title: Functional connectivity of the circadian clock and neural substrates of sleep-wake disturbance in delirium.
abstract: A possible mechanism of disrupted circadian rhythms in delirium was identified using resting-state functional connectivity. Thirty-four delirious patients and 38 non-delirious controls were scanned for resting-state functional MRI. Seed-based connectivity of the suprachiasmatic nucleus was compared between the groups. In delirious patients functional connectivity from the circadian clock was increased to the dorsal anterior cingulate cortex and decreased to the posterior cingulate cortex, parahippocampal gyrus, cerebellum, and thalamus. A dysregulation of the default mode network and mental coordination processing areas by the circadian clock may be the underlying pathophysiology of sleep-wake cycle disturbance and symptom fluctuation in delirium.
authors.affiliation: Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sunghyon
authors.initials: S
authors.lastname: Kyeong
authors.affiliation: Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Soo-Hee
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jung
authors.initials: J
authors.lastname: Eun Shin
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Woo Suk
authors.initials: WS
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyu Hyun
authors.initials: KH
authors.lastname: Yang
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Tae-Sub
authors.initials: TS
authors.lastname: Chung
authors.affiliation: Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: jaejkim@yonsei.ac.kr.
authors.forename: Jae-Jin
authors.initials: JJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000503:physiopathology; D057906:Circadian Clocks / Q000502:physiology*; D002940:Circadian Rhythm / Q000502:physiology; D003693:Delirium / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009415:Nerve Net / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020178:Sleep Disorders, Circadian Rhythm / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013788:Thalamus / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Delirium; Functional connectivity; Suprachiasmatic nucleus