Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
Neurology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
J Neurol. 2022 Jul;269(7):3400-3412. doi: 10.1007/s00415-022-11047-5. Epub 2022 Mar 6.
To explore cognitive, EEG, and MRI features in COVID-19 survivors up to 10 months after hospital discharge.
Adult patients with a recent diagnosis of COVID-19 and reporting subsequent cognitive complaints underwent neuropsychological assessment and 19-channel-EEG within 2 months (baseline, N = 49) and 10 months (follow-up, N = 33) after hospital discharge. A brain MRI was obtained for 36 patients at baseline. Matched healthy controls were included. Using eLORETA, EEG regional current densities and linear lagged connectivity values were estimated. Total brain and white matter hyperintensities (WMH) volumes were measured. Clinical and instrumental data were evaluated between patients and controls at baseline, and within patient whole group and with/without dysgeusia/hyposmia subgroups over time. Correlations among findings at each timepoint were computed.
At baseline, 53% and 28% of patients showed cognitive and psychopathological disturbances, respectively, with executive dysfunctions correlating with acute-phase respiratory distress. Compared to healthy controls, patients also showed higher regional current density and connectivity at delta band, correlating with executive performances, and greater WMH load, correlating with verbal memory deficits. A reduction of cognitive impairment and delta band EEG connectivity were observed over time, while psychopathological symptoms persisted. Patients with acute dysgeusia/hyposmia showed lower improvement at memory tests than those without. Lower EEG delta band at baseline predicted worse cognitive functioning at follow-up.
COVID-19 patients showed interrelated cognitive, EEG, and MRI abnormalities 2 months after hospital discharge. Cognitive and EEG findings improved at 10 months. Dysgeusia and hyposmia during acute COVID-19 were related with increased vulnerability in memory functions over time.
探讨新冠肺炎幸存者出院后长达 10 个月的认知、脑电图和 MRI 特征。
近期诊断为新冠肺炎并报告随后出现认知障碍的成年患者在出院后 2 个月（基线，N=49）和 10 个月（随访，N=33）内接受神经心理学评估和 19 通道脑电图检查。36 名患者在基线时进行脑 MRI 检查。纳入匹配的健康对照组。使用 eLORETA 估计 EEG 区域电流密度和线性滞后连接值。测量全脑和脑白质高信号（WMH）体积。在基线时评估患者和对照组的临床和仪器数据，并在整个患者组内以及有无味觉障碍/嗅觉障碍亚组中随时间进行评估。计算每个时间点的发现之间的相关性。
在基线时，53%和 28%的患者分别表现出认知和精神病理学障碍，执行功能障碍与急性期呼吸窘迫相关。与健康对照组相比，患者在 delta 波段也表现出更高的区域电流密度和连接性，与执行表现相关，并且 WMH 负荷更大，与言语记忆缺陷相关。认知障碍和 delta 波段 EEG 连接性随时间减少，而精神病理学症状持续存在。急性味觉障碍/嗅觉障碍的患者在记忆测试中的改善程度低于无味觉障碍/嗅觉障碍的患者。基线时较低的脑电图 delta 波段预示着随访时较差的认知功能。
新冠肺炎患者在出院后 2 个月表现出相互关联的认知、脑电图和 MRI 异常。认知和脑电图发现随时间改善。新冠肺炎急性期的味觉障碍和嗅觉障碍与记忆功能随时间的脆弱性增加有关。
