Khodanovich Marina, Svetlik Mikhail, Kamaeva Daria, Usova Anna, Kudabaeva Marina, Anan'ina Tatyana, Vasserlauf Irina, Pashkevich Valentina, Moshkina Marina, Obukhovskaya Victoria, Kataeva Nadezhda, Levina Anastasia, Tumentceva Yana, Vasilieva Svetlana, Schastnyy Evgeny, Naumova Anna
Laboratory of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, 36 Lenina Ave., Tomsk 634050, Russia.
Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk 634014, Russia.
J Clin Med. 2024 Aug 9;13(16):4692. doi: 10.3390/jcm13164692.
Depression is one of the most severe sequelae of COVID-19, with major depressive disorder often characterized by disruption in white matter (WM) connectivity stemming from changes in brain myelination. This study aimed to quantitatively assess brain myelination in clinically diagnosed post-COVID depression (PCD) using the recently proposed MRI method, macromolecular proton fraction (MPF) mapping. The study involved 63 recovered COVID-19 patients (52 mild, 11 moderate, and 2 severe) at 13.5 ± 10.0 months post-recovery, with matched controls without prior COVID-19 history (n = 19). A post-COVID depression group (PCD, n = 25) was identified based on psychiatric diagnosis, while a comparison group (noPCD, n = 38) included participants with neurological COVID-19 complications, excluding clinical depression. Fast MPF mapping revealed extensive demyelination in PCD patients, particularly in juxtacortical WM (predominantly occipital lobe and medial surface), WM tracts (inferior fronto-occipital fasciculus (IFOF), posterior thalamic radiation, external capsule, sagittal stratum, tapetum), and grey matter (GM) structures (hippocampus, putamen, globus pallidus, and amygdala). The noPCD group also displayed notable demyelination, but with less magnitude and propagation. Multiple regression analysis highlighted IFOF demyelination as the primary predictor of Hamilton scores, PCD presence, and severity. The number of post-COVID symptoms was a significant predictor of PCD presence, while the number of acute symptoms was a significant predictor of PCD severity. This study, for the first time, reveals extensive demyelination in numerous WM and GM structures in PCD, outlining IFOF demyelination as a key biomarker.
抑郁症是新冠病毒病（COVID-19）最严重的后遗症之一，重度抑郁症通常表现为脑白质（WM）连接中断，这是由脑髓鞘形成变化引起的。本研究旨在使用最近提出的磁共振成像（MRI）方法——大分子质子分数（MPF）映射，定量评估临床诊断的新冠后抑郁症（PCD）患者的脑髓鞘形成情况。该研究纳入了63例康复的COVID-19患者（52例轻症、11例中症和2例重症），康复后13.5±10.0个月，同时纳入了19例无COVID-19病史的匹配对照。根据精神科诊断确定了一个新冠后抑郁症组（PCD，n = 25），而一个比较组（无PCD，n = 38）包括有神经系统COVID-19并发症但无临床抑郁症的参与者。快速MPF映射显示PCD患者存在广泛的脱髓鞘，特别是在皮质下白质（主要是枕叶和内表面）、白质束（额枕下束（IFOF）、丘脑后辐射、外囊、矢状层、毯状层）和灰质（GM）结构（海马体、壳核、苍白球和杏仁核）。无PCD组也显示出明显的脱髓鞘，但程度较轻且范围较小。多元回归分析强调IFOF脱髓鞘是汉密尔顿评分、PCD存在与否及严重程度的主要预测因素。新冠后症状的数量是PCD存在与否的重要预测因素，而急性症状的数量是PCD严重程度的重要预测因素。本研究首次揭示了PCD患者在众多白质和灰质结构中存在广泛的脱髓鞘，并将IFOF脱髓鞘确定为关键生物标志物。
