Emergence delirium and postoperative delirium associated with high plasma NfL and GFAP: an observational study
BackgroundNeuroinflammation and neuronal injury have been reported to be associated with the development of postoperative delirium in both preclinical and clinical settings. This study aimed to investigate the potential correlation between biomarkers of neurofilament light chain and glial fibrillary...
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1107369/full |
| _version_ | 1827891163547303936 |
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| author | Xingyang Liu Xingyang Liu Yanfeng Wang Jinghan Wu Chunyan Ye Daqing Ma E. Wang E. Wang |
| author_facet | Xingyang Liu Xingyang Liu Yanfeng Wang Jinghan Wu Chunyan Ye Daqing Ma E. Wang E. Wang |
| author_sort | Xingyang Liu |
| collection | DOAJ |
| description | BackgroundNeuroinflammation and neuronal injury have been reported to be associated with the development of postoperative delirium in both preclinical and clinical settings. This study aimed to investigate the potential correlation between biomarkers of neurofilament light chain and glial fibrillary acidic protein and emergence and postoperative delirium in elderly patients undergoing surgery.MethodsPatients who developed emergence delirium (n = 30) and postoperative delirium (n = 32), along with their matched controls, were enrolled after obtaining ethics approval and written informed consent. Delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit or Confusion Assessment Method scale, and blood samples were collected before and after surgery for plasma neurofilament light chain and glial fibrillary acidic protein measurements using a single-molecule array.ResultsThe study found that in patients with emergence delirium, the increase in plasma neurofilament light chain protein levels during surgery was significantly higher than in non-delirium patients (P = 0.002). Additionally, in patients with postoperative delirium, both the increase in plasma neurofilament light chain protein levels (P < 0.001) and the increase in plasma glial fibrillary acidic protein levels during surgery (P = 0.008) were significantly higher than in non-delirium patients. Multivariate logistic regression analysis showed that the increase in plasma neurofilament light chain protein was associated with emergence delirium (adjusted OR = 1.872, P = 0.005), and the increase in plasma glial fibrillary acidic protein was associated with postoperative delirium (adjusted OR = 1.419, P = 0.016). Moreover, the American Society of Anesthesiologists Physical Status Classification and surgical duration were also found to be associated with delirium in elderly patients.ConclusionOur findings suggest that emergence delirium is linked to elevated levels of neurofilament light chain, a biomarker of axonal injury, during surgery. Furthermore, in addition to axonal injury, postoperative delirium was also associated with an increase in glial fibrillary acidic protein, a marker of astrocyte activation. |
| first_indexed | 2024-03-12T21:21:52Z |
| format | Article |
| id | doaj.art-7a31d61eb71540cf8905eb877037a987 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-12T21:21:52Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-7a31d61eb71540cf8905eb877037a9872023-07-28T16:47:40ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-07-011010.3389/fmed.2023.11073691107369Emergence delirium and postoperative delirium associated with high plasma NfL and GFAP: an observational studyXingyang Liu0Xingyang Liu1Yanfeng Wang2Jinghan Wu3Chunyan Ye4Daqing Ma5E. Wang6E. Wang7Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDivision of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United KingdomDepartment of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaBackgroundNeuroinflammation and neuronal injury have been reported to be associated with the development of postoperative delirium in both preclinical and clinical settings. This study aimed to investigate the potential correlation between biomarkers of neurofilament light chain and glial fibrillary acidic protein and emergence and postoperative delirium in elderly patients undergoing surgery.MethodsPatients who developed emergence delirium (n = 30) and postoperative delirium (n = 32), along with their matched controls, were enrolled after obtaining ethics approval and written informed consent. Delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit or Confusion Assessment Method scale, and blood samples were collected before and after surgery for plasma neurofilament light chain and glial fibrillary acidic protein measurements using a single-molecule array.ResultsThe study found that in patients with emergence delirium, the increase in plasma neurofilament light chain protein levels during surgery was significantly higher than in non-delirium patients (P = 0.002). Additionally, in patients with postoperative delirium, both the increase in plasma neurofilament light chain protein levels (P < 0.001) and the increase in plasma glial fibrillary acidic protein levels during surgery (P = 0.008) were significantly higher than in non-delirium patients. Multivariate logistic regression analysis showed that the increase in plasma neurofilament light chain protein was associated with emergence delirium (adjusted OR = 1.872, P = 0.005), and the increase in plasma glial fibrillary acidic protein was associated with postoperative delirium (adjusted OR = 1.419, P = 0.016). Moreover, the American Society of Anesthesiologists Physical Status Classification and surgical duration were also found to be associated with delirium in elderly patients.ConclusionOur findings suggest that emergence delirium is linked to elevated levels of neurofilament light chain, a biomarker of axonal injury, during surgery. Furthermore, in addition to axonal injury, postoperative delirium was also associated with an increase in glial fibrillary acidic protein, a marker of astrocyte activation.https://www.frontiersin.org/articles/10.3389/fmed.2023.1107369/fullemergence deliriumpostoperative deliriumneuronal injuryneuroinflammationelderly patients |
| spellingShingle | Xingyang Liu Xingyang Liu Yanfeng Wang Jinghan Wu Chunyan Ye Daqing Ma E. Wang E. Wang Emergence delirium and postoperative delirium associated with high plasma NfL and GFAP: an observational study Frontiers in Medicine emergence delirium postoperative delirium neuronal injury neuroinflammation elderly patients |
| title | Emergence delirium and postoperative delirium associated with high plasma NfL and GFAP: an observational study |
| title_full | Emergence delirium and postoperative delirium associated with high plasma NfL and GFAP: an observational study |
| title_fullStr | Emergence delirium and postoperative delirium associated with high plasma NfL and GFAP: an observational study |
| title_full_unstemmed | Emergence delirium and postoperative delirium associated with high plasma NfL and GFAP: an observational study |
| title_short | Emergence delirium and postoperative delirium associated with high plasma NfL and GFAP: an observational study |
| title_sort | emergence delirium and postoperative delirium associated with high plasma nfl and gfap an observational study |
| topic | emergence delirium postoperative delirium neuronal injury neuroinflammation elderly patients |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1107369/full |
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