Perfusion and Structural Brain Changes Across Psychiatric Symptom Domains in Long COVID
Claire Perry1, Nuno Barros2, Allison Nelson1, Rafay Khan2, Alyssa Michel1, Wadzanayi Mayiseni1, Cheryl Lacadie1, Shelli Farhadian1, Leah Rubin3, Todd Constable1, Serena Spudich1, Lindsay McAlpine1
1Yale University School of Medicine, 2icometrix, 3Johns Hopkins University School of Medicine
Objective:
To characterize perfusion and structural changes associated with neuropsychiatric Long COVID (LC).
Background:
Mood symptoms are common in LC, but the underlying neurobiology remains poorly understood.
Design/Methods:
Individuals with neuropsychiatric LC (new neurologic and/or psychiatric symptoms >3 months after COVID) and recovered controls (COVID >3 months prior and no LC) were prospectively enrolled for neuropsychological testing and scans on a Siemens 3T scanner. Assessments included Perceived Stress Scale (PSS), Apathy Evaluation Scale (AES), Computerized Adaptive Test for Mental Health (CAT-MH) for Post-Traumatic Test Disorder (PTSD) severity, Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). Linear regressions with false detection rate (FDR) correction were calculated between cortical gray matter (CGM) volume and arterial spin labeling (ASL) with neuropsychological test scores.
Results:
There were 32 participants with LC (median [IQR] age 49.5 [39-58], 75% female) and 17 controls (median [IQR] age 40 [33-58], 76% female). LC participants performed worse on all assessments (pPSS=2.31x10-10, pAES=0.0062, pPHQ9=7.21x10-14, pGAD7=7.81x10-8, pPTSD =5.27 x 10-4). In the LC group, CGM variations were associated with PTSD severity in the left precuneus (p=0.0443). Trauma severity was associated with variations in CGM in the parietal (ROIs=6) and occipital (ROIs=3) lobes. In the LC group, decreased perfusion in the right precentral gyrus (p=0.0495) and left superior parietal lobule (p=0.0495) were associated with depression, the right operculum (p=0.0212) and planum temporale (p=0.0212) were associated with apathy, and left amygdala was associated with depression (p=0.0438) and apathy (p=0.0212). Trauma severity was associated with perfusion changes in the frontal (ROIs=4) and temporal (ROIs=3) lobes. No CGM or perfusion associations were found in controls.
Conclusions:
We found that reduced CGM volume correlated with PTSD severity, while decreased perfusion in frontal, parietal, and temporal ROIs correlated with depression and apathy. These findings support neurovascular dysfunction as a key mechanism linking cerebral blood flow alterations to psychiatric symptoms in LC.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.