Neuroimaging Findings of Delirium

Abstract

Neuroimaging is increasingly being used as a tool to gain a greater understanding of the pathogenesis of delirium. While initial neuroimaging investigations of delirium centered on qualitative analysis of brain computerized tomography (CT) or magnetic resonance imaging (MRI) lesions, voxel-based morphometry studies were the first to show specific gray and white matter structural correlates related to delirium. More recently, diffusion tensor imaging has offered insights into alterations in white matter pathways that may underlie delirium. Cerebral blood flow measurements using Xenon CT and MRI techniques have shown both regional and global decreases during delirium compared to baseline. Resting-state functional MRI has also been used to identify changes in functional cortical connectivity. Most recently, positron emission tomography (PET) MRI has given clues to pathologic protein alterations in delirium. Given the constraints of neuroimaging, research must proceed in a focused, hypothesis-driven manner.