Laboratório de Medicina Nuclear e PET/C, Departamento de Imagem Médica, Hematologia e Oncologia Clínica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Braz J Med Biol Res. 2024 Nov 25;57:e14228. doi: 10.1590/1414-431X2024e14228. eCollection 2024.
COVID-19, caused by SARS-CoV-2, presents diverse symptoms, including neurological manifestations. This study investigated COVID-19's neurological sequelae, focusing on the central nervous system's involvement through cerebral glycolytic metabolism assessed via PET/CT. Twenty-two patients with mild long COVID cognitive symptoms and 20 healthy volunteers without cognitive, psychiatric, or neurological impairments and no history of COVID-19 infection underwent cerebral PET/CT scans using [18F]FDG to assess cerebral metabolism. The study meticulously evaluated the uptake of [18F]FDG in various brain regions, employing the CortexID Suite software for quantitative analysis. The analysis focused on identifying areas of hypometabolism and hypermetabolism, indicative of altered glucose metabolism possibly related to COVID-19's neurological impact. No statistically significant differences were found between the mild COVID and healthy groups. Although our sample was too small to generate a statistical difference between groups, future studies should explore some findings, such as hypometabolism in 15 regions and hypermetabolism in 11 regions in the mild COVID group. These changes, especially in areas linked to executive functions, sensory perception, and emotional regulation, suggest nuanced alterations in brain function. Our study did not find significant glycolytic metabolic changes in patients with mild long COVID. However, areas of glycolytic hypometabolism and hypermetabolism found in some patients showed biological plausibility with the cognitive and affective symptoms they presented. Future investigations with a larger sample size should be correlated with neuropsychological and neuropsychiatric examinations to confirm this relationship.
新型冠状病毒(SARS-CoV-2)引发的 COVID-19 可导致多种症状,包括神经系统表现。本研究调查了 COVID-19 的神经系统后遗症,重点关注中枢神经系统受累情况,采用正电子发射断层扫描/计算机断层扫描(PET/CT)评估脑糖代谢。22 例轻度长新冠认知症状患者和 20 例无认知、精神或神经障碍且无 COVID-19 感染史的健康志愿者接受了脑 PET/CT 扫描,使用 [18F]FDG 评估脑代谢。该研究使用 CortexID Suite 软件进行定量分析,仔细评估了[18F]FDG 在大脑各个区域的摄取情况。分析重点是识别代谢率降低和代谢率升高的区域,这些区域可能与 COVID-19 对神经系统的影响导致的葡萄糖代谢改变有关。轻度 COVID 和健康组之间没有发现统计学上的显著差异。尽管我们的样本量太小,无法在组间产生统计学差异,但未来的研究应该探索一些发现,例如轻度 COVID 组中有 15 个区域代谢率降低和 11 个区域代谢率升高。这些变化,特别是在与执行功能、感觉感知和情绪调节相关的区域,表明大脑功能存在细微改变。我们的研究未发现轻度长新冠患者存在明显的糖代谢改变。然而,一些患者中发现的糖代谢率降低和升高区域与他们表现出的认知和情感症状具有生物学上的合理性。未来的研究应使用更大的样本量进行,并与神经心理学和神经精神病学检查相关联,以确认这种关系。