INTRODUCTIONDelirium is associated with mortality and new onset dementia, yet the underlying pathophysiology remains poorly understood. Development of imaging biomarkers has been difficult given the challenging nature of imaging delirious patients. Diffuse optical tomography (DOT) offers a promising approach for investigating delirium given its portability and three‐dimensional capabilities.METHODSTwenty‐five delirious and matched non‐delirious patients (n = 50) were examined using DOT, comparing cerebral oxygenation and functional connectivity in the prefrontal cortex during and after an episode of delirium.RESULTSTotal hemoglobin values were significantly decreased in the delirium group, even after delirium resolution. Functional connectivity between the dorsolateral prefrontal cortex and dorsomedial prefrontal cortex was strengthened post‐resolution compared to during an episode; however, this relationship was still significantly weaker compared to controls.DISCUSSIONThese findings highlight DOT's potential as an imaging biomarker to measure impaired cerebral oxygenation and functional dysconnectivity during and after delirium. Future studies should focus on the role of cerebral oxygenation in delirium pathogenesis and exploring the etiological link between delirium and dementias.Highlights We developed a portable diffuse optical tomography (DOT) system for bedside three‐dimensional functional neuroimaging to study delirium in the hospital. We implemented a novel DOT task‐focused seed‐based correlation analysis. DOT revealed decreased cerebral oxygenation and functional connectivity strength in the delirium group, even after resolution of delirium.

中文翻译：

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漫射光学断层扫描用于绘制谵妄状态下的脑血流动力学和功能连接图

引言谵妄与死亡率和新发痴呆有关，但其潜在的病理生理学仍知之甚少。鉴于对神志不清的患者进行成像具有挑战性，成像生物标志物的开发一直很困难。鉴于其便携性和三维功能，漫反射光学断层扫描 (DOT) 为研究谵妄提供了一种有前途的方法。方法 25 名精神错乱和匹配的非谵妄患者n= 50）使用 DOT 进行检查，比较谵妄发作期间和之后前额皮质的脑氧合和功能连接。结果即使在谵妄消退后，谵妄组的总血红蛋白值也显着下降。与发作期间相比，缓解后背外侧前额叶皮层和背内侧前额叶皮层之间的功能连接得到加强；然而，与对照组相比，这种关系仍然明显较弱。讨论这些发现强调了 DOT 作为成像生物标志物的潜力，用于测量谵妄期间和之后脑氧合受损和功能连接障碍。未来的研究应重点关注脑氧合在谵妄发病机制中的作用，并探讨谵妄与痴呆之间的病因联系。 我们开发了一种便携式扩散光学断层扫描 (DOT) 系统，用于床边三维功能神经成像，以研究医院的谵妄症。 我们实施了一种新颖的以 DOT 任务为中心的基于种子的相关性分析。 DOT 显示谵妄组的脑氧合和功能连接强度下降，即使在谵妄消退后也是如此。