{"id":{"repo_id":"uwo","oai_identifier":"oai:uwo.scholaris.ca:20.500.14721/39203"},"canonical_url":"https://search.dev.ndltd.org/etd/uwo/oai:uwo.scholaris.ca:20.500.14721/39203","repository":{"repo_id":"uwo","name":"Western University","base_url":"https://uwo.scholaris.ca/server/oai/request"},"display":{"title":"Functional Near-Infrared Spectroscopy (fNIRS) Based Functional Connectivity Alterations Associated with Delirium in Critically Ill Children: An Exploratory Study","abstract":"This study evaluated whether functional near-infrared spectroscopy (fNIRS)-derived functional connectivity (FC) could serve as a neurophysiological marker of delirium in critically ill children. We conducted a prospective observational study in a tertiary pediatric intensive care unit (PICU) in London, Ontario, involving 28 children aged 1 month to 18 years. Delirium status was determined using the validated Cornell Assessment of Pediatric Delirium (CAPD) score or based on clinician diagnosis in neuro-atypical children. Behavioural assessments also included the FLACC scale for pain and COMFORT-B for level of sedation and/or comfort. A total of 31 resting-state fNIRS recording sessions were collected at the bedside, including 11 during delirium. As anticipated, CAPD scores were higher during delirious fNIRS recordings compared to non-delirious ones on average. Generalized estimating equation (GEE) modelling revealed that increased functional connectivity between the right temporal and left temporoparietal regions was independently associated with delirium presence, even after false discovery rate (FDR) correction. Sedative opioid use also emerged as a significant predictor of delirium status. In a separate model examining delirium severity, higher CAPD scores were associated with greater sedative opioid exposure, younger age, and developmental delay. However, functional connectivity was not independently associated with delirium severity after correction for multiple comparisons. These findings suggest that fNIRS-derived FC may offer an objective, brain-based biomarker of delirium presence in pediatric critical care, with potential to complement existing behavioural assessment tools.","abstract_html":"This study evaluated whether functional near-infrared spectroscopy (fNIRS)-derived functional connectivity (FC) could serve as a neurophysiological marker of delirium in critically ill children. We conducted a prospective observational study in a tertiary pediatric intensive care unit (PICU) in London, Ontario, involving 28 children aged 1 month to 18 years. Delirium status was determined using the validated Cornell Assessment of Pediatric Delirium (CAPD) score or based on clinician diagnosis in neuro-atypical children. Behavioural assessments also included the FLACC scale for pain and COMFORT-B for level of sedation and/or comfort. A total of 31 resting-state fNIRS recording sessions were collected at the bedside, including 11 during delirium. As anticipated, CAPD scores were higher during delirious fNIRS recordings compared to non-delirious ones on average. Generalized estimating equation (GEE) modelling revealed that increased functional connectivity between the right temporal and left temporoparietal regions was independently associated with delirium presence, even after false discovery rate (FDR) correction. Sedative opioid use also emerged as a significant predictor of delirium status. In a separate model examining delirium severity, higher CAPD scores were associated with greater sedative opioid exposure, younger age, and developmental delay. However, functional connectivity was not independently associated with delirium severity after correction for multiple comparisons. These findings suggest that fNIRS-derived FC may offer an objective, brain-based biomarker of delirium presence in pediatric critical care, with potential to complement existing behavioural assessment tools.","abstract_has_math":false,"creators":["Krivoruk, Brian"],"institution":"The University of Western Ontario","degree_name":"M Sc","degree_level":null,"degree_discipline":"Neuroscience","degree_department":null,"school":null,"contributors":[],"advisors":["Ganesan, Saptharishi Lalgudi","Duerden, Emma"],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025-07-25","date_published":"2025-07-25","updated_at":"2026-07-27T21:55:54Z","subjects":["Delirium","Pediatric Intensive Care Unit","Functional Connectivity","fNIRS","Children","CAPD"],"languages":["en"],"rights":["Attribution-NonCommercial-NoDerivatives 4.0 International"],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/20.500.14721/39203","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Ganesan, Saptharishi Lalgudi","Duerden, Emma"]},{"key":"dc:creator","label":"Author","values":["Krivoruk, Brian"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-12-05T19:15:17Z"]},{"key":"dc:date.issued","label":"Date","values":["2025-07-25"]},{"key":"dc:publisher","label":"Institution","values":["The University of Western Ontario"]},{"key":"dc:type","label":"Dc Type","values":["thesis"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Neuroscience"]},{"key":"thesis:degree_name","label":"Degree Name","values":["M Sc"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["The University of Western Ontario"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Delirium","Pediatric Intensive Care Unit","Functional Connectivity","fNIRS","Children","CAPD"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]},{"key":"dc:rights","label":"Dc Rights","values":["Attribution-NonCommercial-NoDerivatives 4.0 International"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/20.500.14721/39203"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["This study evaluated whether functional near-infrared spectroscopy (fNIRS)-derived functional connectivity (FC) could serve as a neurophysiological marker of delirium in critically ill children. We conducted a prospective observational study in a tertiary pediatric intensive care unit (PICU) in London, Ontario, involving 28 children aged 1 month to 18 years. Delirium status was determined using the validated Cornell Assessment of Pediatric Delirium (CAPD) score or based on clinician diagnosis in neuro-atypical children. Behavioural assessments also included the FLACC scale for pain and COMFORT-B for level of sedation and/or comfort. A total of 31 resting-state fNIRS recording sessions were collected at the bedside, including 11 during delirium. As anticipated, CAPD scores were higher during delirious fNIRS recordings compared to non-delirious ones on average. Generalized estimating equation (GEE) modelling revealed that increased functional connectivity between the right temporal and left temporoparietal regions was independently associated with delirium presence, even after false discovery rate (FDR) correction. Sedative opioid use also emerged as a significant predictor of delirium status. In a separate model examining delirium severity, higher CAPD scores were associated with greater sedative opioid exposure, younger age, and developmental delay. However, functional connectivity was not independently associated with delirium severity after correction for multiple comparisons. These findings suggest that fNIRS-derived FC may offer an objective, brain-based biomarker of delirium presence in pediatric critical care, with potential to complement existing behavioural assessment tools."]},{"key":"dc:title","label":"Title","values":["Functional Near-Infrared Spectroscopy (fNIRS) Based Functional Connectivity Alterations Associated with Delirium in Critically Ill Children: An Exploratory Study"]}]}],"canonical_facts":{"dc:contributor.advisor":["Ganesan, Saptharishi Lalgudi","Duerden, Emma"],"dc:creator":["Krivoruk, Brian"],"dc:date.accessioned":["2025-12-05T19:15:17Z"],"dc:date.issued":["2025-07-25"],"dc:description.abstract":["This study evaluated whether functional near-infrared spectroscopy (fNIRS)-derived functional connectivity (FC) could serve as a neurophysiological marker of delirium in critically ill children. We conducted a prospective observational study in a tertiary pediatric intensive care unit (PICU) in London, Ontario, involving 28 children aged 1 month to 18 years. Delirium status was determined using the validated Cornell Assessment of Pediatric Delirium (CAPD) score or based on clinician diagnosis in neuro-atypical children. Behavioural assessments also included the FLACC scale for pain and COMFORT-B for level of sedation and/or comfort. A total of 31 resting-state fNIRS recording sessions were collected at the bedside, including 11 during delirium. As anticipated, CAPD scores were higher during delirious fNIRS recordings compared to non-delirious ones on average. Generalized estimating equation (GEE) modelling revealed that increased functional connectivity between the right temporal and left temporoparietal regions was independently associated with delirium presence, even after false discovery rate (FDR) correction. Sedative opioid use also emerged as a significant predictor of delirium status. In a separate model examining delirium severity, higher CAPD scores were associated with greater sedative opioid exposure, younger age, and developmental delay. However, functional connectivity was not independently associated with delirium severity after correction for multiple comparisons. These findings suggest that fNIRS-derived FC may offer an objective, brain-based biomarker of delirium presence in pediatric critical care, with potential to complement existing behavioural assessment tools."],"dc:identifier.uri":["https://hdl.handle.net/20.500.14721/39203"],"dc:language.iso":["en"],"dc:publisher":["The University of Western Ontario"],"dc:rights":["Attribution-NonCommercial-NoDerivatives 4.0 International"],"dc:subject":["Delirium","Pediatric Intensive Care Unit","Functional Connectivity","fNIRS","Children","CAPD"],"dc:title":["Functional Near-Infrared Spectroscopy (fNIRS) Based Functional Connectivity Alterations Associated with Delirium in Critically Ill Children: An Exploratory Study"],"dc:type":["thesis"],"thesis:degree_discipline":["Neuroscience"],"thesis:degree_name":["M Sc"],"thesis:institution_name":["The University of Western Ontario"]},"updated_at":"2026-07-27T21:55:54Z"}