Evidence map›Paper›PMID 18693233›Full record

ReviewThe journals of gerontology. Series A, Biological sciences and medical sciences2008

Cholinergic deficiency hypothesis in delirium: a synthesis of current evidence.

Tammy T Hshieh, Tamara G Fong, Edward R Marcantonio, Sharon K Inouye

3 registry-linked trialsOpen access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The journals of gerontology. Series A, Biological sciences and medical sciences, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 205 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
205citing papers in PubMed, 12 pooled it
11.4field-weighted citation impact, top 2% of its field
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.

NCT01700816 naterminatednot on this mapstarted 2012, after this paper: background citation

Usefulness of Bright Light Therapy in the Prevention of Delirium in Patients Undergoing Hematopoietic Stem Cell Transplant (HSCT)

TypeinterventionalSponsorMassachusetts General HospitalRan2012 to 2013Enrolled40ConditionsDeliriumArmsBright light therapy, Sham light
NCT03729011 phase4completednot on this mapstarted 2019, after this paper: background citation

Delirium Reduction by Volatile Anesthesia in Cardiac Surgery: Prospective, Randomized, Single-blinded Study

TypeinterventionalSponsorMeshalkin Research Institute of Pathology of CirculationRan2019 to 2024Enrolled405ConditionsDeliriumArmsVolatile agent, Propofol
NCT07258082 narecruitingnot on this mapstarted 2025, after this paper: background citation

Transauricular Vagus Nerve Stimulation (taVNS) for Delirium

TypeinterventionalSponsorStony Brook UniversityRan2025 to 2028Enrolled10ConditionsDelirium Treatment, DeliriumArmsTransauricular Vagus Nerve Stimulation
3 · Its place in the literature

Who cites it

205 citing papers in PubMed, 12 syntheses or guidelines pooled it, 541 citations in OpenAlex.

  1. Pooled it
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  7. Cholinesterase inhibitors for the treatment of delirium in non-ICU settings.The Cochrane database of systematic reviews · 2018
    Pooled it
  8. Antipsychotics for treatment of delirium in hospitalised non-ICU patients.The Cochrane database of systematic reviews · 2018
    Pooled it
  9. Acetylcholinesterase Inhibitors for Delirium in Older Adults.American journal of Alzheimer's disease and other dementias · 2016
    Pooled it
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  13. Trial
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145 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Tammy T HshiehWarren Alpert Medical School of Brown University, Providence, RI, USA.
Tamara G Fong
Edward R Marcantonio
Sharon K Inouye
Hebrew SeniorLife · USBrown University · US

Funding

Translational Researchin Aging Trainnig ProgramT32AG023480 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI LIPSITZ, LEWIS · 2004 to 2024
$7.6M
OLDER AMERICANS INDEPENDENCE CENTERP60AG008812 · NIA · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI LIPSITZ, LEWIS · 1995 to 2006
$6.9M
MIDCAREER AWARD IN PATIENT ORIENTED RESEARCH ON AGINGK24AG000949 · NIA · YALE UNIVERSITY · PI INOUYE, SHARON K. · 1999 to 2009
$1.4M
Donepezil-enhanced management of delirium in aged hip fracture patientsR21AG027549 · NIA · BETH ISRAEL DEACONESS MEDICAL CENTER · PI MARCANTONIO, EDWARD R · 2006 to 2007
$391k
Risk Factors for Delirium at DischargeR21AG025193 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI INOUYE, SHARON K · 2005 to 2006
$353k
NIA NIH HHS K24 AG000949NIA NIH HHS K24 AG 00949NIA NIH HHS P60 AG 008812NIA NIH HHS P60 AG008812NIA NIH HHS R21 AG 025193NIA NIH HHS R21 AG025193NIA NIH HHS R21 AG 027549NIA NIH HHS R21 AG027549NIA NIH HHS T32 AG023480
6 · The paper itself

Abstract

Deficits in cholinergic function have been postulated to cause delirium and cognitive decline. This review examines current understanding of the cholinergic deficiency hypothesis in delirium by synthesizing evidence on potential pathophysiological pathways. Acetylcholine synthesis involves various precursors, enzymes, and receptors, and dysfunction in these components can lead to delirium. Insults to the brain, like ischemia and immunological stressors, can precipitously alter acetylcholine levels. Imbalances between cholinergic and other neurotransmitter pathways may result in delirium. Furthermore, genetic, enzymatic, and immunological overlaps exist between delirium and dementia related to the cholinergic pathway. Important areas for future research include identifying biomarkers, determining genetic contributions, and evaluating response to cholinergic drugs in delirium. Understanding how the cholinergic pathway relates to delirium may yield innovative approaches in the diagnosis, prevention, and treatment of this common, costly, and morbid condition.

Indexed as

AcetylcholineBrainDeliriumDementiaHumansNeurotransmitter AgentsReceptors, NeurotransmitterAcetylcholineNeurotransmitter AgentsReceptors, Neurotransmitter

Identifiers

PMID18693233
PMCPMC2917793
OpenAlexW2114943413

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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 OpenQuestion graph.