Association between post-COVID-19 neuropsychiatric symptoms and persistent glial activation in the limbic system: a TSPO PET study.

IF 4.6 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2026-04-30 DOI:10.1007/s00415-026-13842-w

Joel Tuomaala, Maija Saraste, Emma Smith, Matilda Kuusi, Elisabet Westerberg, Eveliina Honkonen, Rahim Kargar, Sini Laaksonen, Jussi Lehto, Amelie Luoma, Markus Matilainen, Olavi Misin, Janne Atosuo, Mari Kanerva, Helena Liira, Sini Laakso, Tatiana Posharina, Virva Saunavaara, Saara Wahlroos, Johan Rajander, Laura Airas

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引用次数: 0

Abstract

Background: A subset of individuals experience prolonged neurological and psychiatric symptoms following SARS-CoV-2 infection, a condition referred to as long COVID (LC). Limited evidence implicates ongoing neuroinflammatory processes as a driver of LC. This study investigates neuroinflammation in LC using translocator protein positron emission tomography (TSPO PET).

Methods: 14 LC, 11 healthy control (HC) and 13 multiple sclerosis (MS) participants were included in the study. They underwent [¹¹C]PK11195 TSPO PET and 3T magnetic resonance imaging (MRI) to evaluate glial activation, white matter (WM) pathology and brain volumetrics. Serum neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) were measured as markers of neuronal and glial damage. LC participants completed neurological examinations and mental health assessments.

Results: TSPO availability, measured as distribution volume ratio (DVR), was not elevated in LC compared to HCs but was significantly lower in LC compared to MS (WM DVR 1.03 vs. 1.06; p = 0.007). Individuals imaged within 16 months of SARS-CoV-2 infection showed higher WM DVR compared to those with a longer disease duration (1.05 vs. 1.02; p = 0.04). Moreover, lower quality of life was associated with higher DVRs in the hippocampus, amygdala and thalamus (ρ = - 0.83- - 0.70), and depression and anxiety correlated positively with DVRs in the hippocampus and amygdala (ρ = 0.75-0.97).

Conclusions: LC TSPO availability did not differ from HCs in any studied brain area. However, lower WM TSPO availability in individuals with longer LC duration suggests COVID-19-associated neuroinflammation may subside with time, while the association between limbic TSPO availability and LC severity may imply a role for limbic activity in LC symptomology.

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covid -19后神经精神症状与边缘系统持续胶质细胞激活之间的关系：一项TSPO PET研究

背景：一部分个体在感染SARS-CoV-2后会出现长期的神经和精神症状，这种情况被称为长COVID （LC）。有限的证据表明持续的神经炎症过程是LC的驱动因素。本研究利用转运蛋白正电子发射断层扫描（TSPO PET）研究LC的神经炎症。方法：LC 14例，健康对照11例，多发性硬化症（MS） 13例。他们接受了[11C]PK11195 TSPO PET和3T磁共振成像（MRI）来评估神经胶质激活、白质（WM）病理和脑容量。测定血清神经丝轻链（NfL）和胶质原纤维酸性蛋白（GFAP）作为神经元和胶质损伤的标志物。LC参与者完成了神经系统检查和心理健康评估。结果：TSPO可用性，以分布体积比（DVR）测量，LC与hc相比没有升高，但LC与MS相比显著降低（WM DVR 1.03 vs. 1.06; p = 0.007）。在SARS-CoV-2感染后16个月内成像的个体与病程较长的个体相比，WM DVR更高（1.05 vs 1.02; p = 0.04）。此外，较低的生活质量与较高的海马、杏仁核和丘脑的dvr相关（ρ = - 0.83 ~ - 0.70），抑郁和焦虑与海马和杏仁核的dvr呈正相关（ρ = 0.75 ~ 0.97）。结论：LC TSPO的可用性与hc在任何研究的脑区没有差异。然而，在LC持续时间较长的个体中，较低的WM TSPO可用性表明，covid -19相关的神经炎症可能随着时间的推移而消退，而边缘TSPO可用性与LC严重程度之间的关联可能意味着边缘活动在LC症状中起作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.