Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.
Alzheimers Dement. 2023 May;19(5):2150-2174. doi: 10.1002/alz.12941. Epub 2023 Feb 17.
Delirium is a common, morbid, and costly syndrome that is closely linked to Alzheimer's disease (AD) and AD-related dementias (ADRD) as a risk factor and outcome. Human studies of delirium have advanced our knowledge of delirium incidence and prevalence, risk factors, biomarkers, outcomes, prevention, and management. However, understanding of delirium neurobiology remains limited. Preclinical and translational models for delirium, while challenging to develop, could advance our knowledge of delirium neurobiology and inform the development of new prevention and treatment approaches. We discuss the use of preclinical and translational animal models in delirium, focusing on (1) a review of current animal models, (2) challenges and strategies for replicating elements of human delirium in animals, and (3) the utility of biofluid, neurophysiology, and neuroimaging translational markers in animals. We conclude with recommendations for the development and validation of preclinical and translational models for delirium, with the goal of advancing awareness in this important field.
谵妄是一种常见的、病态的、昂贵的综合征,与阿尔茨海默病 (AD) 和 AD 相关痴呆 (ADRD) 密切相关,是一个风险因素和结果。人类对谵妄的研究提高了我们对谵妄发病率和患病率、危险因素、生物标志物、结局、预防和管理的认识。然而,对谵妄神经生物学的理解仍然有限。谵妄的临床前和转化模型虽然开发具有挑战性,但可以增进我们对谵妄神经生物学的认识,并为新的预防和治疗方法的开发提供信息。我们讨论了在谵妄中使用临床前和转化动物模型,重点是:(1) 当前动物模型的综述,(2) 在动物中复制人类谵妄元素的挑战和策略,以及 (3) 生物流体、神经生理学和神经影像学转化标志物在动物中的应用。我们最后提出了开发和验证谵妄临床前和转化模型的建议,旨在提高人们对这一重要领域的认识。