Decreased Functional Connectivity and Disturbed Directionality of Information Flow in the Electroencephalography of Intensive Care Unit Patients with Delirium after Cardiac Surgery

Dellen, Edwin van; Kooi, Arendina W. van der; Numan, Tianne; Koek, Huiberdina L.; Klijn, Francina A.; Buijsrogge, Marc P.; Stam, Cornelis J.; Slooter, Arjen J. C.

doi:10.1097/aln.0000000000000329

Cited by 90 publications

(99 citation statements)

References 36 publications

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“…As the analysis results tended to be correlated in the frequency domain, we chose to present only the results for the delta, alpha and gamma band. Alpha-band wPLI in particular is a commonly used measure of functional connectivity (Blain-Moraes et al, 2014; Blain-Moraes et al, 2015; Lee et al, 2013a; Lee et al, 2017; van Dellen et al, 2014). In addition, we observed evidence for alpha-band oscillatory components in the resting state power spectra, further motivating focus on this band.…”

Section: Methodsmentioning

confidence: 99%

Cortical functional connectivity indexes arousal state during sleep and anesthesia

Banks

Krause

Endemann

et al. 2019

Preprint

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Disruption of cortical connectivity likely contributes to loss of consciousness (LOC) during both sleep and general anesthesia, but the degree of overlap in the underlying mechanisms is unclear. Both sleep and anesthesia comprise states of varying levels of arousal and consciousness, including states of largely maintained consciousness (sleep: N1, REM; anesthesia: sedated but responsive) as well as states of substantially reduced consciousness (sleep: N2/N3; anesthesia: unresponsive). Here, we tested the hypotheses that (1) cortical connectivity will reflect clear changes when transitioning into states of reduced consciousness, and (2) these changes are similar for arousal states of comparable levels of consciousness during sleep and anesthesia. Using intracranial recordings from five neurosurgical patients, we compared resting state cortical functional connectivity (as measured by weighted phase lag index) in the same subjects across arousal states during natural sleep [wake (WS), N1, N2, N3, REM] and propofol anesthesia [pre-drug wake (WA), sedated/responsive (S) and unresponsive (U)]. In wake states WS and WA, alpha-band connectivity within and between temporal, parietal and occipital regions was dominant. This pattern was largely unchanged in N1, REM and S. Transitions into states of reduced consciousness N2, N3 and U were characterized by dramatic and strikingly similar changes in connectivity, with dominant connections shifting to frontal cortex. We suggest that shifts from temporo-parieto-occipital to frontal cortical connectivity may reflect impaired sensory processing in states of reduced consciousness. The data indicate that functional connectivity can serve as a biomarker of arousal state and suggest common mechanisms of LOC in sleep and anesthesia.

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Section: Methodsmentioning

confidence: 99%

Cortical functional connectivity indexes arousal state during sleep and anesthesia

Banks

Krause

Endemann

et al. 2019

Preprint

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“…For phase synchronization measures, longer epochs could result in lower connectivity values based on the asymmetrical distribution of the phase difference (van Dellen et al , 2014b). From this perspective, we recommend to use epochs of an identical length within a study, as epoch length can influence the connectivity measure (van Dellen et al , 2014b), and to choose an epoch length in accordance with the connectivity measure of choice.…”

Section: Number and Length Of Epochs And Sample Frequencymentioning

confidence: 97%

“…Currently, most studies use visual inspection to eliminate epochs with myogenic or eye-movement artifacts, although the precise procedure is often not described. Some studies mention the removal of frontopolar and auricular channels to reduce the influence of artifacts (de Haan et al , 2009, van Dellen et al , 2014b. Although these artifacts will also affect other channels due to volume conduction, this influence is reduced when excluding frontopolar and auricular channels prior to offline re-referencing.…”

Section: Artifact Handling and Filteringmentioning

confidence: 97%

“…From this perspective, we recommend to use epochs of an identical length within a study, as epoch length can influence the connectivity measure (van Dellen et al , 2014b), and to choose an epoch length in accordance with the connectivity measure of choice. Furthermore, we recommend computing connectivity values per epoch and consequently an average value (over epochs) per subject to increase the stability of connectivity values.…”

Section: Number and Length Of Epochs And Sample Frequencymentioning

confidence: 99%

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Opportunities and methodological challenges in EEG and MEG resting state functional brain network research

Diessen

Numan

Dellen

et al. 2015

Clinical Neurophysiology

349

288

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“…Second, epochs were restricted to 4 s to keep this identical over all subjects, as epoch length can influence the connectivity measure. 43 PLI might be overestimated in epochs <12 s, although the variance seems similar at 4 s and should thus be reliable to register a change in PLI in successive measurements. 44 The equipment used recorded the EEGs at 256 Hz, which might influence connectivity measures.…”

Section: Study Design and Limitationsmentioning

confidence: 99%

The relation between cortisol and functional connectivity in people with and without stress‐sensitive epilepsy

et al. 2017

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SummaryObjective: The most common reported seizure-precipitant is stress. We recently showed a biologic basis for stress sensitivity of seizures: cortisol levels in people with stress-sensitive epilepsy correlated with focal interictal epileptiform discharges (IEDs) on electroencephalography (EEG). Here we aimed to determine whether the effect of cortisol on the epileptic brain is global or focal, and whether cortisol affects all brains or just those of stress-sensitive people. Because epilepsy is associated with changes in functional brain connectivity, we studied the relationship between cortisol and changes in global and focal (node-centered) functional connectivity measures for individuals with stress-sensitive and non-stresssensitive epilepsy. Methods: Seventeen people with epilepsy underwent long-term (>24 h) EEG recording. During the first 5 h after waking, saliva was collected every 15 min for cortisol measurements. Theta-band functional connectivity was assessed for every 15 min of the recording. We calculated the average phase-lag index (PLI) between all channels as a measure of global functional connectivity. We used network Strength, the averaged PLI per channel, as focal functional connectivity measure. We correlated cortisol, global, and focal functional connectivity (Strength) with IED frequency using linear mixed models. Analyses were split for people with and without stress-sensitivity of seizures. Results: Cortisol was negatively correlated with global functional connectivity in people with stress-sensitive seizures (estimate À0.0020; P < .01), whereas not in those without stress-sensitivity (estimate À0.0003; P = .46). This relationship occurred irrespective of the presence of IEDs on a channel (channels without IEDs and stress-sensitivity: estimate À0.0019; P < .01, non-stress-sensitive À0.0003; P = .41). Global and focal functional connectivity were negatively correlated with IED frequency, irrespective of stress sensitivity of seizures or channel type. Significance: People with stress-sensitive epilepsy have a whole-brain neuronal response to cortisol that is different from that of people with non-stress-sensitive epilepsy. This offers a basis for understanding seizure genesis in stress-sensitive epilepsy, which might require a different treatment approach.

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Decreased Functional Connectivity and Disturbed Directionality of Information Flow in the Electroencephalography of Intensive Care Unit Patients with Delirium after Cardiac Surgery

Abstract: Loss of α band functional connectivity, decreased path length, and increased δ band connectivity directed to frontal regions characterize the electroencephalography during delirium after cardiac surgery. These findings may explain why information processing is disturbed in delirium.

Cited by 90 publications

References 36 publications

Cortical functional connectivity indexes arousal state during sleep and anesthesia

Cortical functional connectivity indexes arousal state during sleep and anesthesia

Opportunities and methodological challenges in EEG and MEG resting state functional brain network research

The relation between cortisol and functional connectivity in people with and without stress‐sensitive epilepsy

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