Preclinical and translational models for delirium: Recommendations for future research from the NIDUS delirium network
Sarinnapha M. Vasunilashorn, Nadia Lunardi, John C. Newman, Gregory Crosby, Leah Acker, Ted Abel, Seema Bhatnagar, Colm Cunningham, Rafael de Cabo, Laura L. Dugan, Joseph A. Hippensteel, Yumiko Ishizawa, Shouri Lahiri, Edward R. Marcantonio, Zhongcong Xie, Sharon K. Inouye, Niccolò Terrando, Roderic G. Eckenhoff, for the NIDUS Delirium Network
Abstract
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.