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. 2023 Jan 17;23(1):22.
doi: 10.1186/s12883-023-03049-1.

Cortical Grey matter volume depletion links to neurological sequelae in post COVID-19 "long haulers"

Ted L Rothstein  1
Affiliations

Cortical Grey matter volume depletion links to neurological sequelae in post COVID-19 "long haulers"

Ted L Rothstein. BMC Neurol. .

Abstract

Objective: COVID-19 (SARS-CoV-2) has been associated with neurological sequelae even in those patients with mild respiratory symptoms. Patients experiencing cognitive symptoms such as "brain fog" and other neurologic sequelae for 8 or more weeks define "long haulers". There is limited information regarding damage to grey matter (GM) structures occurring in COVID-19 "long haulers". Advanced imaging techniques can quantify brain volume depletions related to COVID-19 infection which is important as conventional Brain MRI often fails to identify disease correlates. 3-dimensional voxel-based morphometry (3D VBM) analyzes, segments and quantifies key brain volumes allowing comparisons between COVID-19 "long haulers" and normative data drawn from healthy controls, with values based on percentages of intracranial volume.

Methods: This is a retrospective single center study which analyzed 24 consecutive COVID-19 infected patients with long term neurologic symptoms. Each patient underwent Brain MRI with 3D VBM at median time of 85 days following laboratory confirmation. All patients had relatively mild respiratory symptoms not requiring oxygen supplementation, hospitalization, or assisted ventilation. 3D VBM was obtained for whole brain and forebrain parenchyma, cortical grey matter (CGM), hippocampus, and thalamus.

Results: The results demonstrate a statistically significant depletion of CGM volume in 24 COVID-19 infected patients. Reduced CGM volume likely influences their long term neurological sequelae and may impair post COVID-19 patient's quality of life and productivity.

Conclusion: This study contributes to understanding effects of COVID-19 infection on patient's neurocognitive and neurological function, with potential for producing serious long term personal and economic consequences, and ongoing challenges to public health systems.

Keywords: Brain fog; COVID-19; Cognitive impairment; Long haulers; Neurologic sequelae of COVID-19; PASC; SARS-CoV-2; Voxel-based morphometry.

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Conflict of interest statement

The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
An example of NeuroQuant® numeric data acquisition and 3-dimensional voxel-based morphometry results in patient #7 is provided in Fig. 1 which tracks volumes of thalamus, hippocampus and cortical grey matter as their percentage of total intracranial volume (ICV) when compared with normative database drawn from healthy controls and adjusted for age, and sex. Abnormal range is defined as beyond the white zone at the 5th percentile or less, or 95th percentile or more, at a given age
See this image and copyright information in PMC

References

    1. Graham EL, Clark J, Orban ZS, et al. Resistant neurologic symptoms and cognitive dysfunction on hospitalized Covid-19 “long haulers”. Ann Clin Transl Neurol. 2021;8(5):1073–1085. doi: 10.1002/acn3.51350. - DOI - PMC - PubMed
    1. Premraj L, Kannapadi N, Briggs J, et al. Mid and long term neurological and neuropsychiatric manifestations of post COVID-19 syndrome: a meta-analysis. J Neurol Sci. 2022;434:120162. doi: 10.1016/j.jns.2022.120162. - DOI - PMC - PubMed
    1. Natale NR, Lukens JR, Petry WA., Jr The nervous system during COVID-19: caught in the crossfire. Immunol Rev. 2022;311(1):90–111. doi: 10.1111/imr.13114. - DOI - PMC - PubMed
    1. Graham EL, Koralnik IJ, Liotta EM. Therapeutic approaches to the neurologic manifestations of COVID-19. Neurotherapuetics. 2022;19(5):1435–1466. doi: 10.1007/s13311-022-01267-y. - DOI - PMC - PubMed
    1. Soriano JB, Murthy S, Marshall JC, Relan P, Diaz JV, WHO Clinical case definition working group on post-COVID-19 condition. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis. 2022;22(4):e102–7. 10.1016/S1473-3099(21)00703-9. - PMC - PubMed