{
  "abstract": "Objectives Neurogranin (Ng) has a role in synaptic plasticity and is considered a biomarker of synaptic dysfunction, a process hypothesised to be important in delirium. Few studies examining Ng in delirium exist, with mixed findings. This study aimed to investigate associations between cerebrospinal fluid (CSF) Ng concentrations and delirium in acutely admitted hip fracture patients.Design Cross-sectional study.Setting Acutely admitted orthopaedic patients with hip fracture recruited from four participating hospitals in eastern Norway, representing secondary and tertiary care settings.Participants This study included 392 hip fracture patients. All admitted hip fracture patients operated in spinal anaesthesia were, regardless of age, considered for inclusion.Methods An in-house ELISA was used to measure CSF Ng concentration in patients acutely admitted with a hip fracture (n=392). Delirium status was evaluated daily according to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Editions criteria independently by two experienced geriatricians. A value > 3.44 on The Informant Questionnaire on Cognitive Decline in the Elderly was used as a surrogate marker of probable dementia.Results 180 patients (46 %) developed delirium and 70% of these had dementia. CSF Ng concentration did not differ significantly between those with and without delirium (176 pg/mL vs 164 pg/mL), with an estimated difference in medians of 12 (95% CI −5.8 to 29.8), p=0.185. Analyses adjusted for age, gender and dementia status did not show a statistically significant difference in Ng concentrations between the patients.Conclusions We did not find an association between delirium and CSF concentrations of Ng. This could imply that synaptic dysfunction and degeneration, involving Ng, are not key processes in the development of delirium. Further studies on other synaptic proteins are warranted to better explore synaptic dysfunction’s potential role in the pathophysiology of delirium.",
  "authors": [
    {
      "affiliations": [
        "Department of Clinical Medicine, University of Bergen, Bergen, Norway",
        "Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway"
      ],
      "name": "Mathias N P Hella"
    },
    {
      "affiliations": [
        "Oslo Delirium Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway"
      ],
      "name": "Nathalie B Halaas"
    },
    {
      "affiliations": [
        "Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway"
      ],
      "name": "Hogne Soennesyn"
    },
    {
      "affiliations": [
        "Department of Clinical Medicine, University of Bergen, Bergen, Norway",
        "Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway"
      ],
      "name": "Anne K Bergland"
    },
    {
      "affiliations": [
        "Department of Research, Stavanger University Hospital, Stavanger, Norway"
      ],
      "name": "Hanne B Hetland"
    },
    {
      "affiliations": [
        "Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy, University of Gothenburg, Goteborg, Västra Götaland, Sweden",
        "Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden",
        "Paris Brain Institute, ICM, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, Île-de-France, France",
        "Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, and Department of Neurology, Institute on Aging and Brain Disorders, University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Kaj Blennow"
    },
    {
      "affiliations": [
        "Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy, University of Gothenburg, Goteborg, Västra Götaland, Sweden",
        "UCL, UK Dementia Research Institute, London, England, UK",
        "UCL Institute of Neurology, UCL Department of Neurodegenerative Disease, London, UK",
        "Hong Kong Center for Neurodegenerative Diseases, Hong Kong, People's Republic of China",
        "Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA"
      ],
      "name": "Henrik Zetterberg"
    },
    {
      "affiliations": [
        "Department of Clinical Medicine, University of Bergen, Bergen, Norway",
        "Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway"
      ],
      "name": "Audun O Vik-Mo"
    },
    {
      "affiliations": [
        "Oslo Delirium Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway",
        "Department of Anesthesiology, Akershus University Hospital, Lorenskog, Norway"
      ],
      "name": "Ane-Victoria Idland"
    },
    {
      "affiliations": [
        "Department of Orthopedic Surgery, Akershus University Hospital, Lorenskog, Lørenskog, Norway"
      ],
      "name": "Christian T Pollmann"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway"
      ],
      "name": "Marius Myrstad"
    },
    {
      "affiliations": [
        "Oslo Delirium Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway",
        "Department of Geriatric Medicine, Oslo University Hospital Ullevaal, Oslo, Norway"
      ],
      "name": "Bjørn E Neerland"
    },
    {
      "affiliations": [
        "Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway",
        "Department of Old Age Psychiatry, King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK"
      ],
      "name": "Dag Aarsland"
    },
    {
      "affiliations": [
        "Oslo Delirium Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway",
        "Department of Geriatric Medicine, Akershus University Hospital, Lorenskog, Norway"
      ],
      "name": "Leiv O Watne"
    }
  ],
  "title": "Neurogranin in cerebrospinal fluid as a marker of synaptic dysfunction in hip fracture patients with delirium: a multicentre cross-sectional study",
  "uid": "74974d9b-65f7-57cc-87a4-216153d922c8"
}