfort, Simone J.T.

AU - van Dellen, Edwin

AU - van den Bosch, Aletta M.R.

AU - Otte, Willem M.

AU - Schutte, Maya J.L.

AU - Choi, Soo Hee

AU - Chung, Tae Sub

AU - Kyeong, Sunghyon

AU - Slooter, Arjen J.C.

AU - Kim, Jae-Jin

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N2 - Delirium is characterized by inattention and other cognitive deficits, symptoms that have been associated with disturbed interactions between remote brain regions. Recent EEG studies confirm that disturbed global network topology may underlie the syndrome, but lack an anatomical basis. The aim of this study was to increase our understanding of the global organization of functional connectivity during delirium and to localize possible alterations. Resting-state fMRI data from 44 subjects were analyzed, and motion-free data were available in nine delirious patients, seven post delirium patients and thirteen non-delirious clinical controls. We focused on the functional network backbones using the minimum spanning tree, which allows unbiased network comparisons. During delirium a longer diameter (mean (M) = 0.30, standard deviation (SD) = 0.05, P =.024) and a lower leaf fraction (M = 0.32, SD = 0.03, P =.027) was found compared to the control group (M = 0.28, SD = 0.04 respectively M = 0.35, SD = 0.03), suggesting reduced functional network integration and efficiency. Delirium duration was strongly related to loss of network hierarchy (rho = −0.92, P =.001). Connectivity strength was decreased in the post delirium group (M = 0.16, SD = 0.01) compared to the delirium group (M = 0.17, SD = 0.03, P =.024) and the control group (M = 0.19, SD = 0.02, P =.001). Permutation tests revealed a decreased degree of the right posterior cingulate cortex during delirium and complex regional alterations after delirium. These findings indicate that delirium reflects disintegration of functional interactions between remote brain areas and suggest long-term impact after the syndrome resolves.

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van Montfort SJT, van Dellen E, van den Bosch AMR, Otte WM, Schutte MJL, Choi SH et al. Resting-state fMRI reveals network disintegration during delirium. NeuroImage: Clinical. 2018 Jan 1;20:35-41. https://doi.org/10.1016/j.nicl.2018.06.024