Delirium Bibliography

Reference Information

Title

Delirium as a non-traumatic brain injury: Older patients with delirium have similar biomarker profiles to patients with isolated traumatic brain injury

Authors

Jackson, T. A., Shears, B., Lord, J. M., Belli, A., Hazeldine, J.

Year

2016

Journal

European Geriatric Medicine

Abstract

Introduction: Deliriumis an acute, severe neuropsychiatric syndrome associated with poor outcomes. Delirium is associated with a central inflammatory response, usually due to a precipitating peripheral inflammatory insult. However the pathophysiology remains poorly understood. Traumatic brain injury (TBI) is also common, associated with poor outcome. It mirrors delirium as it is associated with a peripheral inflammatory response secondary to a precipitating central inflammatory insult. As such investigating peripheral serum biomarkers of neuronal injury in both conditions may provide insights into their pathophysiology. Methods: Peripheral serum biomarkers of neuronal injury (S100β, neurone specific enolase [NSE], eotaxin and glial fibrillary acidic protein [GFAP]) were analysed by ELISA and multiplex. These were then compared in patients with delirium and isolated TBI, and healthy controls. Relationships between these biomarkers with delirium outcome and motoric subtype were also explored. Results: Delirium (n = 62, age = 85.6 ± 0.8 yrs) and TBI (n = 8, age = 37.1 ± 3.41 yrs)were associated with significantly higher serum S100β, NSE and GFAP compared with controls (all p < 0.05). There was no difference with eotaxin. Serum NSE (p = 0.002) and GFAP (p = 0.01) were significantly higher in TBI compared with delirium. NSE was higher in non-survivors (p = 0.04) and no serum biomarker was associated with delirium motor subtype. Conclusions: Neuronal injury, as expressed in peripheral biomarkers, is present in both delirium and TBI. However these markers are generally higher in TBI. These findings suggest delirium pathophysiology may be similar to mild traumatic brain injury. Future research using TBI as a “mirror model” of delirium are therefore justified.

PMID

Keywords

biological marker
endogenous compound
eotaxin
glial fibrillary acidic protein
neuron specific enolase
protein S100B
adult
aged
controlled study
delirium
enzyme linked immunosorbent assay
human
human tissue
inflammation
major clinical study
nerve injury
traumatic brain injury
very elderly

Page(s)

S12-S13

Volume

7

Issue