Structural brain changes in post-COVID condition and its relationship with cognitive impairment

It has been estimated that ∼4% of individuals infected with SARS-CoV-2 will be diagnosed with post-COVID condition. Previous studies have evidenced the presence of cognitive dysfunction and structural brain changes in infected individuals; however, the relationship between structural changes and cognitive alterations in post-COVID condition is still not clear. Consequently, the aim of this work is to study structural brain alterations in post-COVID condition patients after almost 2 years of infection and their likely relationship with patients' cognitive impairment. Additionally, the association with blood biomarkers and clinical variables was also explored. One hundred and twenty-eight individuals with post-COVID condition and 37 non-infected healthy controls from the Nautilus Project (ClinicalTrials.gov IDs: NCT05307549 and NCT05307575) underwent structural brain magnetic resonance imaging and a comprehensive neuropsychological assessment. A subsample of 66 post-COVID participants also underwent blood extraction to obtain levels of blood biomarkers. Cortical thickness and subcortical volumes were obtained and analysed using FreeSurfer (v7.1). FMRIB Software Library software (v6.0.4) was used to perform grey matter voxel-based analysis and to study microstructural white matter integrity. Patients with post-COVID performed significantly worse in working and verbal memory, processing speed, verbal fluency and executive functions, compared to healthy controls. Moreover, patients with post-COVID showed increased cortical thickness in the right superior frontal and the right rostral middle frontal gyri that negatively correlated with working memory performance. Diffusion tensor imaging data showed lower fractional anisotropy in patients in the right superior longitudinal fasciculus, the splenium and genu of the corpus callosum, the right uncinate fasciculus and the forceps major, that negatively correlated with subjective memory failures. No differences in blood biomarkers were found. Once patients were classified according to their cognitive status, post-COVID clinically cognitively altered presented increased cortical thickness compared to those classified as non-cognitively altered. In conclusion, our study showed that grey and white matter brain changes are relevant in this condition after almost 2 years of infection and partly explain long-term cognitive sequelae. These findings underscore the critical importance of monitoring this at-risk population over time.

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Publication Details

Journal
Brain Communications
Published
2024-12-24
DOI
https://doi.org/10.1093/braincomms/fcaf070
Citations
14
Primary Topic
Long-Term Effects of COVID-19
Type
article
Field-Weighted Citation Impact
5.17

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article

Structural brain changes in post-COVID condition and its relationship with cognitive impairment

Sílvia Cañizares, Laura Casas, Sonia Vega, Anna Prats-Paris et al.
14 citations
Brain Communications
Long-Term Effects of COVID-19
5.17
article

Structural brain changes in post-COVID condition and its relationship with cognitive impairment

Sílvia Cañizares, Laura Casas, Sonia Vega, Anna Prats-Paris, Maite Garolera, Susana Vazquez-Rivera, Mar Ariza, Maria J. Maldonado-Belmonte, Jèssica Pardo, Bàrbara Segura, Núria Sabé, Carme Junqué, Inmaculada Rico, Susanna Forné, Vanesa Arauzo, Javier Oltra, Tamar Garzon, Anna Campabadal, Marta Cullell, Cristian Barruè, Ulises Cortés, Marta Almería, Carme Tayó-Juli, Yaiza Molina, Roser Sala‐Llonch, Núria Bargalló, Jose A. Bernia, Javier Alonso, Marta Balague-Marmaña, Ester Gonzalez-Aguado, Neus Cano, Victòria Olivé, Ignacio Roura, Berta Valles-Pauls, Anna Ferré, Silvia Reverte-Vilarroya, José A. Muñoz-Moreno, Jordina Muñoz-Padros, Eva Forcadell-Ferreres, Eva Baillés, Sílvia Alsina, Sandra Sanz Navarro, Lourdes Carreras-Vidal, Anna Bartes-Plans, Clara Capdevila-Lacasa, Jesús Caballero, María José Ciudad, Manuela Lozano, A Hernández, Cristina Martín‐Barceló, Laura Pacheco-Jaime, Carla Garcia-Vicente
article en
14 citations

Abstract

It has been estimated that ∼4% of individuals infected with SARS-CoV-2 will be diagnosed with post-COVID condition. Previous studies have evidenced the presence of cognitive dysfunction and structural brain changes in infected individuals; however, the relationship between structural changes and cognitive alterations in post-COVID condition is still not clear. Consequently, the aim of this work is to study structural brain alterations in post-COVID condition patients after almost 2 years of infection and their likely relationship with patients' cognitive impairment. Additionally, the association with blood biomarkers and clinical variables was also explored. One hundred and twenty-eight individuals with post-COVID condition and 37 non-infected healthy controls from the Nautilus Project (ClinicalTrials.gov IDs: NCT05307549 and NCT05307575) underwent structural brain magnetic resonance imaging and a comprehensive neuropsychological assessment. A subsample of 66 post-COVID participants also underwent blood extraction to obtain levels of blood biomarkers. Cortical thickness and subcortical volumes were obtained and analysed using FreeSurfer (v7.1). FMRIB Software Library software (v6.0.4) was used to perform grey matter voxel-based analysis and to study microstructural white matter integrity. Patients with post-COVID performed significantly worse in working and verbal memory, processing speed, verbal fluency and executive functions, compared to healthy controls. Moreover, patients with post-COVID showed increased cortical thickness in the right superior frontal and the right rostral middle frontal gyri that negatively correlated with working memory performance. Diffusion tensor imaging data showed lower fractional anisotropy in patients in the right superior longitudinal fasciculus, the splenium and genu of the corpus callosum, the right uncinate fasciculus and the forceps major, that negatively correlated with subjective memory failures. No differences in blood biomarkers were found. Once patients were classified according to their cognitive status, post-COVID clinically cognitively altered presented increased cortical thickness compared to those classified as non-cognitively altered. In conclusion, our study showed that grey and white matter brain changes are relevant in this condition after almost 2 years of infection and partly explain long-term cognitive sequelae. These findings underscore the critical importance of monitoring this at-risk population over time.

Brain CommunicationsVol. 7(1)
Stockholm University (SE), Karolinska Institutet (SE), Universitat Internacional de Catalunya (ES), Biomedical Research Networking Center on Neurodegenerative Diseases (ES), Consorci Sanitari de Terrassa (ES), Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (ES), Hospital Clínic de Barcelona (ES), Corporació Sanitària Parc Taulí (ES), Institute for Research in Biomedicine (ES), Institut d'Investigacions Biomèdiques de Barcelona (ES), Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES), Universitat de Barcelona (ES), Universitat Politècnica de Catalunya (ES)
Fundació la Marató de TV3, Ministerio de Ciencia, Innovación y Universidades, Generalitat de Catalunya, Ministerio de Economía y Competitividad, Ministerio de Ciencia e Innovación, Universitat de Barcelona, Agència de Gestió d'Ajuts Universitaris i de Recerca, Agencia Estatal de Investigación
Openalex Percentile: Top 4%
Long-Term Effects of COVID-19
5.17
DOIOpen Access PDFOpenAlex
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