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Functional connectivity and network analysis during hypoactive delirium and recovery from anesthesia
Tianne Numan1, Arjen J C Slooter1, Arendina W van der Kooi1
1Department of Intensive Care Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, The Netherlands.
Summary
Electroencephalography (EEG) revealed that both hypoactive delirium and anesthesia recovery impair brain connectivity. However, network topology differs, allowing distinction between these states of reduced consciousness.
Area of Science:
- Neuroscience
- Medical Imaging
- Computational Biology
Background:
- Reduced consciousness following surgery can stem from hypoactive delirium or anesthesia effects.
- Understanding the neural mechanisms differentiating these states is crucial for patient care.
Purpose of the Study:
- To investigate the differences in functional connectivity and network topology between hypoactive delirium, anesthesia recovery, and control states using EEG.
- To identify EEG-based biomarkers for distinguishing these conditions.
Main Methods:
- EEG recordings were analyzed for functional and directed connectivity using phase lag index and directed phase transfer entropy.
- Network topology was assessed using minimum spanning tree (MST) analysis.
- A random forest classifier was employed to differentiate between the three patient groups.
Main Results:
- Both hypoactive delirium and anesthesia recovery showed a loss of back-to-front information flow compared to controls.
- Anesthesia recovery exhibited a more integrated delta-band network, while hypoactive delirium showed a less integrated alpha-band network.
- High classification accuracy was achieved in distinguishing anesthesia recovery from controls (95%) and hypoactive delirium from controls (86%), with 73% accuracy between hypoactive delirium and anesthesia recovery.
Conclusions:
- Functional and directed connectivity disruptions are common in reduced consciousness states like hypoactive delirium and post-anesthesia recovery.
- Distinct network topology alterations, particularly in the alpha and delta bands, allow for differentiation between hypoactive delirium and anesthesia recovery.
- EEG analysis provides valuable insights into the neural underpinnings of altered consciousness and aids in differential diagnosis.