Korean J Psychosom Med.  2018 Dec;26(2):194-200. 10.22722/KJPM.2018.26.2.194.

The Effect of Leukoaraiosis on the Severity and Course of Delirium

Affiliations
  • 1Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea. jaejkim@yonsei.ac.kr
  • 2Yonsei Hana Psychiatry Clinic and Institute of Mental Health, Goyang, Korea.
  • 3Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.

Abstract


OBJECTIVES
The significance of leukoaraiosis on brain magnetic resonance imaging (MRI) is uncertain, but it is often seen with vascular risk factors or in the context of cognitive impairment. We aimed to investigate the effect of leukoaraiosis on the severity and course of delirium.
METHODS
Periventricular hyperintensity and deep white matter hyperintensity on brain MRI were rated in 42 patients with delirium by semiquantative visual rating scale. Correlations between their grades and the scores of Korean version of Delirium Rating Scale-Revised-98 (K-DRS-R-98) were analyzed, and the interaction effects between the groups according to the levels of leukoaraiosis and two evaluation points were also analyzed.
RESULTS
The grade of deep white matter hyperintensity in the occipital lobe was positively correlated with the scores on the total, severity items, cognitive items, and non-cognitive items of K-DRS-R-98. The cognitive items scores of K-DRS-R-98 in the low grade group of periventricular hyperintensity showed significantly steeper decrease than the high grade group.
CONCLUSIONS
A difference in severity or recovery speed of delirium according to the level of leukoaraiosis may result from disruption in brain functional connectivity. Our results have a clinical implication in that the severity and course of delirium can be possibly predicted using the level of leukoaraiosis.

Keyword

Delirium; Brain magnetic resonance imaging; Leukoaraiosis; Periventricular hyperintensity; Deep white matter hyperintensity
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