Abstract
Postoperative delirium can lead to increased morbidity and mortality, and may even be a potentially life-threatening clinical syndrome. However, the neural mechanism underlying this condition has not been fully understood and there is little knowledge regarding potential preventive strategies. To date, investigation of transcranial direct current stimulation (tDCS) for the relief of symptoms caused by neuropsychiatric disorders and the enhancement of cognitive performance has led to promising results. In this study, we demonstrated that tDCS has a possible effect on the fast recovery from delirium in rats after microelectrode implant surgery, as demonstrated by postoperative behavior and neurophysiology compared with sham stimulation. This is the first study to describe the possible effects of tDCS for the fast recovery from delirium based on the study of both electroencephalography and behavioral changes. Postoperative rats showed decreased attention, which is the core symptom of delirium. However, anodal tDCS over the right frontal area immediately after surgery exhibited positive effects on acute attentional deficit. It was found that relative power of theta was lower in the tDCS group than in the sham group after surgery, suggesting that the decrease might be the underlying reason for the positive effects of tDCS. Connectivity analysis revealed that tDCS could modulate effective connectivity and synchronization of brain activity among different brain areas, including the frontal cortex, parietal cortex, and thalamus. It was concluded that anodal tDCS on the right frontal regions may have the potential to help patients recover quickly from delirium.
Highlights
Delirium is described as an acute, transient, fluctuating disturbance in attention, consciousness, and cognition [1]
All animal experiments complied with the guidelines of the Institutional Animal Care and Use Committee (IACUC) of the Gwangju Institute of Science and Technology (GIST)
The goal of this study was to elucidate the possible effects of single-session transcranial direct current stimulation (tDCS) on postoperative delirium including cognitive and behavioral changes in rats
Summary
Delirium is described as an acute, transient, fluctuating disturbance in attention, consciousness, and cognition [1]. Considering that proper cognitive function requires connectivity among brain regions [11], and that patients with delirium have cognitive problems, we would expect that delirium is related to disturbances in functional brain networks. Studies using electroencephalography (EEG) have shown that delirium is characterized by excessive EEG slowing, demonstrated by increases in theta and delta power [10]. This EEG change may be resolved after an episode of delirium [12]. In terms of neuroimaging studies, our group has previously reported that disruptions in reciprocity between the dorsolateral prefrontal cortex and posterior cingulate cortex, as well as the reduction of functional connectivity among subcortical regions, may contribute to the pathophysiology of delirium [9]
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