Deuter Daniel, Hense Katharina, Kunkel Kevin, Vollmayr Johanna, Schachinger Sebastian, Wendl Christina, Schicho Andreas, Fellner Claudia, Salzberger Bernd, Hitzenbichler Florian, Zeller Judith, Vielsmeier Veronika, Dodoo-Schittko Frank, Schmidt Nils Ole, Rosengarth Katharina
Klinik und Poliklinik für Neurochirurgie, University Hospital Regensburg, Regensburg, Germany.
Institut für Röntgendiagnostik, University Hospital Regensburg, Regensburg, Germany.
PLoS One. 2024 Mar 12;19(3):e0298837. doi: 10.1371/journal.pone.0298837. eCollection 2024.
Several research has underlined the multi-system character of COVID-19. Though effects on the Central Nervous System are mainly discussed as disease-specific affections due to the virus' neurotropism, no comprehensive disease model of COVID-19 exists on a neurofunctional base by now. We aimed to investigate neuroplastic grey- and white matter changes related to COVID-19 and to link these changes to neurocognitive testings leading towards a multi-dimensional disease model.
Groups of acutely ill COVID-19 patients (n = 16), recovered COVID-19 patients (n = 21) and healthy controls (n = 13) were prospectively included into this study. MR-imaging included T1-weighted sequences for analysis of grey matter using voxel-based morphometry and diffusion-weighted sequences to investigate white matter tracts using probabilistic tractography. Comprehensive neurocognitive testing for verbal and non-verbal domains was performed.
Alterations strongly focused on grey matter of the frontal-basal ganglia-thalamus network and temporal areas, as well as fiber tracts connecting these areas. In acute COVID-19 patients, a decline of grey matter volume was found with an accompanying diminution of white matter tracts. A decline in executive function and especially verbal fluency was found in acute patients, partially persisting in recovered.
Changes in gray matter volume and white matter tracts included mainly areas involved in networks of executive control and language. Deeper understanding of these alterations is necessary especially with respect to long-term impairments, often referred to as 'Post-COVID'.
多项研究强调了新型冠状病毒肺炎（COVID-19）的多系统特征。尽管由于病毒的嗜神经性，对中枢神经系统的影响主要被视为特定疾病的表现，但目前尚无基于神经功能的COVID-19综合疾病模型。我们旨在研究与COVID-19相关的神经可塑性灰质和白质变化，并将这些变化与神经认知测试联系起来，以建立一个多维疾病模型。
前瞻性纳入急性病COVID-19患者组（n = 16）、康复的COVID-19患者组（n = 21）和健康对照组（n = 13）。磁共振成像包括用于基于体素的形态学分析灰质的T1加权序列和用于使用概率性纤维束成像研究白质束的扩散加权序列。对语言和非语言领域进行了全面的神经认知测试。
变化主要集中在额叶-基底神经节-丘脑网络和颞叶区域的灰质，以及连接这些区域的纤维束。在急性COVID-19患者中，发现灰质体积减少，同时白质束也减少。急性患者的执行功能下降，尤其是语言流畅性下降，部分在康复后仍持续存在。
灰质体积和白质束的变化主要包括参与执行控制和语言网络的区域。特别是对于通常被称为“新冠后”的长期损伤，有必要更深入地了解这些改变。
