The network model of delirium.

Area of Science:

• Neuroscience
• Cognitive Science
• Psychiatry

Background:

• Delirium is characterized by impaired consciousness, attention, and reality testing.
• Several brain networks, including the default-mode network (DMN), salience network (SN), frontoparietal control network (FPCN), and dorsal attention network (DAN), are crucial for cognitive functions.
• Evidence suggests these networks are dysfunctional in delirium.

Purpose of the Study:

• To propose a model explaining how brain network dysfunction contributes to delirium.
• To connect the diverse precipitants of delirium with its clinical manifestations through network disruption.

Main Methods:

• Review of existing evidence linking brain networks to delirium.
• Hypothesizing the convergence of neurobiological stressors on brain networks.
• Considering neuroimaging and neuroanatomy findings.

Main Results:

• Brain network dysfunction, specifically in the DMN, SN, FPCN, and DAN, is implicated in delirium.
• Neurotransmitter changes, neuroendocrine, and inflammatory stressors converge on these networks.
• This convergence disrupts both bottom-up and top-down attentional control.

Conclusions:

• A model of brain network dysfunction provides a unifying framework for understanding delirium.
• This model helps explain how various factors lead to delirium's symptoms.
• Further neuroimaging and neuroanatomical studies can validate this network-centric hypothesis.