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Prolongación de las latencias de la negatividad de la discrepancia en pacientes de cuidados intensivos con delirio

Yi-Cian Chen^1,2,3, Huai-Jen Chang⁴, Ching-Wen Chang¹

¹Department of Occupational Therapy, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.

Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society

|January 30, 2026

Resumen

Los pacientes críticamente enfermos con disfunción renal que experimentan delirio muestran una prolongación de la actividad cerebral de negatividad de la discrepancia (MMN). Este marcador electrofisiológico sugiere un procesamiento neuronal alterado durante los episodios activos de delirio en la UCI.

Área de la Ciencia:

Neurociencia
Medicina de Cuidados Críticos
Electrophysiology

Sus antecedentes:

El delirio es una complicación frecuente y grave en pacientes críticamente enfermos, asociada con un aumento de la mortalidad y déficits cognitivos.
La disfunción renal es un factor de riesgo conocido para el delirio en la unidad de cuidados intensivos (UCI).
La comprensión de la neurofisiología de los episodios activos de delirio es crucial pero poco explorada.

Objetivo del estudio:

Investigar las características neurofisiológicas del delirio en pacientes críticamente enfermos con disfunción renal.
Utilizar la negatividad de la discrepancia (MMN) como marcador electrofisiológico para estudiar la actividad cerebral durante el delirio.
Explorar la relación entre la MMN, la gravedad del delirio, la función cognitiva y los resultados clínicos.

Principales métodos:

Se utilizó un paradigma de tono oddball auditivo para registrar potenciales relacionados con eventos y medir la MMN en pacientes de UCI con disfunción renal.
La MMN se calculó restando las respuestas a los tonos desviados de los tonos estándar.
Se comparó la MMN entre pacientes con y sin delirio, y se evaluó su asociación con la función cognitiva, la gravedad de la enfermedad y los resultados clínicos.

Principales resultados:

Los pacientes con delirio exhibieron latencias de MMN significativamente prolongadas en comparación con aquellos sin delirio (P = 0.005).
Las latencias de MMN retrasadas mostraron una tendencia hacia la asociación con una mayor gravedad del delirio.
La MMN no predijo los resultados clínicos en el momento del alta de la UCI.

Conclusiones:

Los pacientes críticamente enfermos con disfunción renal demuestran latencias de MMN prolongadas durante el delirio.
Estos hallazgos sugieren un procesamiento neuronal alterado en el cerebro de los pacientes de UCI que experimentan delirio.
La MMN puede servir como un marcador valioso para comprender la fisiopatología del delirio en esta población.

Palabras clave:

Delirio Potencial evocado Unidad de cuidados intensivos Negatividad de la discrepancia Disfunción renal

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