Nemati Shadman, Haghani Dogahe Mohammad, Saberi Alia, Ramezani Naghi, Kiani Pejman, Yaghubi Kalurazi Tofigh, Kazemnejad Leili Ehsan, Seddighi Sara, Monsef Abbas
Department of Otolaryngology and Head and Neck Surgery School of Medicine, Otorhinolaryngology Research Center, Guilan University of Medical Sciences Rasht Iran.
Guilan Road Trauma Research Center Guilan University of Medical Sciences Rasht Guilan Iran.
World J Otorhinolaryngol Head Neck Surg. 2023 Aug 28;10(2):105-112. doi: 10.1002/wjo2.132. eCollection 2024 Jun.
2019 novel coronavirus disease (COVID-19) infection is commonly associated with olfactory dysfunctions, but the basic pathogenesis of these complications remains controversial. This study seeks to evaluate the value of magnetic resonance spectroscopy (MRS) in determining the molecular neurometabolite alterations within the main brain olfactory areas in patients with COVID-19-related anosmia.
In a cross-sectional study, seven patients with persistent COVID-19-related anosmia (mean age: 29.57 years) and seven healthy volunteers (mean age: 27.28 years) underwent MRS in which N-acetyl-aspartate (NAA), choline (Cho), creatine (Cr), and their ratios were measured in the anterior cingulate cortex, dorsolateral prefrontal cortex, orbitofrontal cortex (OFC), insular cortex, and ventromedial prefrontal cortex. Data were analyzed using TARQUIN software (version 4.3.10), and the results were compared with an independent sample -test and nonparametric Mann-Whitney test based on the normality of the MRS data distribution.
The mean duration of anosmia before imaging was 8.5 months in COVID-19-related anosmia group. MRS analysis elucidated a significant association between MRS findings within OFC and COVID-19-related anosmia ( < 0.01), and NAA was among the most important neurometabolites ( = 0.006). Reduced levels of NAA ( < 0.001), Cr ( < 0.001) and / ratio ( = 0.007) within OFC characterize COVID-19-related anosmia.
This study emphasizes that MRS can be illuminating in COVID-19-related anosmia and indicates a possible association between central nervous system impairment and persistent COVID-19-related anosmia.
2019年新型冠状病毒病（COVID-19）感染常伴有嗅觉功能障碍，但这些并发症的基本发病机制仍存在争议。本研究旨在评估磁共振波谱（MRS）在确定COVID-19相关性嗅觉丧失患者主要脑嗅觉区域内分子神经代谢物改变方面的价值。
在一项横断面研究中，7例持续性COVID-19相关性嗅觉丧失患者（平均年龄：29.57岁）和7名健康志愿者（平均年龄：27.28岁）接受了MRS检查，测量了前扣带回皮质、背外侧前额叶皮质、眶额皮质（OFC）、岛叶皮质和腹内侧前额叶皮质中的N-乙酰天门冬氨酸（NAA）、胆碱（Cho）、肌酸（Cr）及其比值。使用TARQUIN软件（版本4.3.10）分析数据，并根据MRS数据分布的正态性，将结果与独立样本t检验和非参数曼-惠特尼检验进行比较。
COVID-19相关性嗅觉丧失组成像前嗅觉丧失的平均持续时间为8.5个月。MRS分析表明，OFC内的MRS结果与COVID-19相关性嗅觉丧失之间存在显著关联（P＜0.01），NAA是最重要的神经代谢物之一（P = 0.006）。OFC内NAA（P＜0.001）、Cr（P＜0.001）和NAA/Cho比值（P = 0.007）水平降低是COVID-19相关性嗅觉丧失的特征。
本研究强调MRS对COVID-19相关性嗅觉丧失具有指导意义，并表明中枢神经系统损伤与持续性COVID-19相关性嗅觉丧失之间可能存在关联。
