{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T11:39:59Z","timestamp":1784720399373,"version":"3.55.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"vor","delay-in-days":261,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of Health and Care Research Applied Research Collaboration North Thames Dementia Fellowship"},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["WT107467"],"award-info":[{"award-number":["WT107467"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007155","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MC_UU_00019\/1"],"award-info":[{"award-number":["MC_UU_00019\/1"]}],"id":[{"id":"10.13039\/501100007155","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007155","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MC_UU_00019\/2"],"award-info":[{"award-number":["MC_UU_00019\/2"]}],"id":[{"id":"10.13039\/501100007155","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Central and North West London NHS Foundation Trust Starter Grant Scheme award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Delirium is associated with the risk of future long-term cognitive impairment, but the degree to which markers of neuronal injury may be distinct or shared with dementia has yet to be comprehensively described. We investigated CSF biomarkers of dementia, astrocytosis and neuronal damage in a clinical cohort with persistent delirium, comparing them with an outpatient memory clinic sample. Our aim was to determine if different patterns of biomarker changes could implicate specific mechanisms for delirium-related neuronal injury over and above that attributable to comorbid dementia. We recruited 35 participants from the Prince of Wales Hospital, Sydney, Australia. We included inpatients with delirium persisting for at least 5 days (n = 15, 10 with underlying dementia) and participants from outpatient memory clinics (n = 20, 17 with dementia). CSF assays were as follows: amyloid-\u03b242, amyloid-\u03b240, phosphorylated tau181, neurofilament light chain and glial fibrillary acidic protein. We used propensity score matching to estimate effect sizes for each standardized CSF biomarker separately for persistent delirium (irrespective of underlying dementia) and dementia (irrespective of superimposed delirium). Compared with individuals without delirium, persistent delirium was associated with elevated glial fibrillary acidic protein (normalized coefficient per transformed standard deviation, \u03b2 = 0.85; 95% confidence interval: 0.03\u20131.68) and neurofilament light chain (\u03b2 = 1.1; 95% confidence interval: 0.5\u20131.6), but not phosphorylated tau181. Compared with individuals without dementia, glial fibrillary acidic protein, neurofilament light chain and phosphorylated tau181 were all increased to expected levels in dementia cases, with the former two biomarkers at levels comparable to those seen in persistent delirium [glial fibrillary acidic protein (\u03b2 = 1.54; 95% confidence interval: 1.05\u20132.0) and neurofilament light chain (\u03b2 = 0.65; 95% confidence interval: 0.24\u20131.1)]. Persistent delirium was linked with changes in CSF biomarkers not necessarily attributable to dementia. These findings support the potential that delirium is associated with direct neuronal injury independent of dementia pathophysiology. Whether this neuronal injury involves astrocyte dysfunction or direct axonal damage are both possibilities. Future work examining acute brain injury in delirium is needed.<\/jats:p>","DOI":"10.1093\/braincomms\/fcae319","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T20:10:10Z","timestamp":1726690210000},"source":"Crossref","is-referenced-by-count":9,"title":["Persistent delirium is associated with cerebrospinal fluid markers of neuronal injury"],"prefix":"10.1093","volume":"6","author":[{"given":"Alex","family":"Tsui","sequence":"first","affiliation":[{"name":"Department of Population Science and Experimental Medicine, MRC Unit for Lifelong Health and Ageing at University College London (UCL) , 1-19 Torrington Place, London WC1E 7HB ,","place":["UK"]},{"name":"St Pancras Rehabilitation Unit, Central and North West London NHS Foundation Trust , London NW1 0PE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Johnstone","sequence":"additional","affiliation":[{"name":"St Pancras Rehabilitation Unit, Central and North West London NHS Foundation Trust , London NW1 0PE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Heslegrave","sequence":"additional","affiliation":[{"name":"UK Dementia Research Institute at University College London (UCL) , London W1T 7NF ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Zetterberg","sequence":"additional","affiliation":[{"name":"UK Dementia Research Institute at University College London (UCL) , London W1T 7NF ,","place":["UK"]},{"name":"Department of Neurochemical Pathophysiology and Diagnostics, University of Gothenburg , 405 30 Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leiv Otto","family":"Watne","sequence":"additional","affiliation":[{"name":"Oslo Delirium Research Group, Department of Geriatric Medicine, Oslo University Hospital , 0318 Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f8rn Erik","family":"Neerland","sequence":"additional","affiliation":[{"name":"Oslo Delirium Research Group, Department of Geriatric Medicine, Oslo University Hospital , 0318 Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Krogseth","sequence":"additional","affiliation":[{"name":"Oslo Delirium Research Group, Department of Geriatric Medicine, Oslo University Hospital , 0318 Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colm","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Institute of Neurology, Trinity College Dublin , Dublin, D02 PX31 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3159-9370","authenticated-orcid":false,"given":"Alasdair","family":"MacLullich","sequence":"additional","affiliation":[{"name":"Queen\u2019s Medical Research Institute, University of Edinburgh , Edinburgh EH16 4TJ ,","place":["UK"]},{"name":"Usher Institute Centre for Population Health Sciences, University of Edinburgh , Edinburgh EH16 4UX ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciela","family":"Muniz Terrera","sequence":"additional","affiliation":[{"name":"Heritage College of Osteopathic Medicine, Ohio University , Athens, Ohio 45701 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1560-1955","authenticated-orcid":false,"given":"Daniel","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Population Science and Experimental Medicine, MRC Unit for Lifelong Health and Ageing at University College London (UCL) , 1-19 Torrington Place, London WC1E 7HB ,","place":["UK"]},{"name":"St Pancras Rehabilitation Unit, Central and North West London NHS Foundation Trust , London NW1 0PE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon","family":"Caplan","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Prince of Wales Hospital , Sydney, 2031 ,","place":["Australia"]},{"name":"University of New South Wales , Sydney, 2052 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"2024103011255326200_fcae319-B1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1186\/s12916-014-0141-2","article-title":"The DSM-5 criteria, level of arousal and delirium diagnosis: Inclusiveness is safer","volume":"12","author":"European Delirium Association; American 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