Evidence mapPaperPMID 41222553Full record

Observational studyAge and ageing2025

Prediction of postoperative delirium in older adults from preoperative cognition and occipital alpha power from resting-state electroencephalogram.

Matthew H Ning, Andrei Rodionov, Jessica M Ross, Recep A Ozdemir, Maja Burch, Shu J Lian, David Alsop, Michele Cavallari, Bradford Dickerson, Tamara Fong and 15 more

Abstract readObservational Study
In one paragraph

Observational study in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

25 authors.

Matthew H NingBerenson-Allen Center for Noninvasive Brain Stimulation, Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave Boston, MA 02215, USA.
Andrei RodionovDepartment of Education, University of Helsinki, Siltavuorenpenger 5A, Helsinki 00014, Finland.
Jessica M RossPsychiatry and Behavioral Sciences, Stanford Medicine, 401 Quarry Road, Stanford, CA 94304, USA.ORCID 0000-0002-7487-8946
Recep A OzdemirBerenson-Allen Center for Noninvasive Brain Stimulation, Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave Boston, MA 02215, USA.ORCID 0000-0003-2832-1300
Maja BurchBerenson-Allen Center for Noninvasive Brain Stimulation, Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave Boston, MA 02215, USA.
Shu J LianBerenson-Allen Center for Noninvasive Brain Stimulation, Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave Boston, MA 02215, USA.
David AlsopRadiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Ansin 226, Boston, MA 02215, USA.
Michele CavallariRadiology, Brigham and Women's Hospital, Assembly Row, 399 Revolution Drive, Ste. 1180, BWH Radiology Research Somerville, Boston, MA 02115, USA.ORCID 0000-0003-1876-639X
Bradford DickersonNeurology, Massachusetts General Hospital, 149 13th St., Boston, MA 02114, USA.ORCID 0000-0002-5958-3445
Tamara FongNeurology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
Richard N JonesPsychiatry and Human Behavior, Brown University, 345 Blackstone Boulevard, Box G-BH, Providence, RI 02912, USA.ORCID 0000-0002-1049-218X
Towia LibermannThe Genomics and Proteomics Core, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.
Edward MarcantonioGeneral Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.ORCID 0000-0002-2911-4250
Emiliano SantarnecchiNeuroscience, Massachusetts General Hospital, Fruit Street, Boston, MA 02114, USA.
Eva M SchmittHinda and Arthur Marcus Institute for Aging Research - Marcus Institute, 1200 Centre Street, Boston, MA 02131, USA.
Alexandra TouroutoglouHarvard Medical School, 149 13th Street, Boston, MA 02115, USA.
Thomas TravisonHarvard Medical School, 1200 Centre St, Boston, MA 02131, USA.
Leah AckerAnesthesiology, Duke University, 303 Research Drive Office 136, Durham, NC 27710, USA.ORCID 0000-0002-5534-6020
Melody R SmithDepartment of Anesthesiology Perioperative & Pain Medicine, Stanford University, 300 Pasteur Drive Room H3580 MC 5640, Stanford, CA 94305, USA.ORCID 0000-0002-8288-7914
Haoqi SunNeurology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.ORCID 0000-0002-5041-8312
M Brandon WestoverNeurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.ORCID 0000-0003-4803-312X
Álvaro Pascual-LeoneHinda and Arthur Marcus Institute for Aging Research, 1200 Centre Street, Boston, MA 02131, USA.
Miles BergerAnesthesiology, Stanford University, Lane Building Room L202B 300 Pasteur Drive, Palo Alto, CA Stanford, NC 94304, USA.
Sharon K InouyeDepartment of Medicine, Harvard Medical School - Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Mouhsin ShafiBerenson-Allen Center for Noninvasive Brain Stimulation, Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.ORCID 0000-0002-4531-1967

Funding

Research Education ComponentP30AG072958 · DUKE UNIVERSITY · 2025 to 2025
$2.8M
Treating hyperexcitability in Alzheimer's disease with levetiracetam to improve brain function and cognitionR01AG060987 · NIA · BETH ISRAEL DEACONESS MEDICAL CENTER · PI Mouhsin Shafi · 2021 to 2023
$1.8M
AD/ADRD and biological aging proteomic signatures in the etiopathology of delirium and its associated long-term cognitive declineR01AG051658 · NIA · BETH ISRAEL DEACONESS MEDICAL CENTER · 2024 to 2025
$1.7M
NIDUS II: Advanced-Stage Development and Utilization of the NIDUS Research Infrastructure to Advance Interdisciplinary Aging Research in DeliriumR33AG071744 · NIA · HEBREW REHABILITATION CENTER FOR AGED · 2023 to 2025
$1.6M
Research Education Component (REC)P30AG028716 · DUKE UNIVERSITY · 2025 to 2025
$1.3M
Low Neurophysiologic Resistance to Anesthetics as a Marker of Preclinical/Prodromal Alzheimer's Disease and Neurovascular Pathology, Delirium risk and InattentionR01AG073598 · DUKE UNIVERSITY · 2025 to 2025
$704k
NIA NIH HHS K24 AG035075NIA NIH HHS K76 AG057022NIA NIH HHS P01 AG031720NIA NIH HHS P30 AG028716NIA NIH HHS P30 AG072958NIA NIH HHS R01 AG051658NIA NIH HHS R01 AG059089NIA NIH HHS R01 AG060987NIA NIH HHS R01 AG073598NIA NIH HHS R01 AG076708NIA NIH HHS R03 AG072233NIA NIH HHS R24 AG054259NIA NIH HHS R33 AG071744NIA NIH HHS UH2 AG056925NIMH NIH HHS R01 MH115949
6 · The paper itself

Abstract

backgroundPostoperative delirium is the most common complication following surgery amongst older adults, and has been consistently associated with increased mortality and morbidity, cognitive decline, loss of independence and increased health-care costs. We sought to identify preoperative predictors that could identify individuals at high risk for postoperative delirium, which could guide clinical decision-making and enable targeted interventions to potentially decrease delirium incidence and postoperative delirium-related complications.

methodsPreoperative resting-state electroencephalograms (EEGs) and the Montreal Cognitive Assessment were collected from a prospective observational cohort of 85 older adults (12 cases of delirium) undergoing elective surgery. Four machine learning models were tested and the model with the highest f1-score was subsequently validated in an independent, prospective cohort of 51 older adults (6 cases of delirium) undergoing elective surgery.

resultsOccipital alpha powers have higher f1-score (0.57 ± 0.07) than frontal alpha powers (0.47 ± 0.07), EEG spectral slowing (0.48 ± 0.08), or modelling of EEG power spectral density into periodic and aperiodic components (0.44 ± 0.09) in the training cohort. Occipital alpha powers plus cognitive scores were able to predict postoperative delirium with area under the receiver operating characteristic curve (AUC) (0.94, 95% CI: [0.86-0.99]), sensitivity (0.83, 95% CI: [0.50-1.00]) and specificity (0.91, 95% CI: [0.82-0.98]) in the validation cohort, and outperformed models incorporating occipital alpha powers alone or cognitive scores alone.

conclusionsWhilst the sample size is small and findings require confirmation in larger studies, our results suggest that the thalamocortical circuit exhibits different EEG patterns under stressors, with occipital alpha powers potentially reflecting baseline vulnerabilities.

Indexed as

Alpha RhythmCognitionDeliriumElectroencephalographyOccipital LobePostoperative ComplicationsAgedAged, 80 and overElective Surgical ProceduresFemaleHumansMachine LearningMaleMental Status and Dementia TestsPredictive Value of TestsProspective Studiesalpha powersmachine learningMontréal Cognitive Assessmentpostoperative deliriumresting-state EEG

Identifiers

PMID41222553
PMCPMC13171208

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.