{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T21:02:23Z","timestamp":1792616543778,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T00:00:00Z","timestamp":1694390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AG063849"],"award-info":[{"award-number":["R01 AG063849"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>INTRODUCTION<\/jats:title><jats:p>Post\u2010operative delirium (POD) is associated with increased morbidity and mortality but is bereft of treatments, largely due to our limited understanding of the underlying pathophysiology. We hypothesized that delirium reflects a disturbance in cortical connectivity that leads to altered predictions of the sensory environment.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>High\u2010density electroencephalogram recordings during an oddball auditory roving paradigm were collected from 131 patients. Dynamic causal modeling (DCM) analysis facilitated inference about the neuronal connectivity and inhibition\u2013excitation dynamics underlying auditory\u2010evoked responses.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Mismatch negativity amplitudes were smaller in patients with POD. DCM showed that delirium was associated with decreased left\u2010sided superior temporal gyrus (l\u2010STG) to auditory cortex feedback connectivity. Feedback connectivity also negatively correlated with delirium severity and systemic inflammation. Increased inhibition of l\u2010STG, with consequent decreases in feed\u2010forward and feed\u2010back connectivity, occurred for oddball tones during delirium.<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>Delirium is associated with decreased feedback cortical connectivity, possibly resulting from increased intrinsic inhibitory tone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Mismatch negativity amplitude was reduced in patients with delirium.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Patients with postoperative delirium had increased feedforward connectivity before surgery.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Feedback connectivity was diminished from left\u2010side superior temporal gyrus to left primary auditory sensory area during delirium.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Feedback connectivity inversely correlated with inflammation and delirium severity.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.13471","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T08:40:01Z","timestamp":1694421601000},"page":"511-524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Delirium is associated with loss of feedback cortical connectivity"],"prefix":"10.1002","volume":"20","author":[{"given":"Klevest","family":"Gjini","sequence":"first","affiliation":[{"name":"Department of Neurology University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Casey","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Wisconsin\u2013Madison  Madison Wisconsin USA"},{"name":"Pediatric Neuromodulation Laboratory, Waisman Center University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kunkel","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maihlee","family":"Her","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew I.","family":"Banks","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Wisconsin\u2013Madison  Madison Wisconsin USA"},{"name":"Department of Neuroscience University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Pearce","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Lennertz","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Sanders","sequence":"additional","affiliation":[{"name":"Department of Anaesthetics &amp; Institute of Academic Surgery Royal Prince Alfred Hospital  Camperdown New South Wales Australia"},{"name":"NHMRC Clinical Trials Centre and Central Clinical School University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.2273"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5508"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2020.7260"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4331"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2011.03.048"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-00223-4"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.02.027"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2020.09.009"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glab352"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00198477"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2005.1622"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2016.01792"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2013.00047"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcac209"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.01.005"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-113-12-941"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0865"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.21.2703"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1176\/jnp.13.2.229"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2008.05.018"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneumeth.2003.10.009"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.4255-12.2013"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneumeth.2007.03.024"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/156869"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2008.03.061"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.07.066"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2004.12.030"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1202043"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/nn.2331"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2019.06.032"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000329"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.12.040"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhw243"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005532"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181a4129a"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12604"}],"container-title":["Alzheimer's &amp; 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