Delirium assessment and prevention has a tremendous impact on hospitalization outcomes and health care costs. Delirium is a multi-component syndrome characterized by an acute reduction in cognitive functioning, affecting awareness, thinking, attention, and memory. Stroke survivors, representing 17% of the US population aged 65 and over (CDC, 2012), are at major risk for developing delirium (up to 50% incidence in right-brain stroke). Further, about 50% of right-brain stroke patients experience spatial neglect, impairing safety and recovery. The proposed project will investigate a potential neural mechanism explaining the high incidence of both delirium and spatial neglect after right-brain stroke. We will test the hypothesis that the brain networks for arousal and attention, comprised of ascending projections from the mesencephalic reticular formation and integrating right-dominant dorsal and ventral cortical and limbic components, may be affected in these disorders. In the proposed study, we will assess magnetic resonance imaging (MRI) and behavioral data in right-brain stroke patients. We expect that impaired activity and structural integrity of the brain networks for arousal and attention will correlate with behavioral signs of delirium and spatial neglect. Our findings have the potential to impact stroke care by providing a critical biomarker and behavioral profile of post-stroke delirium. This may alert clinicians to initiating preventive care and targeted interventions in patients who are at high risk of hospital morbidity and loss of independence.
|Program type||Scientist Development Grant|
|Effective start/end date||07/01/2017 → 06/30/2020|