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Within a conceptual framework that delirium is triggered by stressors when vulnerabilities exist in cerebral connectivity and plasticity, we previously suggested that neurophysiologic measures might identify individuals at risk for post\u2010surgical delirium. Here we demonstrate the feasibility of the approach and provide preliminary experimental evidence of the predictive value of such neurophysiologic measures for the risk of delirium in older persons undergoing elective surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Electroencephalography (EEG) and transcranial magnetic stimulation (TMS) were collected from 23 patients prior to elective surgery. Resting\u2010state EEG spectral power ratio (SPR) served as a measure of integrity of neural circuits. TMS\u2013EEG metrics of plasticity (TMS\u2010plasticity) were used as indicators of brain capacity to respond to stressors. Presence or absence of delirium was assessed using the confusion assessment method (CAM). We included individuals with no baseline clinically relevant cognitive impairment (MoCA scores \u226521) in order to focus on subclinical neurophysiological measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In patients with no baseline cognitive impairment (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a020, age\u00a0=\u00a072\u2009\u00b1\u20096), 3 developed post\u2010surgical delirium (MoCA\u00a0=\u00a024\u2009\u00b1\u20092.6) and 17 did not (controls; MoCA\u00a0=\u00a025\u2009\u00b1\u20092.4). Patients who developed delirium had pre\u2010surgical resting\u2010state EEG power ratios outside the 95% confidence interval of controls, and 2\/3 had TMS\u2010plasticity measures outside the 95% CI of controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Consistent with our proposed conceptual framework, this pilot study suggests that non\u2010invasive and scalable neurophysiologic measures can identify individuals at risk of post\u2010operative delirium. Specifically, abnormalities in resting\u2010state EEG spectral power or TMS\u2010plasticity may indicate sub\u2010clinical risk for post\u2010surgery delirium. Extension and confirmation of these findings in a larger sample is needed to assess the clinical utility of the proposed neurophysiologic markers, and to identify specific connectivity and plasticity targets for therapeutic interventions that might minimize the risk of delirium.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18072","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T08:34:23Z","timestamp":1665650063000},"page":"235-244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Neurophysiologic predictors of individual risk for\n                    <scp>post\u2010operative<\/scp>\n                    delirium after elective surgery"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7487-8946","authenticated-orcid":false,"given":"Jessica M.","family":"Ross","sequence":"first","affiliation":[{"name":"Berenson\u2010Allen Center for Noninvasive Brain Stimulation Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Department of Neurology Harvard Medical School  Boston Massachusetts USA"},{"name":"Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness Research, Education, and Clinical Center  Palo Alto California USA"},{"name":"Department of Psychiatry and Behavioral Sciences Stanford Medical School  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiliano","family":"Santarnecchi","sequence":"additional","affiliation":[{"name":"Berenson\u2010Allen Center for Noninvasive Brain Stimulation Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Department of Neurology Harvard Medical School  Boston Massachusetts USA"},{"name":"Precision Neuroscience &amp; Neuromodulation Program (PNN), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu Jing","family":"Lian","sequence":"additional","affiliation":[{"name":"Berenson\u2010Allen Center for Noninvasive Brain Stimulation Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara G.","family":"Fong","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"},{"name":"Aging Brain Center, Marcus Institute for Aging Research, Hebrew SeniorLife Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Touroutoglou","sequence":"additional","affiliation":[{"name":"Department of Neurology Harvard Medical School  Boston Massachusetts USA"},{"name":"Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital Harvard 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