Ibrahim Ibrahim, Antonín Škoch, Monika Dezortová, Theodor Adla, Vlasta Flusserová, Markéta Nagy, Irena Douchová, Martina Fialová, Vanda Filová, Dita Pajuelo, Markéta Ibrahimová, Jaroslav Tintěra
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Therefore, the study aimed to evaluate microstructural changes in whole-brain (WB) diffusion, with a specific focus on the CC.</p><p><strong>Methods: </strong>A total of 101 probands (age range from 18 to 69 years) participated in this retrospective study, consisting of 55 volunteers and 46 post-COVID-19 patients experiencing neurological symptoms. The participants were recruited from April 2022 to September 2023 at the Institute for Clinical and Experimental Medicine in Prague, Czech Republic. All participants underwent MRI examinations on a 3T MR scanner with a diffusion protocol, complemented by additional MRI techniques. Two volunteers and five patients were excluded from the study due to motion artefacts, severe hypoperfusion or the presence of lesions. Participants were selected by a neurologist based on clinical examination and a serological test for COVID-19 antibodies. They were then divided into three groups: a control group of healthy volunteers (n=28), an asymptomatic group (n=25) with a history of infection but no symptoms, and a symptomatic group (n=41) with a history of COVID-19 and neurological symptoms. Symptomatic patients did not exhibit neurological symptoms before contracting COVID-19. Diffusion data underwent eddy current and susceptibility distortion corrections, and fiber tracking was performed using default parameters in DSI studio. Subsequently, various diffusion metrics, were computed within the reconstructed tracts of the WB and CC. To assess the impact of COVID-19 and its associated symptoms on diffusion indices within the white matter of the WB and CC regions, while considering age, we employed a statistical analysis using a linear mixed-effects model within the R framework.</p><p><strong>Results: </strong>Statistical analysis revealed a significant difference in mean diffusivity (MD) between the symptomatic and control groups in the forceps minor (P=0.001) and CC body (P=0.003). In addition to changes in diffusion, alterations in brain perfusion were observed in two post-COVID-19 patients who experienced a severe course. Furthermore, hyperintense lesions were identified in subcortical and deep white matter areas in the vast majority of symptomatic patients.</p><p><strong>Conclusions: </strong>The main finding of our study was that post-COVID-19 patients exhibit increased MD in the forceps minor and body of the CC. This finding suggests a potential association between microstructural brain changes in post-COVID-19 patients and reported neurological symptoms, with significant implications for research and clinical applications.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11320515/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluation of microstructural brain changes in post-coronavirus disease 2019 (COVID-19) patients with neurological symptoms: a cross-sectional study.\",\"authors\":\"Ibrahim Ibrahim, Antonín Škoch, Monika Dezortová, Theodor Adla, Vlasta Flusserová, Markéta Nagy, Irena Douchová, Martina Fialová, Vanda Filová, Dita Pajuelo, Markéta Ibrahimová, Jaroslav Tintěra\",\"doi\":\"10.21037/qims-24-162\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Changes in both the vascular system and brain tissues can occur after a prior episode of coronavirus disease 2019 (COVID-19), detectable through modifications in diffusion parameters using magnetic resonance imaging (MRI) techniques. 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引用次数: 0
摘要
背景:2019年冠状病毒病(COVID-19)发生后,血管系统和脑组织都会发生变化,可通过磁共振成像(MRI)技术检测到弥散参数的变化。在胼胝体(CC)等高度组织化的结构(包括其主要组成部分)中,这些扩散参数的变化可能尤为突出,而在感染 COVID-19 病毒后,尚未对这些结构进行充分研究。因此,本研究旨在评估全脑(WB)弥散的微观结构变化,重点关注 CC:共有 101 名原发性患者(年龄在 18 岁至 69 岁之间)参与了这项回顾性研究,其中包括 55 名志愿者和 46 名出现神经系统症状的 COVID-19 后患者。研究人员于2022年4月至2023年9月在捷克共和国布拉格临床与实验医学研究所招募。所有参与者都在 3T 磁共振扫描仪上接受了磁共振成像检查,检查采用弥散方案,并辅以其他磁共振成像技术。两名志愿者和五名患者因运动伪影、严重灌注不足或存在病变而被排除在研究之外。参加者由一名神经科医生根据临床检查和 COVID-19 抗体血清学检测结果选出。然后将他们分为三组:健康志愿者对照组(28 人)、有感染史但无症状的无症状组(25 人)和有 COVID-19 病史和神经症状的有症状组(41 人)。无症状患者在感染COVID-19之前没有神经系统症状。扩散数据经过涡流和感性畸变校正,并使用 DSI studio 的默认参数进行纤维追踪。随后,在重建的 WB 和 CC 束内计算了各种扩散指标。为了评估 COVID-19 及其相关症状对 WB 和 CC 区域白质内弥散指数的影响,同时考虑到年龄因素,我们在 R 框架内使用线性混合效应模型进行了统计分析:统计分析显示,症状组和对照组在镊子小体(P=0.001)和 CC 体(P=0.003)的平均弥散度(MD)上存在显著差异。除了弥散度的变化,在两名经历了严重病程的 COVID-19 后患者身上还观察到了脑灌注的改变。此外,在绝大多数有症状的患者中,皮层下和深部白质区域发现了高强度病变:我们研究的主要发现是,COVID-19 后患者在 CC 的镊小体和体部表现出 MD 增高。这一发现表明,COVID-19 后患者的大脑微结构变化与所报告的神经症状之间存在潜在联系,对研究和临床应用具有重要意义。
Evaluation of microstructural brain changes in post-coronavirus disease 2019 (COVID-19) patients with neurological symptoms: a cross-sectional study.
Background: Changes in both the vascular system and brain tissues can occur after a prior episode of coronavirus disease 2019 (COVID-19), detectable through modifications in diffusion parameters using magnetic resonance imaging (MRI) techniques. These changes in diffusion parameters may be particularly prominent in highly organized structures such as the corpus callosum (CC), including its major components, which have not been adequately studied following COVID-19 infection. Therefore, the study aimed to evaluate microstructural changes in whole-brain (WB) diffusion, with a specific focus on the CC.
Methods: A total of 101 probands (age range from 18 to 69 years) participated in this retrospective study, consisting of 55 volunteers and 46 post-COVID-19 patients experiencing neurological symptoms. The participants were recruited from April 2022 to September 2023 at the Institute for Clinical and Experimental Medicine in Prague, Czech Republic. All participants underwent MRI examinations on a 3T MR scanner with a diffusion protocol, complemented by additional MRI techniques. Two volunteers and five patients were excluded from the study due to motion artefacts, severe hypoperfusion or the presence of lesions. Participants were selected by a neurologist based on clinical examination and a serological test for COVID-19 antibodies. They were then divided into three groups: a control group of healthy volunteers (n=28), an asymptomatic group (n=25) with a history of infection but no symptoms, and a symptomatic group (n=41) with a history of COVID-19 and neurological symptoms. Symptomatic patients did not exhibit neurological symptoms before contracting COVID-19. Diffusion data underwent eddy current and susceptibility distortion corrections, and fiber tracking was performed using default parameters in DSI studio. Subsequently, various diffusion metrics, were computed within the reconstructed tracts of the WB and CC. To assess the impact of COVID-19 and its associated symptoms on diffusion indices within the white matter of the WB and CC regions, while considering age, we employed a statistical analysis using a linear mixed-effects model within the R framework.
Results: Statistical analysis revealed a significant difference in mean diffusivity (MD) between the symptomatic and control groups in the forceps minor (P=0.001) and CC body (P=0.003). In addition to changes in diffusion, alterations in brain perfusion were observed in two post-COVID-19 patients who experienced a severe course. Furthermore, hyperintense lesions were identified in subcortical and deep white matter areas in the vast majority of symptomatic patients.
Conclusions: The main finding of our study was that post-COVID-19 patients exhibit increased MD in the forceps minor and body of the CC. This finding suggests a potential association between microstructural brain changes in post-COVID-19 patients and reported neurological symptoms, with significant implications for research and clinical applications.