sharon sanders
Editor-in-Chief & President
Brain abnormalities in survivors of COVID-19 after 2-year recovery: a functional MRI study
DOI:https://doi.org/10.1016/j.lanwpc.2024.101086
Summary
Background
A variety of symptoms, particularly cognitive, psychiatric and neurological symptoms, may persist for a long time among individuals recovering from COVID-19. However, the underlying mechanism of these brain abnormalities remains unclear. This study aimed to investigate the long-term neuroimaging effects of COVID-19 infection on brain functional activities using resting-state functional magnetic resonance imaging (rs-fMRI).
Methods
Fifty-two survivors 27 months after infection (mild-moderate group: 25 participants, severe-critical: 27 participants), from our previous community participants, along with 35 healthy controls, were recruited to undergo fMRI scans and comprehensive cognitive function measurements. Participants were evaluated by subjective assessment of Cognitive Failures Questionnaire-14 (CFQ-14) and Fatigue Scale-14 (FS-14), and objective assessment of Montreal Cognitive Assessment (MoCA), N-back, and Simple Reaction Time (SRT). Each had rs-fMRI at 3T. Measures such as the amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) were calculated.
Findings
Compared with healthy controls, survivors of mild-moderate acute symptoms group and severe-critical group had a significantly higher score of cognitive complains involving cognitive failure and mental fatigue. However, there was no difference of cognitive complaints between two groups of COVID-19 survivors. The performance of three groups was similar on the score of MoCA, N-back and SRT. The rs-fMRI results showed that COVID-19 survivors exhibited significantly increased ALFF values in the left putamen (PUT.L), right inferior temporal gyrus (ITG.R) and right pallidum (PAL.R), while decreased ALFF values were observed in the right superior parietal gyrus (SPG.R) and left superior temporal gyrus (STG.L). Additionally, decreased ReHo values in the right precentral gyrus (PreCG.R), left postcentral gyrus (PoCG.L), left calcarine fissure and surrounding cortex (CAL.L) and left superior temporal gyrus (STG.L). Furthermore, significant negative correlations between the ReHo values in the STG.L, and CFQ-14 and mental fatigue were found.
snip
In conclusion, our study revealed that COVID-19 survivors commonly experienced psychiatric symptoms, neurological symptoms and cognitive complaints even 2 years after recovery.
We observed significant differences in ALFF and ReHo values in brain regions associated with cognitive function when comparing survivors to healthy controls. Additionally, we found correlations between cognitive function indices and spontaneous brain function, indicating the persistence of brain impairment even after 2 years of infection. Long-term follow up studies are needed to further explore the trajectory of psychiatric symptoms, neurological symptoms and cognitive function, and understand the mechanisms of brain damage and SARS-CoV-2 infection.
more... https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(24)00080-4/fulltext
- Yimiao Zhao [SUP]o[/SUP]
- Qiongdan Liang [SUP]o[/SUP]
- Zhendong Jiang [SUP]o[/SUP]
- Huan Mei
- Na Zeng
- Sizhen Su
- et al.
- Show all authors
- Show footnotes
DOI:https://doi.org/10.1016/j.lanwpc.2024.101086
- Summary
- Keywords
- Introduction
- Methods
- Results
- Discussion
- Contributors
- Data sharing statement
- Declaration of interests
- Acknowledgements
- Supplementary data
- References
- Article info
- Figures
- Tables
Summary
Background
A variety of symptoms, particularly cognitive, psychiatric and neurological symptoms, may persist for a long time among individuals recovering from COVID-19. However, the underlying mechanism of these brain abnormalities remains unclear. This study aimed to investigate the long-term neuroimaging effects of COVID-19 infection on brain functional activities using resting-state functional magnetic resonance imaging (rs-fMRI).
Methods
Fifty-two survivors 27 months after infection (mild-moderate group: 25 participants, severe-critical: 27 participants), from our previous community participants, along with 35 healthy controls, were recruited to undergo fMRI scans and comprehensive cognitive function measurements. Participants were evaluated by subjective assessment of Cognitive Failures Questionnaire-14 (CFQ-14) and Fatigue Scale-14 (FS-14), and objective assessment of Montreal Cognitive Assessment (MoCA), N-back, and Simple Reaction Time (SRT). Each had rs-fMRI at 3T. Measures such as the amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) were calculated.
Findings
Compared with healthy controls, survivors of mild-moderate acute symptoms group and severe-critical group had a significantly higher score of cognitive complains involving cognitive failure and mental fatigue. However, there was no difference of cognitive complaints between two groups of COVID-19 survivors. The performance of three groups was similar on the score of MoCA, N-back and SRT. The rs-fMRI results showed that COVID-19 survivors exhibited significantly increased ALFF values in the left putamen (PUT.L), right inferior temporal gyrus (ITG.R) and right pallidum (PAL.R), while decreased ALFF values were observed in the right superior parietal gyrus (SPG.R) and left superior temporal gyrus (STG.L). Additionally, decreased ReHo values in the right precentral gyrus (PreCG.R), left postcentral gyrus (PoCG.L), left calcarine fissure and surrounding cortex (CAL.L) and left superior temporal gyrus (STG.L). Furthermore, significant negative correlations between the ReHo values in the STG.L, and CFQ-14 and mental fatigue were found.
snip
In conclusion, our study revealed that COVID-19 survivors commonly experienced psychiatric symptoms, neurological symptoms and cognitive complaints even 2 years after recovery.
We observed significant differences in ALFF and ReHo values in brain regions associated with cognitive function when comparing survivors to healthy controls. Additionally, we found correlations between cognitive function indices and spontaneous brain function, indicating the persistence of brain impairment even after 2 years of infection. Long-term follow up studies are needed to further explore the trajectory of psychiatric symptoms, neurological symptoms and cognitive function, and understand the mechanisms of brain damage and SARS-CoV-2 infection.
more... https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(24)00080-4/fulltext