Dysfunctional resting state network connectivity predicts postoperative delirium after major surgery
Authors' conclusion
Resting 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.
Study context
- Population
- Adults >65 yr undergoing major elective non-intracranial surgery52 female
- Participants
- 120 adults
- Exposure
- Postoperative delirium vs no delirium
- Postoperative deliriumn = 31
- Non-deliriousn = 89reference
- Outcome
- Resting state functional connectivity within and between canonical resting state networks, and its prediction of postoperative delirium
Methodological detailspreoperative resting state functional MRI, support vector machine, non-parametric permutation test
- Preoperative resting state functional MRI
- Support vector machine
- Non-parametric permutation test
Main finding
As reported in the abstract
Within-network resting state functional connectivity
- Significantly decreased within-network connectivity in salience-ventral attention, cognitive control and default mode network in delirium vs non-delirious participants
- P<0.05
- Visual and salience-ventral attentional networks predicted postoperative delirium incidence (supervised machine learning), accuracy
- 68%
Observational data: associations, not effects.
Original publication
Dysfunctional resting state network connectivity predicts postoperative delirium after major surgery. Br J Anaesth. Published 31 December 2025. doi:10.
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