Eyal Y. Kimchi, MD, PhD -- Delirium Lab

The Delirium Lab at Massachusetts General Hospital is committed to determining the causes and treatments of delirium through a combination of translational and clinical research.

Overview

The Delirium Lab at Massachusetts General Hospital, led by Eyal Kimchi, MD, PhD, is working to determine the causes of delirium and to identify new treatments through a combination of translational and clinical research.

Delirium is an acute and fluctuating disturbance of attention and awareness that represents a dramatic change in condition for persons suffering from it. Patients suffering from delirium can have a large variety of symptoms including confusion, agitation, hallucinations, fluctuations in consciousness and abnormal movements, both too many (hyperactive) or too few (hypoactive).  

Delirium is most common in elderly patients and patients with neurologic diseases such as dementia. Delirium can be associated with complications such as falls, and can suggest a person is at higher risk of dependence and death.

At any given time, approximately 20% of patients in hospital wards suffer from delirium, making it one of the most common complications suffered by hospitalized patients.

Though some epidemiology studies have identified key risk factors for delirium, including aging, sedation and inflammation, this data has failed to translate into satisfactory therapies.

Despite its profound and alarming nature, delirium remains poorly understood and difficult to treat due an incomplete understanding of its pathophysiology.

 

Group Members

Principal Investigator

Eyal Kimchi, MD, PhD

Eyal Y. Kimchi, MD, PhD
Department of Neurology

Research Projects

Translational Research

We are currently performing experiments to determine the pathophysiology of delirium using translational models. By studying the responses of rodents to sedation and inflammation, we can determine which factors are necessary and sufficient to cause delirium-like behavior. 

Our translational work is rigorously validated using state-of-the-art clinical research scales that were developed to screen for delirium in intubated intensive care unit (ICU) patients who cannot speak.

In order to characterize delirium-related behavior, we leverage leading-edge, open-source technologies to develop novel and cost-efficient behavioral devices that can monitor rodent behavior continuously.

By identifying and confirming the factors that can cause delirium, we are working to determine the brain networks involved in the development and possible treatment of delirium.

Clinical Research

In addition to bench research, we perform collaborative clinical research in patients to determine who will develop delirium and how we can prevent it. This work is conducted through the SAGES Study (Successful AGing after Elective Surgery) at the Institute for Aging Research at Hebrew SeniorLife, and through the Department of Neurology at Massachusetts General Hospital.

Clinical Care

We strive to provide the best care possible for our patients and their families. Members of our lab provide acute clinical care for patients with delirium at Mass General. We are constantly improving our understanding and ability to care for patients with delirium. We are working to improve this care through several concurrent and interdisciplinary quality improvement projects.

Publications

  1. Inouye SK, Westendorp RG, Saczynski JS, Kimchi EY, Cleinman AA. Delirium in elderly people—authors’ reply. Lancet. 2014 Jun 14; 383(9934):2045.
  2. Berkowitz AL, Kimchi EY, Hwang DY, Vaitkevicius H, Henderson GV, Feske SK, Chou SH. Clinical Reasoning: a 44-year-old woman with headache followed by sudden neurologic decline. Neurology. 2013 Mar 26; 80(13):e136-41.
  3. Diamond EL, Kimchi EY, Shankar GM, Silverman SB. Transient aqueductal occlusion in intracerebral haemorrhage. Pract Neurol. 2012 Dec; 12(6):388-9.
  4. Horst NK, Heath CJ, Neugebauer NM, Kimchi EY, Laubach M, Picciotto MR. Impaired auditory discrimination learning following perinatal nicotine exposure or ß2 nicotinic acetylcholine receptor subunit deletion. Behav Brain Res. 2012 May 16; 231(1):170-80.
  5. Kimchi EY, Laubach M. The dorsomedial striatum reflects response bias during learning. J Neurosci. 2009 Nov 25; 29(47):14891-902.
  6. Kimchi EY, Torregrossa MM, Taylor JR, Laubach M. Neuronal correlates of instrumental learning in the dorsal striatum. J Neurophysiol. 2009 Jul; 102(1):475-89.
  7. Kimchi EY, Laubach M. Dynamic encoding of action selection by the medial striatum. J Neurosci. 2009 Mar 11; 29(10):3148-59.
  8. Narayanan NS, Kimchi EY, Laubach M. Redundancy and synergy of neuronal ensembles in motor cortex. J Neurosci. 2005 Apr 27; 25(17):4207-16.
  9. Klein JP, Khera DS, Nersesyan H, Kimchi EY, Waxman SG, Blumenfeld H. Dysregulation of sodium channel expression in cortical neurons in a rodent model of absence epilepsy. Brain Res. 2004 Mar 12; 1000(1-2):102-9.
  10. Christie R, Kimchi E, Kajdasz S, Bacskai B, Hyman BT. Multiphoton microscopy and amyloid angiopathy. Amyloid. 2001 Jul; 8 Suppl 1:48-50.
  11. Kimchi EY, Kajdasz S, Bacskai BJ, Hyman BT. Analysis of cerebral amyloid angiopathy in a transgenic mouse model of Alzheimer disease using in vivo multiphoton microscopy. J Neuropathol Exp Neurol. 2001 Mar; 60(3):274-9.

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