Cerebral Venous-Associated Brain Damage May Lead to Anxiety and Depression

Case Report: Neuropsychological Profile of a Patient With Intravascular Large B-Cell Lymphoma Following Infection and Vaccination

OBJECTIVE

Intravascular large B-cell lymphoma (IVLBCL) is a rare and aggressive lymphoma that can have heterogeneous central nervous system involvement and cerebrovascular complications. The development of IVLBCL can be fatal. Although relatively rare, the development of specific clinical syndromes, such as IVLBCL, has been implicated following infection and vaccination. To our knowledge, this is the first comprehensive neuropsychological evaluation assessing neurocognitive and psychological status after IVLBCL diagnosis.

METHODS

The current study presents a right-handed mid-60-year-old male with a university-level education, who was diagnosed with IVLBCL following viral vector SARS-CoV-2 vaccination. He presented with a complex medical history including antiphospholipid syndrome, deafness (prior to cochlear implant), and cardiovascular complications secondary to lymphoma. Brain magnetic resonance imaging showed parietal, frontal, and cerebellar infarcts; encephalomalacia; and periventricular deep chronic ischemic changes. A comprehensive neuropsychological evaluation was completed.

RESULTS

In consideration of an individual with an estimated above-average baseline, his neurocognitive profile demonstrated impairments across multiple domains that were more lateralized to the non-dominant hemisphere including visual attention, visual processing speed, visuo-construction, memory, motor dexterity, and right-sided ataxia (e.g., dysmetria). Clinical elevations for depression, hopelessness, and anxiety were also found.

CONCLUSIONS

The current study highlights a novel cognitive profile of IVLBCL and comorbidities with the patient having more predominant nondominant hemispheric-related deficits. There was evidence of disruption to visual processing networks, largely consistent with neuroimaging lesions. The current case also describes the unique experience of an individual coping with a rare condition, especially when resulting in functional decline (e.g., loss of audition). Implications are discussed.

Gut microbiota-derived short-chain fatty acids and depression: deep insight into biological mechanisms and potential applications

The gut microbiota is a complex and dynamic ecosystem known as the 'second brain'. Composing the microbiota-gut-brain axis, the gut microbiota and its metabolites regulate the central nervous system through neural, endocrine and immune pathways to ensure the normal functioning of the organism, tuning individuals' health and disease status. Short-chain fatty acids (SCFAs), the main bioactive metabolites of the gut microbiota, are involved in several neuropsychiatric disorders, including depression. SCFAs have essential effects on each component of the microbiota-gut-brain axis in depression. In the present review, the roles of major SCFAs (acetate, propionate and butyrate) in the pathophysiology of depression are summarised with respect to chronic cerebral hypoperfusion, neuroinflammation, host epigenome and neuroendocrine alterations. Concluding remarks on the biological mechanisms related to gut microbiota will hopefully address the clinical value of microbiota-related treatments for depression.