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Altered brain function and structure pre- and post- COVID-19 infection: a longitudinal study

  • COVID-19
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Abstract

Background

Evidence indicates that the SARS-CoV-2 virus can infect the brain, resulting in central nervous system symptoms. However, there is a lack of a longitudinal imaging study investigating the impact of Coronavirus disease 2019 (COVID-19) infection on brain function. Consequently, this study aimed to fill this knowledge gap using functional magnetic resonance imaging (fMRI).

Methods

Twenty-one participants underwent two resting-state fMRI scans before and after infection. The amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) were assessed to identify the brain function changes. Additionally, voxel-based morphometry (VBM) was utilized to assess changes in brain structure. Subsequently, brain regions that showed significant differences were identified as regions of interest (ROI) in functional connectivity analysis (FC).

Results

After infection, ALFF was increased in the bilateral paracentral lobe and postcentral gyrus while decreased in the bilateral precuneus. Moreover, ReHo was decreased in the cerebellar vermis, accompanied by a decrease in FC with the bilateral postcentral gyrus. Furthermore, gray matter volume (GMV) reduction was observed in the left thalamus. The results of the correlation analysis revealed a negative correlation between ALFF values in the bilateral precuneus and scores on the self-rating anxiety scale (SAS) in pre- and post-infection datasets.

Conclusion

Neuroimaging alterations may occur before the manifestation of clinical symptoms, indicating that the functioning of the motor and sensory systems, as well as their connection, might be affected following infection. This alteration can potentially increase the potential of maladaptive responses to environmental stimuli. Furthermore, patients may be susceptible to future emotional disorders.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

COVID-19:

Coronavirus disease 2019

fMRI:

Functional magnetic resonance imaging

ALFF:

Amplitude of low-frequency fluctuation

ReHo:

Regional homogeneity

FC:

Functional connectivity

VBM:

Voxel-based morphometry

GMV:

Gray matter volume

ROI:

Regions of interest

SAS:

Self-anxiety scale

SDS:

Self-depression scale

BMI:

Body mass index

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Acknowledgements

We would like to thank the volunteers for their involvement in the study.

Funding

This study was supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Plan [grant number 2022ZA103].

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Authors and Affiliations

  1. Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Stadium Road 453#, ** Zhang

Authors
  1. ** **
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  2. Feng Cui
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  3. Min Xu
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  4. Yue Ren
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  5. Lu** Zhang
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Contributions

** **: Conceptualization, Methodology, Investigation, Data curation, Validation, Formal analysis, Writing—original draft, Visualization, Funding acquisition. Feng Cui: Software, Methodology, Data curation, Formal analysis. Min Xu: Investigation, Writing—review & editing. Yue Ren: Software, Methodology. Lu** Zhang: Conceptualization, Project administration, Writing—review & editing, Supervision, Resources.

Corresponding author

Correspondence to Lu** Zhang.

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Competing interests

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The study was carried out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki) and was approved by the Ethics Committee of Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University (2023KLL014). Informed consent all participants were informed about the experimental procedures and gave their informed written consent to participate in the study.

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**, P., Cui, F., Xu, M. et al. Altered brain function and structure pre- and post- COVID-19 infection: a longitudinal study. Neurol Sci 45, 1–9 (2024). https://doi.org/10.1007/s10072-023-07236-3

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