{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T12:20:57Z","timestamp":1781698857332,"version":"3.54.5"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Structural disconnectivity was found to precede dementia. Global white matter abnormalities might also be associated with postoperative delirium (POD).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We recruited older patients (\u226565 years) without dementia that were scheduled for major surgery. Diffusion kurtosis imaging metrics were obtained preoperatively, after 3 and 12 months postoperatively. We calculated fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK), and free water (FW). A structured and validated delirium assessment was performed twice daily.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Of 325 patients, 53 patients developed POD (16.3%). Preoperative global MD (standardized beta 0.27 [95% confidence interval [CI] 0.21\u20130.32] <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) was higher in patients with POD. Preoperative global MK (\u22120.07 [95% CI \u22120.11 to (\u22120.04)] <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and FA (0.07 [95% CI \u22120.10 to (\u22120.04)] <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) were lower. When correcting for baseline diffusion, postoperative MD was lower after 3 months (0.05 [95% CI \u22120.08 to (\u22120.03)] <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001; <jats:italic>n<\/jats:italic> = 183) and higher after 12 months (0.28 [95% CI 0.20\u20130.35] <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001; <jats:italic>n<\/jats:italic> = 45) among patients with POD.<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>Preoperative structural disconnectivity was associated with POD. POD might lead to white matter depletion 3 and 12 months after surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.13749","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T12:23:45Z","timestamp":1709814225000},"page":"2861-2872","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Structural disconnectivity in postoperative delirium: A perioperative two\u2010center cohort study in older patients"],"prefix":"10.1002","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9102-1373","authenticated-orcid":false,"given":"Marinus","family":"Fislage","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"Department of Neurology National Taiwan University Hospital  Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Winzeck","sequence":"additional","affiliation":[{"name":"Department of Computing Imperial College London BioMedIA Group  London UK"},{"name":"University Division of Anaesthesia, Department of Medicine University of Cambridge, Addenbrooke's Hospital  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8097-5905","authenticated-orcid":false,"given":"Rebecca","family":"Woodrow","sequence":"additional","affiliation":[{"name":"University Division of Anaesthesia, Department of Medicine University of Cambridge, Addenbrooke's Hospital  Cambridge UK"},{"name":"Department of Clinical Neurosciences University of Cambridge; 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