tetano
Editor, Senior Moderator
AJNR Am J Neuroradiol
. 2021 Apr 22.
doi: 10.3174/ajnr.A7113. Online ahead of print.
Modelling the Anatomic Distribution of Neurologic Events in Patients with COVID-19: A Systematic Review of MRI Findings
N Parsons[SUP] 1 2 [/SUP], A Outsikas[SUP] 2 [/SUP], A Parish[SUP] 2 [/SUP], R Clohesy[SUP] 2 [/SUP], F D'Aprano[SUP] 3 4 [/SUP], F Toomey[SUP] 5 [/SUP], S Advani[SUP] 6 [/SUP], G R Poudel[SUP] 7 [/SUP]
Affiliations
Abstract
Background: Neurologic events have been reported in patients with coronavirus disease 2019 (COVID-19). However, a model-based evaluation of the spatial distribution of these events is lacking.
Purpose: Our aim was to quantitatively evaluate whether a network diffusion model can explain the spread of small neurologic events.
Data sources: The MEDLINE, EMBASE, Scopus, and LitCovid data bases were searched from January 1, 2020, to July 19, 2020.
Study selection: Thirty-five case series and case studies reported 317 small neurologic events in 123 unique patients with COVID-19.
Data analysis: Neurologic events were localized to gray or white matter regions of the Illinois Institute of Technology (gray-matter and white matter) Human Brain Atlas using radiologic images and descriptions. The total proportion of events was calculated for each region. A network diffusion model was implemented, and any brain regions showing a significant association (P < .05, family-wise error-corrected) between predicted and measured events were considered epicenters.
Data synthesis: Within gray matter, neurologic events were widely distributed, with the largest number of events (?10%) observed in the bilateral superior temporal, precentral, and lateral occipital cortices, respectively. Network diffusion modeling showed a significant association between predicted and measured gray matter events when the spread of pathology was seeded from the bilateral cerebellum (r =0.51, P < .001, corrected) and putamen (r =0.4, P = .02, corrected). In white matter, most events (?26%) were observed within the bilateral corticospinal tracts.
Limitations: The risk of bias was not considered because all studies were either case series or case studies.
Conclusions: Transconnectome diffusion of pathology via the structural network of the brain may contribute to the spread of neurologic events in patients with COVID-19.
. 2021 Apr 22.
doi: 10.3174/ajnr.A7113. Online ahead of print.
Modelling the Anatomic Distribution of Neurologic Events in Patients with COVID-19: A Systematic Review of MRI Findings
N Parsons[SUP] 1 2 [/SUP], A Outsikas[SUP] 2 [/SUP], A Parish[SUP] 2 [/SUP], R Clohesy[SUP] 2 [/SUP], F D'Aprano[SUP] 3 4 [/SUP], F Toomey[SUP] 5 [/SUP], S Advani[SUP] 6 [/SUP], G R Poudel[SUP] 7 [/SUP]
Affiliations
- PMID: 33888458
- DOI: 10.3174/ajnr.A7113
Abstract
Background: Neurologic events have been reported in patients with coronavirus disease 2019 (COVID-19). However, a model-based evaluation of the spatial distribution of these events is lacking.
Purpose: Our aim was to quantitatively evaluate whether a network diffusion model can explain the spread of small neurologic events.
Data sources: The MEDLINE, EMBASE, Scopus, and LitCovid data bases were searched from January 1, 2020, to July 19, 2020.
Study selection: Thirty-five case series and case studies reported 317 small neurologic events in 123 unique patients with COVID-19.
Data analysis: Neurologic events were localized to gray or white matter regions of the Illinois Institute of Technology (gray-matter and white matter) Human Brain Atlas using radiologic images and descriptions. The total proportion of events was calculated for each region. A network diffusion model was implemented, and any brain regions showing a significant association (P < .05, family-wise error-corrected) between predicted and measured events were considered epicenters.
Data synthesis: Within gray matter, neurologic events were widely distributed, with the largest number of events (?10%) observed in the bilateral superior temporal, precentral, and lateral occipital cortices, respectively. Network diffusion modeling showed a significant association between predicted and measured gray matter events when the spread of pathology was seeded from the bilateral cerebellum (r =0.51, P < .001, corrected) and putamen (r =0.4, P = .02, corrected). In white matter, most events (?26%) were observed within the bilateral corticospinal tracts.
Limitations: The risk of bias was not considered because all studies were either case series or case studies.
Conclusions: Transconnectome diffusion of pathology via the structural network of the brain may contribute to the spread of neurologic events in patients with COVID-19.