MRS in delirium
Research type
Research Study
Full title
Magnetic Resonance Spectroscopy to validate brain glutamate as a therapeutic target in delirium and dementia
IRAS ID
223423
Contact name
Jeremy Isaacs
Contact email
Sponsor organisation
St George's University Hospitals NHS Foundation Trust
Duration of Study in the UK
2 years, 6 months, 2 days
Research summary
Delirium is an acute confusional state that affects up to one third of older people in hospital. It is associated with increased risk of death, nursing home admission and developing (or worsening existing) dementia. Surprisingly little is known about the biology of delirium, or why it seems to cause and accelerate dementia.
We propose to study delirium using a non-invasive imaging technique called Magnetic Resonance Spectroscopy (MRS). This is performed in exactly the same way as a conventional MRI brain scan but provides detailed information on the chemical content of the brain. Several brain chemicals, including neurotransmitters such as glutamate, have been proposed to be implicated in causing delirium. There are several drugs already in clinical use that act on these neurotransmitters.
By performing MRS in older people with delirium and in age-matched controls, we hope to demonstrate whether levels of glutamate and other brain chemicals are altered in delirium. If so, this will open up the possibility of using existing medications to restore normal brain levels of neurotransmitters. This might improve the clinical features of the delirium (which are very distressing to patients and carers) and reduce progression to dementia.
We will recruit people with delirium and non-delirious controls from the medical wards at St George's Hospital. Our investigators will confirm delirium using internationally recognised criteria. We will not include people with known or suspected dementia. Only people well enough to leave the ward for up to 90 minutes will be included. People who are unable to give consent themselves will be consented by a personal consultee. Participants will undergo a single MRI brain scan including routine structural and MRS sequences, with a maximum duration of 45 minutes. MRS data will be analysed by the MRI research group at St George's University of London.
REC name
Wales REC 6
REC reference
18/WA/0063
Date of REC Opinion
12 Mar 2018
REC opinion
Further Information Favourable Opinion