1
|
Serrano Del Pueblo VM, Serrano-Heras G, Romero Sánchez CM, Piqueras Landete P, Rojas-Bartolome L, Feria I, Morris RGM, Strange B, Mansilla F, Zhang L, Castro-Robles B, Arias-Salazar L, López-López S, Payá M, Segura T, Muñoz-López M. Brain and cognitive changes in patients with long COVID compared with infection-recovered control subjects. Brain 2024:awae101. [PMID: 38562097 DOI: 10.1093/brain/awae101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/15/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Between 2.5 and 28% of people infected with SARS-CoV-2 suffer Long COVID or persistence of symptoms for months after acute illness. Many symptoms are neurological, but the brain changes underlying the neuropsychological impairments remain unclear. This study aimed to provide a detailed description of the cognitive profile, the pattern of brain alterations in Long COVID and the potential association between them. To address these objectives, 83 patients with persistent neurological symptoms after COVID-19 were recruited, and 22 now healthy controls chosen because they had suffered COVID-19 but did not experience persistent neurological symptoms. Patients and controls were matched for age, sex and educational level. All participants were assessed by clinical interview, comprehensive standardized neuropsychological tests and structural MRI. The mean global cognitive function of patients with Long COVID assessed by ACE III screening test (Overall Cognitive level - OCLz= -0.39± 0.12) was significantly below the infection recovered-controls (OCLz= +0.32± 0.16, p< 0.01). We observed that 48% of patients with Long COVID had episodic memory deficit, with 27% also impaired overall cognitive function, especially attention, working memory, processing speed and verbal fluency. The MRI examination included grey matter morphometry and whole brain structural connectivity analysis. Compared to infection recovered controls, patients had thinner cortex in a specific cluster centred on the left posterior superior temporal gyrus. In addition, lower fractional anisotropy (FA) and higher radial diffusivity (RD) were observed in widespread areas of the patients' cerebral white matter relative to these controls. Correlations between cognitive status and brain abnormalities revealed a relationship between altered connectivity of white matter regions and impairments of episodic memory, overall cognitive function, attention and verbal fluency. This study shows that patients with neurological Long COVID suffer brain changes, especially in several white matter areas, and these are associated with impairments of specific cognitive functions.
Collapse
Affiliation(s)
| | - Gemma Serrano-Heras
- Research Unit. University General Hospital of Albacete, 02008 Albacete, Spain
| | | | | | | | - Inmaculada Feria
- Neurology Service, University General Hospital of Albacete, 02008 Albacete, Spain
| | | | - Bryan Strange
- The Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Madrid Polytechnic University, IdISSC, 28223 Madrid, Spain
- Reina Sofia Centre for Alzheimer's Research, 28031 Madrid, Spain
| | - Francisco Mansilla
- Radiology Service, University Hospital Complex of Albacete and Mansilla Diagnostic Imaging Clinic, 02008 Albacete, Spain
| | - Linda Zhang
- The Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Madrid Polytechnic University, IdISSC, 28223 Madrid, Spain
- Reina Sofia Centre for Alzheimer's Research, 28031 Madrid, Spain
| | | | | | - Susana López-López
- Research Unit. University General Hospital of Albacete, 02008 Albacete, Spain
| | - María Payá
- Neurology Service, University General Hospital of Albacete, 02008 Albacete, Spain
| | - Tomás Segura
- Faculty of Medicine, Albacete, University of Castilla-La Mancha, 02008 Albacete, Spain
- Neurology Service, University General Hospital of Albacete, 02008 Albacete, Spain
- Institute for Research in Neurological Disabilities (IDINE), 02008 Albacete, Spain
| | - Mónica Muñoz-López
- Faculty of Medicine, Albacete, University of Castilla-La Mancha, 02008 Albacete, Spain
- Regional Centre for Biomedical Research (CRIB), 02008 Albacete, Spain
| |
Collapse
|
2
|
Rojas-Bartolome L, Pardal-Fernandez JM, Garcia-Garcia J, Ayo-Martin O, Fernandez-Valiente M, Romero-Sanchez CM, Segura T. [Ultrasound study of the vagal nerve as a diagnostic tool in Guillain-Barre syndrome]. Rev Neurol 2018; 66:65-66. [PMID: 29323403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | | | - J Garcia-Garcia
- Complejo Hospitalario Universitario de Albacete, Albacete, Espana
| | - O Ayo-Martin
- Complejo Hospitalario Universitario de Albacete, Albacete, Espana
| | | | | | - T Segura
- Complejo Hospitalario Universitario de Albacete, Albacete, Espana
| |
Collapse
|
3
|
Fernandez-Valiente M, Rojas-Bartolome L, Segura T, Garcia-Garcia J. [Halo sign in the facial artery. An aid in the diagnosis of giant-cell arteritis]. Rev Neurol 2016; 62:570-571. [PMID: 27270679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
| | | | - T Segura
- Hospital General Universitario de Albacete, 02006 Albacete, Espana
| | - J Garcia-Garcia
- Hospital General Universitario de Albacete, 02006 Albacete, Espana
| |
Collapse
|