Summary: Neuroimaging study reveals significant brain changes in areas associated with language comprehension, cognition and circadian rhythm control six months after COVID-19 infection.
Using a special type of MRI, researchers have found brain changes in patients up to six months after they recovered from COVID-19, according to a study presented next week at the annual meeting of the Radiological Society of North America (RSNA).
About one in five adults will develop long-term effects from COVID-19, according to the US Centers for Disease Control and Prevention. Neurological symptoms associated with long COVID include difficulty thinking or concentrating, headache, trouble sleeping, dizziness, pins and needles sensation, change in smell or taste, and depression or anxiety. However, studies have shown that COVID-19 can be associated with changes in the heart, lungs or other organs, even in asymptomatic patients.
As more people become infected with and recover from COVID-19, research has begun to emerge focusing on the lasting consequences of the disease.
For this study, the researchers used sensitivity-weighted imaging to analyze the effects of COVID-19 on the brain. Magnetic susceptibility indicates how strongly certain materials, such as blood, iron, and calcium, will be magnetized in an applied magnetic field. This capability facilitates the detection and monitoring of a host of neurological conditions, including microhemorrhages, vascular malformations, brain tumors and strokes.
“Group-level studies have not previously focused on COVID-19 changes in brain magnetic susceptibility despite multiple case reports of such abnormalities,” said study co-author Sapna S. Mishra, Ph.D. candidate at Indian Institute of Technology, Delhi. “Our study highlights this novel aspect of the neurological effects of COVID-19 and reports significant abnormalities in COVID survivors.
The researchers analyzed sensitivity-weighted imaging data from 46 COVID-recovered patients and 30 healthy controls. Imaging was performed within six months of healing. Among patients with long-term COVID, the most frequently reported symptoms were fatigue, sleep disturbances, lack of attention, and memory problems.
“Changes in brain region susceptibility values may indicate local compositional changes,” Mishra said. “Sensitivities may reflect the presence of abnormal amounts of paramagnetic compounds, whereas lower sensitivity could be caused by abnormalities such as calcification or lack of paramagnetic iron-containing molecules.”
MRI results showed that patients who recovered from COVID-19 had significantly higher sensitivity values in the frontal lobe and brainstem compared to healthy controls. The clusters obtained in the frontal lobe mainly show differences in the white matter.
“These brain regions are linked to fatigue, insomnia, anxiety, depression, headaches and cognitive problems,” Mishra said.
Parts of the left orbital-inferior frontal gyrus (a key region for understanding and producing language) and the right orbital-inferior frontal gyrus (associated with various cognitive functions, including attention, motor inhibition, and imagery, as well as social cognitive processes) and the adjacent gyrus white matter areas constituted the frontal lobe clusters.
The researchers also found a significant difference in the right ventral diencephalon region of the brainstem. This region is associated with many crucial bodily functions, including coordinating with the endocrine system to release hormones, relay sensory and motor signals to the cerebral cortex, and regulate circadian rhythms (the sleep-wake cycle).
“This study highlights serious long-term complications that can be caused by the coronavirus, even months after the infection has cleared,” Mishra said. “The current results come from the small time window. However, longitudinal time points over a few years will elucidate whether there is a permanent change.
The researchers are conducting a longitudinal study on the same cohort of patients to determine if these brain abnormalities persist over a longer period.
Co-authors are Rakibul Hafiz, Ph.D., Tapan Gandhi, Ph.D., Vidur Mahajan, MBBS, Alok Prasad, MD, and Bharat Biswal, Ph.D.
About this Neurology and COVID-19 Research News
Author: Linda Brooks
Contact: Linda Brooks – RSNA
Image: Image is credited to RSNA and Sapna S. Mishra
Original research: Results will be presented at the 108th Scientific Assembly and Annual Meeting of the Radiological Society of North America
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