Evidence map›Paper›PMID 41475933›Full record

ArticleBritish journal of anaesthesia2026

Dysfunctional resting state network connectivity predicts postoperative delirium after major surgery.

Natasha L Taylor, Jordan Wehrman, Matthew I Banks, Veena Nair, Robert A Pearce, David Kunkel, James M Shine, Vivek Prabhakaran, Richard Lennertz, Robert D Sanders

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

NCT01980511 completednot on this map

Detection and Neurological Impact of CerebroVascular Events In Noncardiac Surgery PatIents: A COhort EvaluatioN

TypeobservationalSponsorMcMaster UniversityRan2014 to 2018Enrolled1,116ConditionsCovert Postoperative Stroke
NCT03124303 recruitingnot on this map

Interventions for Postoperative Delirium: Biomarker-3

TypeobservationalSponsorUniversity of Wisconsin, MadisonRan2017 to 2029Enrolled468ConditionsDeliriumArmsHigh Density-Electroencephalogram, Magnetic Resonance Imaging, Blood specimen collection, Pupillometry
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
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

10 authors.

Natasha L TaylorCentral Clinical School, Faculty of Medicine & Health, The University of Sydney, Camperdown, NSW, Australia; Brain & Mind Centre, Faculty of Medicine & Health, The University of Sydney, Camperdown, NSW, Australia; Complex Systems Group, School of Physics, The University of Sydney, Camperdown, NSW, Australia.
Jordan WehrmanCentral Clinical School, Faculty of Medicine & Health, The University of Sydney, Camperdown, NSW, Australia.
Matthew I BanksDepartment of Anaesthesiology, University of Wisconsin, Madison, WI, USA.
Veena NairDepartment of Anaesthesiology, University of Wisconsin, Madison, WI, USA.
Robert A PearceDepartment of Anaesthesiology, University of Wisconsin, Madison, WI, USA.
David KunkelDepartment of Anaesthesiology, University of Wisconsin, Madison, WI, USA.
James M ShineBrain & Mind Centre, Faculty of Medicine & Health, The University of Sydney, Camperdown, NSW, Australia; Complex Systems Group, School of Physics, The University of Sydney, Camperdown, NSW, Australia.
Vivek PrabhakaranDepartment of Radiology, University of Wisconsin, Madison, WI, USA.
Richard LennertzDepartment of Anaesthesiology, University of Wisconsin, Madison, WI, USA.
Robert D SandersCentral Clinical School, Faculty of Medicine & Health, The University of Sydney, Camperdown, NSW, Australia; Brain & Mind Centre, Faculty of Medicine & Health, The University of Sydney, Camperdown, NSW, Australia; Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. Electronic address: robert.sanders@sydney.edu.au.

Funding

Clarifying the overlapping pathology of delirium and dementiaR01AG063849 · NIA · UNIVERSITY OF WISCONSIN-MADISON · PI Richard C Lennertz, Robert D Sanders · 2019 to 2026
$5.0M
Stroke Connectome MRI Biomarkers for VCID Risk AssessmentR01NS123378 · NINDS · UNIVERSITY OF WISCONSIN-MADISON · PI Nagesh Adluru, Veena A Nair · 2022 to 2026
$3.6M
PET/MR Correlates of Accelerated Aging in Chronic EpilepsyR01NS117568 · NINDS · UNIVERSITY OF WISCONSIN-MADISON · PI Alan Blair McMillan, Vivek Prabhakaran · 2021 to 2026
$3.0M
NIA NIH HHS R01 AG063849NINDS NIH HHS R01 NS117568NINDS NIH HHS R01 NS123378
6 · The paper itself

Abstract

backgroundPostoperative delirium is associated with increased morbidity, mortality, future cognitive decline, or dementia. Understanding the neural mechanisms that differentiate individual brain vulnerabilities is critical for future therapeutic development and prevention of postoperative delirium. We investigated the hypothesis that impaired resting state functional connectivity indicates predisposition to delirium.

methodsPreoperative blood oxygen level-dependent functional MRI data were collected from 120 participants (>65 yr, 52 female) undergoing major elective non-intracranial surgery. Denoised blood oxygen level-dependent signal time-series for 400 cortical regions were used to calculate resting state functional connectivity within and between canonical resting state networks. We used a support vector machine to determine whether resting state functional connectivity across higher-order cortical networks was predictive of postoperative delirium.

resultsGroup comparisons revealed significantly decreased within-network connectivity in salience-ventral attention, cognitive control, and default mode network in participants with postoperative delirium (n=31) compared with non-delirious participants (n=89; non-parametric permutation test, 1000 iterations, P<0.05). We found overall weaker connectivity within the default mode network and specific differences across the sub-networks of the default mode which overlap with higher-order cognitive processing. Supervised machine learning identified that the visual and salience-ventral attentional networks predicted postoperative delirium incidence with an accuracy of 68%.

conclusionsResting state functional connectivity is a neural correlate of vulnerability to postoperative delirium. Disrupted resting state connectivity within higher-order cognitive association areas, including the default mode network, salience attention, and cognitive control networks, was specifically correlated with delirium. CLINICAL

trial registrationNCT01980511 and NCT03124303.

Indexed as

BrainDeliriumNerve NetPostoperative ComplicationsAgedFemaleHumansMagnetic Resonance ImagingMaleRestSupport Vector Machinecognitive declinedefault mode networkdeliriumfunctional connectivitypostoperative neurocognitive dysfunctionresting state fMRI

Identifiers

PMID41475933
PMCPMC12967321

What OpenQuestion holds

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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.