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. 2023 Apr 18;13(4):675.
doi: 10.3390/brainsci13040675.

Effect of Post-COVID-19 on Brain Volume and Glucose Metabolism: Influence of Time Since Infection and Fatigue Status

Justin R Deters  1 , Alexandra C Fietsam  1 , Phillip E Gander  2 , Laura L Boles Ponto  2 , Thorsten Rudroff  1
Affiliations

Effect of Post-COVID-19 on Brain Volume and Glucose Metabolism: Influence of Time Since Infection and Fatigue Status

Justin R Deters et al. Brain Sci. .

Abstract

Post-COVID-19 syndrome (PCS) fatigue is typically most severe <6 months post-infection. Combining magnetic resonance imaging (MRI) and positron emission tomography (PET) imaging with the glucose analog [18F]-Fluorodeoxyglucose (FDG) provides a comprehensive overview of the effects of PCS on regional brain volumes and metabolism, respectively. The primary purpose of this exploratory study was to investigate differences in MRI/PET outcomes between people < 6 months (N = 18, 11 female) and > 6 months (N = 15, 6 female) after COVID-19. The secondary purpose was to assess if any differences in MRI/PET outcomes were associated with fatigue symptoms. Subjects > 6 months showed smaller volumes in the putamen, pallidum, and thalamus compared to subjects < 6 months. In subjects > 6 months, fatigued subjects had smaller volumes in frontal areas compared to non-fatigued subjects. Moreover, worse fatigue was associated with smaller volumes in several frontal areas in subjects > 6 months. The results revealed no brain metabolism differences between subjects > 6 and < 6 months. However, both groups exhibited both regional hypo- and hypermetabolism compared to a normative database. These results suggest that PCS may alter regional brain volumes but not metabolism in people > 6 months, particularly those experiencing fatigue symptoms.

Keywords: FDG-PET; brain volume; fatigue; neuroimaging in post-COVID-19; post-COVID-19.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Single subject MNI template [36] T1 MRI showing the putamen (red), pallidum (cyan), and thalamus (green), which all had smaller volumes in subjects > 6 months post-infection than subjects < 6 months post-infection.
Figure 2
Figure 2
Regional volumetric comparisons for fatigued (blue) and non-fatigued (red) subjects > 6 months post-infection. Y axis is the percent of total volume (i.e., 1.5 = 1.5%). Dots represent individual data points. * Represents a p < 0.05. Data are means ± SEM. Fatigued subjects > 6 months post-infection had smaller relative volumes across each brain region.
Figure 3
Figure 3
Pearson’s correlations for FSS (A,B) or FAS (C,D) and RRV in the middle and straight frontal gyri in subjects > 6 months post-infection. In all cases, a smaller RRV was associated with worse fatigue (FSS) and perceived fatigability (FAS).
See this image and copyright information in PMC

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