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De Luca I, Di Carlo F, Burkauskas J, Dores AR, Carvalho IP, Gómez-Martínez MÁ, Szabo A, Fujiwara H, Barbosa CM, Di Nicola M, Mazza M, Sani G, Luciani D, Pettorruso M, di Giannantonio M, Cataldo I, Esposito G, Martinotti G, Zandonai T, Rabin O, Corazza O. Profiling and assessing the risks of image- and performance-enhancing drugs use during the COVID-19 lockdown. Front Public Health 2024; 12:1386721. [PMID: 38962770 PMCID: PMC11221326 DOI: 10.3389/fpubh.2024.1386721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 06/07/2024] [Indexed: 07/05/2024] Open
Abstract
Background Image and Performance-Enhancing Drugs (IPEDs) can enhance mental and physical capabilities and impact one's overall health. Initially confined in sport environments, IPEDs use has become increasingly widespread in a high-performing society. The present study was aimed at profiling IPEDs use during the COVID-19 lockdown among an international sample of young adults. Methods A cross-sectional observational study was carried out in eight countries (United Kingdom, Italy, Lithuania, Hungary, Portugal, Spain, Brazil, and Japan) between April and May 2020. The survey questionnaire included validated measurements such as Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI), and Self-Compassion Scale (SCS) as well as questions about the type of IPEDs, purchasing methods and socio-demographic information. Results A total of 736 IPEDs users were included in the survey. Their mean age was 33.05 years (±SD = 10.06), and 64.2% were female participants. Overall, 6.8% were found at risk of exercise addiction (EAI >24), 27.6% presented high levels of appearance anxiety, and 24.9% revealed low levels of emotional regulation's self-compassion. Most participants (55.6%) purchased IPEDs through pharmacies/specialized shops, while 41.3% purchased IPEDs on the Internet. Online IPEDs buyers were mainly men who had higher scores on the Exercise Addiction Inventory. One or more IPEDs classifiable as "potentially risky" were used by 66.3% of the sample. Users of "potentially risky IPEDs" were younger and primarily men. They showed higher scores both on the Exercise Addiction Inventory and Appearance Anxiety Inventory. Conclusion This study profiled users of IPEDs when the most restrictive COVID-19 lockdown policies were implemented in all the participating countries. More targeted post-COVID 19 prevention strategies should be implemented according to the emerged socio-demographic and psychopathological traits and cross-cultural differences emerged. Longitudinal studies will also be needed to determine the long-term effect of the COVID-19 lockdown on IPEDs consumption.
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Affiliation(s)
- Ilaria De Luca
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Francesco Di Carlo
- Department of Neuroscience, Imaging, and Clinical Science, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Julius Burkauskas
- Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Artemisa R. Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- School of Health, Polytechnic of Porto, Porto, Portugal
| | - Irene P. Carvalho
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | | | - Attila Szabo
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Hironobu Fujiwara
- Department of Neuropsychiatry, Graduate School of Medicine, University of Kyoto, Kyoto, Japan
- Decentralized Big Data Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
- The General Research Division, Osaka University Research Center on Ethical, Legal and Social Issues, Osaka, Japan
| | - Cristina Monteiro Barbosa
- Department of Psychometrics, Institute of Psychology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marco Di Nicola
- Department of Psychometrics, Institute of Psychology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marianna Mazza
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriele Sani
- Department of Psychometrics, Institute of Psychology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Debora Luciani
- Department of Neuroscience, Imaging, and Clinical Science, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging, and Clinical Science, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Massimo di Giannantonio
- Department of Neuroscience, Imaging, and Clinical Science, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Ilaria Cataldo
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Gianluca Esposito
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Martinotti
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Neuroscience, Imaging, and Clinical Science, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Thomas Zandonai
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Olivier Rabin
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
- World Anti-Doping Agency, Montreal, QC, Canada
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
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2
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Arrigoni A, Previtali M, Bosticardo S, Pezzetti G, Poloni S, Capelli S, Napolitano A, Remuzzi A, Zangari R, Lorini FL, Sessa M, Daducci A, Caroli A, Gerevini S. Brain microstructure and connectivity in COVID-19 patients with olfactory or cognitive impairment. Neuroimage Clin 2024; 43:103631. [PMID: 38878591 PMCID: PMC11225694 DOI: 10.1016/j.nicl.2024.103631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/31/2024] [Accepted: 06/11/2024] [Indexed: 07/08/2024]
Abstract
INTRODUCTION The COVID-19 pandemic has affected millions worldwide, causing mortality and multi-organ morbidity. Neurological complications have been recognized. This study aimed to assess brain structural, microstructural, and connectivity alterations in patients with COVID-19-related olfactory or cognitive impairment using post-acute (time from onset: 264[208-313] days) multi-directional diffusion-weighted MRI (DW-MRI). METHODS The study included 16 COVID-19 patients with cognitive impairment (COVID-CM), 35 COVID-19 patients with olfactory disorder (COVID-OD), and 14 controls. A state-of-the-art processing pipeline was developed for DW-MRI pre-processing, mean diffusivity and fractional anisotropy computation, fiber density and cross-section analysis, and tractography of white-matter bundles. Brain parcellation required for probing network connectivity, region-specific microstructure and volume, and cortical thickness was based on T1-weighted scans and anatomical atlases. RESULTS Compared to controls, COVID-CM patients showed overall gray matter atrophy (age and sex corrected p = 0.004), and both COVID-19 patient groups showed regional atrophy and cortical thinning. Both groups presented an increase in gray matter mean diffusivity (corrected p = 0.001), decrease in white matter fiber density and cross-section (corrected p < 0.05), , and COVID-CM patients also displayed an overall increased diffusivity (p = 0.022) and decreased anisotropy (corrected p = 0.038) in white matter. Graph-based analysis revealed reduced network modularity, with an extensive pattern of connectivity increase, in conjunction with a localized reduction in a few connections, mainly located in the left hemisphere. The left cingulate, anterior cingulate, and insula were primarily involved. CONCLUSION Expanding upon previous findings, this study further investigated significant alterations in brain morphology, microstructure, and connectivity in COVID-19 patients with olfactory or cognitive disfunction. These findings suggest underlying neurodegeneration, neuroinflammation, and concomitant compensatory mechanisms. Future longitudinal studies are required to monitor the alterations over time and assess their transient or permanent nature.
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Affiliation(s)
- Alberto Arrigoni
- Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy.
| | - Mattia Previtali
- Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy
| | - Sara Bosticardo
- Department of Computer Science, University of Verona, Italy; Translational Imaging in Neurology (ThINK), Department of Biomedical Engineering, Faculty of Medicine, Basel, Switzerland.
| | - Giulio Pezzetti
- Department of Neuroradiology, ASST Papa Giovanni XXIII, Bergamo, Italy.
| | - Sofia Poloni
- Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy.
| | - Serena Capelli
- Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy.
| | - Angela Napolitano
- Department of Neuroradiology, ASST Papa Giovanni XXIII, Bergamo, Italy.
| | - Andrea Remuzzi
- Department of Management Information and Production Engineering, University of Bergamo, Dalmine, Italy.
| | - Rosalia Zangari
- FROM Research Foundation, ASST Papa Giovanni XXIII, Bergamo, Italy.
| | - Ferdinando Luca Lorini
- Department of Emergency and Critical Care Area, ASST Papa Giovanni XXIII, Bergamo, Italy.
| | - Maria Sessa
- Department of Neurology, ASST Papa Giovanni XXIII, Bergamo, Italy.
| | | | - Anna Caroli
- Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy.
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Petersen M, Becker B, Schell M, Mayer C, Naegele FL, Petersen E, Twerenbold R, Thomalla G, Cheng B, Betz C, Hoffmann AS. Reduced olfactory bulb volume accompanies olfactory dysfunction after mild SARS-CoV-2 infection. Sci Rep 2024; 14:13396. [PMID: 38862636 PMCID: PMC11167024 DOI: 10.1038/s41598-024-64367-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 06/06/2024] [Indexed: 06/13/2024] Open
Abstract
Despite its high prevalence, the determinants of smelling impairment in COVID-19 remain not fully understood. In this work, we aimed to examine the association between olfactory bulb volume and the clinical trajectory of COVID-19-related smelling impairment in a large-scale magnetic resonance imaging (MRI) analysis. Data of non-vaccinated COVID-19 convalescents recruited within the framework of the prospective Hamburg City Health Study COVID Program between March and December 2020 were analyzed. At baseline, 233 participants underwent MRI and neuropsychological testing as well as a structured questionnaire for olfactory function. Between March and April 2022, olfactory function was assessed at follow-up including quantitative olfactometric testing with Sniffin' Sticks. This study included 233 individuals recovered from mainly mild to moderate SARS-CoV-2 infections. Longitudinal assessment demonstrated a declining prevalence of self-reported olfactory dysfunction from 67.1% at acute infection, 21.0% at baseline examination and 17.5% at follow-up. Participants with post-acute self-reported olfactory dysfunction had a significantly lower olfactory bulb volume at baseline than normally smelling individuals. Olfactory bulb volume at baseline predicted olfactometric scores at follow-up. Performance in neuropsychological testing was not significantly associated with the olfactory bulb volume. Our work demonstrates an association of long-term self-reported smelling dysfunction and olfactory bulb integrity in a sample of individuals recovered from mainly mild to moderate COVID-19. Collectively, our results highlight olfactory bulb volume as a surrogate marker that may inform diagnosis and guide rehabilitation strategies in COVID-19.
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Affiliation(s)
- Marvin Petersen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Benjamin Becker
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Schell
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Carola Mayer
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Felix L Naegele
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Elina Petersen
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
| | - Raphael Twerenbold
- Population Health Research Department, University Heart and Vascular Center, Hamburg, Germany
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- University Center of Cardiovascular Science, University Heart and Vascular Center, Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Christian Betz
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna S Hoffmann
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Gezegen H, Ay U, Samancı B, Kurt E, Yörük SS, Medetalibeyoğlu A, Şen C, Şahin E, Barbüroğlu M, Doğan FU, Bilgiç B, Hanağası H, Gürvit H. Cognitive deficits and cortical volume loss in COVID-19-related hyposmia. Eur J Neurol 2024:e16378. [PMID: 38850121 DOI: 10.1111/ene.16378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/29/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND AND PURPOSE Studies have found that up to 73% of COVID-19 patients experience hyposmia. It is unclear if the loss of smell in COVID-19 is due to damage to the peripheral or central mechanisms. This study aimed to explore the impacts of COVID-19-induced hyposmia on brain structure and cognitive functions. METHODS The study included 36 hyposmic (h-COV) and 21 normosmic (n-COV) participants who had recovered from mild COVID-19 infection, as well as 25 healthy controls (HCs). All participants underwent neurological examination, neuropsychiatric assessment and Sniffin' Sticks tests. High-resolution anatomical images were collected; olfactory bulb (OB) volume and cortical thickness were measured. RESULTS Addenbrooke's Cognitive Examination-Revised total and language sub-scores were slightly but significantly lower in the h-COV group compared to the HC group (p = 0.04 and p = 0.037). The h-COV group exhibited poorer performance in the Sniffin' Sticks test terms of discrimination score, identification score and the composite score compared to the n-COV and HC groups (p < 0.001, p = 0.001 and p = 0.002 respectively). A decrease in left and right OB volumes was observed in the h-COV group compared to the n-COV and HC groups (p = 0.003 and p = 0.006 respectively). The cortical thickness analysis revealed atrophy in the left lateral orbitofrontal cortex in the h-COV group compared to HCs. A significant low positive correlation of varying degrees was detected between discrimination and identification scores and both OB and left orbital sulci. CONCLUSION Temporary or permanent hyposmia after COVID-19 infection leads to atrophy in the OB and olfactory-related cortical structures and subtle cognitive problems in the long term.
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Affiliation(s)
- Haşim Gezegen
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ulaş Ay
- Neuroimaging Unit, Istanbul University Hulusi Behçet Life Sciences Research Laboratory, Istanbul, Turkey
- Department of Neuroscience, Istanbul University Aziz Sancar Institute of Experimental Medicine, Istanbul, Turkey
| | - Bedia Samancı
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Elif Kurt
- Department of Neuroscience, Istanbul University Aziz Sancar Institute of Experimental Medicine, Istanbul, Turkey
| | - Sanem Sultan Yörük
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alpay Medetalibeyoğlu
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Cömert Şen
- Department of Otolaryngology, Head and Neck Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erdi Şahin
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Barbüroğlu
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Faruk Uğur Doğan
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Başar Bilgiç
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Haşmet Hanağası
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hakan Gürvit
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Martin-Lopez E, Brennan B, Mao T, Spence N, Meller SJ, Han K, Yahiaoui N, Wang C, Iwasaki A, Greer CA. Inflammatory Response and Defects on Myelin Integrity in the Olfactory System of K18hACE2 Mice Infected with SARS-CoV-2. eNeuro 2024; 11:ENEURO.0106-24.2024. [PMID: 38834299 PMCID: PMC11185043 DOI: 10.1523/eneuro.0106-24.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/09/2024] [Accepted: 05/24/2024] [Indexed: 06/06/2024] Open
Abstract
Viruses, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), use respiratory epithelial cells as an entry point for infection. Within the nasal cavity, the olfactory epithelium (OE) is particularly sensitive to infections which may lead to olfactory dysfunction. In patients suffering from coronavirus disease 2019, deficits in olfaction have been characterized as a distinctive symptom. Here, we used the K18hACE2 mice to study the spread of SARS-CoV-2 infection and inflammation in the olfactory system (OS) after 7 d of infection. In the OE, we found that SARS-CoV-2 selectively targeted the supporting/sustentacular cells (SCs) and macrophages from the lamina propria. In the brain, SARS-CoV-2 infected some microglial cells in the olfactory bulb (OB), and there was a widespread infection of projection neurons in the OB, piriform cortex (PC), and tubular striatum (TuS). Inflammation, indicated by both elevated numbers and morphologically activated IBA1+ cells (monocyte/macrophage lineages), was preferentially increased in the OE septum, while it was homogeneously distributed throughout the layers of the OB, PC, and TuS. Myelinated OS axonal tracts, the lateral olfactory tract, and the anterior commissure, exhibited decreased levels of 2',3'-cyclic-nucleotide 3'-phosphodiesterase, indicative of myelin defects. Collectively, our work supports the hypothesis that SARS-CoV-2 infected SC and macrophages in the OE and, centrally, microglia and subpopulations of OS neurons. The observed inflammation throughout the OS areas and central myelin defects may account for the long-lasting olfactory deficit.
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Affiliation(s)
- Eduardo Martin-Lopez
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut 06520-8082
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut 06520-8001
| | - Bowen Brennan
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut 06520-8082
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut 06520-8001
| | - Tianyang Mao
- Department of Immunobiology, Yale University School of Medicine, The Anlyan Center, New Haven, Connecticut 06520-8043
- Yale University School of Public Health, New Haven, Connecticut 06520-0834
- Howard Hughes Medical Institute, Chevy Chase, Maryland 20815
| | - Natalie Spence
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut 06520-8082
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut 06520-8001
| | - Sarah J Meller
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut 06520-8082
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut 06520-8001
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, Connecticut 06520-8074
| | - Kimberly Han
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut 06520-8082
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut 06520-8001
| | - Nawal Yahiaoui
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut 06520-8082
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut 06520-8001
| | - Chelsea Wang
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut 06520-8082
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut 06520-8001
| | - Akiko Iwasaki
- Department of Immunobiology, Yale University School of Medicine, The Anlyan Center, New Haven, Connecticut 06520-8043
- Yale University School of Public Health, New Haven, Connecticut 06520-0834
- Howard Hughes Medical Institute, Chevy Chase, Maryland 20815
| | - Charles A Greer
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut 06520-8082
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut 06520-8001
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, Connecticut 06520-8074
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Cecchini MP, Pizzini FB, Boschi F, Marcon A, Moro L, Gordon E, Guizard N, Cavedo E, Ricatti MJ, Veronese S, Tamburin S, Tinazzi M, Mansueto G, Sbarbati A. Long-term effects of SARS-CoV-2 infection in patients with and without chemosensory disorders at disease onset: a psychophysical and magnetic resonance imaging exploratory study. Neurol Sci 2024; 45:2409-2418. [PMID: 38441790 PMCID: PMC11082021 DOI: 10.1007/s10072-024-07429-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/28/2024] [Indexed: 05/12/2024]
Abstract
A preserved sense of smell and taste allows us to understand many environmental "messages" and results in meaningfully improvements to quality of life. With the COVID-19 pandemic, it became clear how important these senses are for social and nutritional status and catapulted this niche chemosensory research area towards widespread interest. In the current exploratory work, we assessed two groups of post-COVID-19 patients who reported having had (Group 1) or not (Group 2) a smell/taste impairment at the disease onset. The aim was to compare them using validated smell and taste tests as well as with brain magnetic resonance imaging volumetric analysis. Normative data were used for smell scores comparison and a pool of healthy subjects, recruited before the pandemic, served as controls for taste scores. The majority of patients in both groups showed an olfactory impairment, which was more severe in Group 1 (median UPSIT scores: 24.5 Group 1 vs 31.0 Group 2, p = 0.008), particularly among women (p = 0.014). No significant differences emerged comparing taste scores between Group 1 and Group 2, but dysgeusia was only present in Group 1 patients. However, for taste scores, a significant difference was found between Group 1 and controls (p = 0.005). No MRI anatomical abnormalities emerged in any patients while brain volumetric analysis suggested a significant difference among groups for the right caudate nucleus (p = 0.028), although this was not retained following Benjamini-Hochberg correction. This exploratory study could add new information in COVID-19 chemosensory long-lasting impairment and address future investigations on the post-COVID-19 patients' research.
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Affiliation(s)
- Maria Paola Cecchini
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy.
| | | | - Federico Boschi
- Department of Engineering for Innovation Medicine, Engineering and Physics Section, Verona University, Verona, Italy
| | - Alessandro Marcon
- Department of Diagnostics and Public Heath, Unit of Epidemiology and Medical Statistics, Verona University, Verona, Italy
| | - Lucia Moro
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore, Negrar, Italy
| | | | | | | | - Maria Jimena Ricatti
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy
| | - Sheila Veronese
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicines and Movement Sciences, Neurology Unit, Verona University, Verona, Italy
| | - Michele Tinazzi
- Department of Neurosciences, Biomedicines and Movement Sciences, Neurology Unit, Verona University, Verona, Italy
| | - Giancarlo Mansueto
- Department of Engineering for Innovation Medicine, Radiology Unit, Verona University, Verona, Italy
| | - Andrea Sbarbati
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy
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7
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Mohammadi S, Ghaderi S. Post-COVID-19 conditions: a systematic review on advanced magnetic resonance neuroimaging findings. Neurol Sci 2024; 45:1815-1833. [PMID: 38421524 DOI: 10.1007/s10072-024-07427-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Abstract
Post-COVID conditions (PCCs) cover a wide spectrum of lingering symptoms experienced by survivors of coronavirus disease 2019 (COVID-19). Neurological and neuropsychiatric sequelae are common in PCCs. Advanced magnetic resonance imaging (MRI) techniques can reveal subtle alterations in brain structure, function, and perfusion that underlie these sequelae. This systematic review aimed to synthesize findings from studies that used advanced MRI to characterize brain changes in individuals with PCCs. A detailed literature search was conducted in the PubMed and Scopus databases to identify relevant studies that used advanced MRI modalities, such as structural MRI (sMRI), diffusion tensor imaging (DTI), functional MRI (fMRI), and perfusion-weighted imaging (PWI), to evaluate brain changes in PCCs. Twenty-five studies met the inclusion criteria, comprising 1219 participants with PCCs. The most consistent findings from sMRI were reduced gray matter volume (GMV) and cortical thickness (CTh) in cortical and subcortical regions. DTI frequently reveals increased mean diffusivity (MD), radial diffusivity (RD), and decreased fractional anisotropy (FA) in white matter tracts (WMTs) such as the corpus callosum, corona radiata, and superior longitudinal fasciculus. fMRI demonstrated altered functional connectivity (FC) within the default mode, salience, frontoparietal, somatomotor, subcortical, and cerebellar networks. PWI showed decreased cerebral blood flow (CBF) in the frontotemporal area, thalamus, and basal ganglia. Advanced MRI shows changes in the brain networks and regions of the PCCs, which may cause neurological and neuropsychiatric problems. Multimodal neuroimaging may help understand brain-behavior relationships. Longitudinal studies are necessary to better understand the progression of these brain anomalies.
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Affiliation(s)
- Sana Mohammadi
- Department of Medical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sadegh Ghaderi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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8
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Schirinzi T, Maftei D, Maurizi R, Albanese M, Simonetta C, Bovenzi R, Bissacco J, Mascioli D, Boffa L, Di Certo MG, Gabanella F, Francavilla B, Di Girolamo S, Mercuri NB, Passali FM, Lattanzi R, Severini C. Post-COVID-19 Hyposmia Does Not Exhibit Main Neurodegeneration Markers in the Olfactory Pathway. Mol Neurobiol 2024:10.1007/s12035-024-04157-w. [PMID: 38570429 DOI: 10.1007/s12035-024-04157-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 03/29/2024] [Indexed: 04/05/2024]
Abstract
The biological substrate of persistent post-COVID-19 hyposmia is still unclear. However, as many neurodegenerative diseases present with smell impairment at onset, it may theoretically reflect degeneration within the central olfactory circuits. However, no data still exist regarding the post-COVID-19 patients. As the olfactory neurons (ONs) mirror pathological changes in the brain, allowing for tracking the underlying molecular events, here, we performed a broad analysis of ONs from patients with persistent post-COVID-19 OD to identify traces of potential neurodegeneration. ONs were collected through the non-invasive brushing of the olfactory mucosa from ten patients with persistent post-COVID-19 hyposmia (lasting > 6 months after infection) and ten age/sex-matched controls. Immunofluorescence staining for protein quantification and RT-PCR for gene expression levels were combined to measure ONs markers of α-synuclein, amyloid-β, and tau pathology, axonal injury, and mitochondrial network. Patients and controls had similar ONs levels of oligomeric α-synuclein, amyloid-β peptide, tau protein, neurofilament light chain (NfL), cytochrome C oxidase subunit 3 (COX3), and the heat shock protein 60 (HSP60). Our findings thus did not provide evidence for synucleinopathy and amyloid-β mismetabolism or gross traces of neuronal injury and mitochondrial dysfunction within the olfactory system in the early phase of persistent post-COVID-19 hyposmia.
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Affiliation(s)
- Tommaso Schirinzi
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Via Montpellier 1, 00133, Rome, Italy.
| | - Daniela Maftei
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Riccardo Maurizi
- Unit of ENT, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Maria Albanese
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Via Montpellier 1, 00133, Rome, Italy
| | - Clara Simonetta
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Via Montpellier 1, 00133, Rome, Italy
| | - Roberta Bovenzi
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Via Montpellier 1, 00133, Rome, Italy
| | - Jacopo Bissacco
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Via Montpellier 1, 00133, Rome, Italy
| | - Davide Mascioli
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Via Montpellier 1, 00133, Rome, Italy
| | - Laura Boffa
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Via Montpellier 1, 00133, Rome, Italy
| | - Maria Grazia Di Certo
- Department of Biochemistry and Cell Biology, National Research Council of Italy, Rome, Italy
| | - Francesca Gabanella
- Department of Biochemistry and Cell Biology, National Research Council of Italy, Rome, Italy
| | - Beatrice Francavilla
- Unit of ENT, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Stefano Di Girolamo
- Unit of ENT, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Nicola Biagio Mercuri
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Via Montpellier 1, 00133, Rome, Italy
| | - Francesco Maria Passali
- Unit of ENT, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Roberta Lattanzi
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Cinzia Severini
- Department of Biochemistry and Cell Biology, National Research Council of Italy, Rome, Italy
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9
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Chang K, Zaikos T, Kilner-Pontone N, Ho CY. Mechanisms of COVID-19-associated olfactory dysfunction. Neuropathol Appl Neurobiol 2024; 50:e12960. [PMID: 38419211 PMCID: PMC10906737 DOI: 10.1111/nan.12960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/26/2023] [Accepted: 01/08/2024] [Indexed: 03/02/2024]
Abstract
Olfactory dysfunction is one of the most common symptoms of COVID-19. In the first 2 years of the pandemic, it was frequently reported, although its incidence has significantly decreased with the emergence of the Omicron variant, which has since become the dominant viral strain. Nevertheless, many patients continue to suffer from persistent dysosmia and dysgeusia, making COVID-19-associated olfactory dysfunction an ongoing health concern. The proposed pathogenic mechanisms of COVID-19-associated olfactory dysfunction are complex and likely multifactorial. While evidence suggests that infection of sustentacular cells and associated mucosal inflammation may be the culprit of acute, transient smell loss, alterations in other components of the olfactory system (e.g., olfactory receptor neuron dysfunction, olfactory bulb injury and alterations in the olfactory cortex) may lead to persistent, long-term olfactory dysfunction. This review aims to provide a comprehensive summary of the epidemiology, clinical manifestations and current understanding of the pathogenic mechanisms of COVID-19-associated olfactory dysfunction.
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Affiliation(s)
- Koping Chang
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department and Graduate Institute of Pathology, National Taiwan University, Taipei, Taiwan
| | - Thomas Zaikos
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Cheng-Ying Ho
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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10
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McClelland AC, Benitez SJ, Burns J. COVID-19 Neuroimaging Update: Pathophysiology, Acute Findings, and Post-Acute Developments. Semin Ultrasound CT MR 2024:S0887-2171(24)00026-X. [PMID: 38518814 DOI: 10.1053/j.sult.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
COVID-19 has prominent effects on the nervous system with important manifestations on neuroimaging. In this review, we discuss the neuroimaging appearance of acute COVID-19 that became evident during the early stages of the pandemic. We highlight the underlying pathophysiology mediating nervous system effects and neuroimaging appearances including systemic inflammatory response such as cytokine storm, coagulopathy, and para/post-infections immune mediated phenomena. We also discuss the nervous system manifestations of COVID-19 and the role of imaging as the pandemic has evolved over time, including related to the development of vaccines and the emergence of post-acute sequalae such as long COVID.
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Affiliation(s)
| | - Steven J Benitez
- Department of Radiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Judah Burns
- Department of Radiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
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11
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van der Knaap N, Ariës MJH, van der Horst ICC, Jansen JFA. On the merits and potential of advanced neuroimaging techniques in COVID-19: A scoping review. Neuroimage Clin 2024; 42:103589. [PMID: 38461701 PMCID: PMC10938171 DOI: 10.1016/j.nicl.2024.103589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 03/12/2024]
Abstract
Many Coronavirus Disease 2019 (COVID-19) patients are suffering from long-term neuropsychological sequelae. These patients may benefit from a better understanding of the underlying neuropathophysiological mechanisms and identification of potential biomarkers and treatment targets. Structural clinical neuroimaging techniques have limited ability to visualize subtle cerebral abnormalities and to investigate brain function. This scoping review assesses the merits and potential of advanced neuroimaging techniques in COVID-19 using literature including advanced neuroimaging or postmortem analyses in adult COVID-19 patients published from the start of the pandemic until December 2023. Findings were summarized according to distinct categories of reported cerebral abnormalities revealed by different imaging techniques. Although no unified COVID-19-specific pattern could be subtracted, a broad range of cerebral abnormalities were revealed by advanced neuroimaging (likely attributable to hypoxic, vascular, and inflammatory pathology), even in absence of structural clinical imaging findings. These abnormalities are validated by postmortem examinations. This scoping review emphasizes the added value of advanced neuroimaging compared to structural clinical imaging and highlights implications for brain functioning and long-term consequences in COVID-19.
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Affiliation(s)
- Noa van der Knaap
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Research Institute of Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Marcel J H Ariës
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Research Institute of Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Iwan C C van der Horst
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Jacobus F A Jansen
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Research Institute of Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
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12
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Mohammadi S, Ghaderi S. Advanced magnetic resonance neuroimaging techniques: feasibility and applications in long or post-COVID-19 syndrome - a review. Ann Med Surg (Lond) 2024; 86:1584-1589. [PMID: 38463042 PMCID: PMC10923379 DOI: 10.1097/ms9.0000000000001808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/29/2024] [Indexed: 03/12/2024] Open
Abstract
Long-term or post-COVID-19 syndrome (PCS) is a condition that affects people infected with SARS‑CoV‑2, the virus that causes COVID-19. PCS is characterized by a wide range of persistent or new symptoms that last months after the initial infection, such as fatigue, shortness of breath, cognitive dysfunction, and pain. Advanced magnetic resonance (MR) neuroimaging techniques can provide valuable information on the structural and functional changes in the brain associated with PCS as well as potential biomarkers for diagnosis and prognosis. In this review, we discuss the feasibility and applications of various advanced MR neuroimaging techniques in PCS, including perfusion-weighted imaging (PWI), diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), functional MR imaging (fMRI), diffusion tensor imaging (DTI), and tractography. We summarize the current evidence on neuroimaging findings in PCS, the challenges and limitations of these techniques, and the future directions for research and clinical practice. Although still uncertain, advanced MRI techniques show promise for gaining insight into the pathophysiology and guiding the management of COVID-19 syndrome, pending larger validation studies.
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Affiliation(s)
- Sana Mohammadi
- Department of Medical Sciences, School of Medicine, Iran University of Medical Sciences
| | - Sadegh Ghaderi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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13
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Bungenberg J, Hohenfeld C, Costa AS, Heine J, Schwichtenberg K, Hartung T, Franke C, Binkofski F, Schulz JB, Finke C, Reetz K. Characteristic functional connectome related to Post-COVID-19 syndrome. Sci Rep 2024; 14:4997. [PMID: 38424415 PMCID: PMC10904373 DOI: 10.1038/s41598-024-54554-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/14/2024] [Indexed: 03/02/2024] Open
Abstract
Post-COVID-19 syndrome is a serious complication following SARS-CoV-2 infection, characterized primarily by fatigue and cognitive complaints. Although first metabolic and structural imaging alterations in Post-COVID-19 syndrome have been identified, their functional consequences remain unknown. Thus, we explored the impact of Post-COVID-19 syndrome on the functional connectome of the brain providing a deeper understanding of pathophysiological mechanisms. In a cross-sectional observational study, resting-state functional magnetic resonance imaging data of 66 patients with Post-COVID-19 syndrome after mild infection (mean age 42.3 years, 57 female) and 57 healthy controls (mean age 42.1 years, 38 female) with a mean time of seven months after acute COVID-19 were analysed using a graph theoretical approach. Network features were quantified using measures including mean distance, nodal degree, betweenness and Katz centrality, and compared between both groups. Graph measures were correlated with clinical measures quantifying fatigue, cognitive function, affective symptoms and sleep disturbances. Alterations were mainly found in the brainstem, olfactory cortex, cingulate cortex, thalamus and cerebellum on average seven months after SARS-CoV-2 infection. Additionally, strong correlations between fatigue severity, cognitive functioning and daytime sleepiness from clinical scales and graph measures were observed. Our study confirms functional relevance of brain imaging changes in Post-COVID-19 syndrome as mediating factors for persistent symptoms and improves our pathophysiological understanding.
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Affiliation(s)
- Julia Bungenberg
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
- JARA Brain Institute Molecular Neuroscience and Neuroimaging (INM-11), Research Centre Jülich and RWTH Aachen University, 52056, Aachen, Germany
| | - Christian Hohenfeld
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
- JARA Brain Institute Molecular Neuroscience and Neuroimaging (INM-11), Research Centre Jülich and RWTH Aachen University, 52056, Aachen, Germany
| | - Ana S Costa
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
- JARA Brain Institute Molecular Neuroscience and Neuroimaging (INM-11), Research Centre Jülich and RWTH Aachen University, 52056, Aachen, Germany
| | - Josephine Heine
- Department of Neurology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Katia Schwichtenberg
- Department of Neurology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Tim Hartung
- Department of Neurology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Christiana Franke
- Department of Neurology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Ferdinand Binkofski
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
- Division for Clinical Cognitive Sciences, Department of Neurology, RWTH Aachen University, 52074, Aachen, Germany
- Institute for Neuroscience and Medicine (INM-4), Research Center Jülich GmbH, 52425, Jülich, Germany
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
- JARA Brain Institute Molecular Neuroscience and Neuroimaging (INM-11), Research Centre Jülich and RWTH Aachen University, 52056, Aachen, Germany
| | - Carsten Finke
- Department of Neurology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
- Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.
- JARA Brain Institute Molecular Neuroscience and Neuroimaging (INM-11), Research Centre Jülich and RWTH Aachen University, 52056, Aachen, Germany.
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14
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Churchill NW, Roudaia E, Jean Chen J, Gilboa A, Sekuler A, Ji X, Gao F, Lin Z, Masellis M, Goubran M, Rabin JS, Lam B, Cheng I, Fowler R, Heyn C, Black SE, MacIntosh BJ, Graham SJ, Schweizer TA. Persistent post-COVID headache is associated with suppression of scale-free functional brain dynamics in non-hospitalized individuals. Brain Behav 2023; 13:e3212. [PMID: 37872889 PMCID: PMC10636408 DOI: 10.1002/brb3.3212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 10/25/2023] Open
Abstract
INTRODUCTION Post-acute coronavirus disease 2019 (COVID-19) syndrome (PACS) is a growing concern, with headache being a particularly debilitating symptom with high prevalence. The long-term effects of COVID-19 and post-COVID headache on brain function remain poorly understood, particularly among non-hospitalized individuals. This study focused on the power-law scaling behavior of functional brain dynamics, indexed by the Hurst exponent (H). This measure is suppressed during physiological and psychological distress and was thus hypothesized to be reduced in individuals with post-COVID syndrome, with greatest reductions among those with persistent headache. METHODS Resting-state blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging data were collected for 57 individuals who had COVID-19 (32 with no headache, 14 with ongoing headache, 11 recovered) and 17 controls who had cold and flu-like symptoms but tested negative for COVID-19. Individuals were assessed an average of 4-5 months after COVID testing, in a cross-sectional, observational study design. RESULTS No significant differences in H values were found between non-headache COVID-19 and control groups., while those with ongoing headache had significantly reduced H values, and those who had recovered from headache had elevated H values, relative to non-headache groups. Effects were greatest in temporal, sensorimotor, and insular brain regions. Reduced H in these regions was also associated with decreased BOLD activity and local functional connectivity. CONCLUSIONS These findings provide new insights into the neurophysiological mechanisms that underlie persistent post-COVID headache, with reduced BOLD scaling as a potential biomarker that is specific to this debilitating condition.
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Affiliation(s)
- Nathan W. Churchill
- Neuroscience Research Program, St. Michael's HospitalTorontoOntarioCanada
- Keenan Research Centre for Biomedical Science, St. Michael's HospitalTorontoOntarioCanada
- Physics DepartmentToronto Metropolitan UniversityTorontoOntarioCanada
| | - Eugenie Roudaia
- Rotman Research InstituteBaycrest Academy for Research and EducationTorontoOntarioCanada
| | - J. Jean Chen
- Rotman Research InstituteBaycrest Academy for Research and EducationTorontoOntarioCanada
- Department of Medical BiophysicsUniversity of TorontoTorontoOntarioCanada
- Institute of Biomedical EngineeringUniversity of TorontoTorontoOntarioCanada
| | - Asaf Gilboa
- Rotman Research InstituteBaycrest Academy for Research and EducationTorontoOntarioCanada
- Department of PsychologyUniversity of TorontoTorontoOntarioCanada
| | - Allison Sekuler
- Rotman Research InstituteBaycrest Academy for Research and EducationTorontoOntarioCanada
- Department of PsychologyUniversity of TorontoTorontoOntarioCanada
- Department of Psychology, Neuroscience & BehaviourMcMaster UniversityHamiltonOntarioCanada
| | - Xiang Ji
- LC Campbell Cognitive Neurology Research Group, Sunnybrook Health Sciences CentreTorontoOntarioCanada
| | - Fuqiang Gao
- Hurvitz Brain Sciences ProgramSunnybrook Research InstituteTorontoOntarioCanada
| | - Zhongmin Lin
- Department of Medical BiophysicsUniversity of TorontoTorontoOntarioCanada
- Physical Sciences PlatformSunnybrook Research InstituteTorontoOntarioCanada
| | - Mario Masellis
- Rotman Research InstituteBaycrest Academy for Research and EducationTorontoOntarioCanada
- Hurvitz Brain Sciences ProgramSunnybrook Research InstituteTorontoOntarioCanada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoOntarioCanada
| | - Maged Goubran
- Department of Medical BiophysicsUniversity of TorontoTorontoOntarioCanada
- Hurvitz Brain Sciences ProgramSunnybrook Research InstituteTorontoOntarioCanada
- Physical Sciences PlatformSunnybrook Research InstituteTorontoOntarioCanada
- Harquail Centre for NeuromodulationSunnybrook Research InstituteTorontoOntarioCanada
| | - Jennifer S. Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoOntarioCanada
- Harquail Centre for NeuromodulationSunnybrook Research InstituteTorontoOntarioCanada
- Rehabilitation Sciences InstituteUniversity of TorontoTorontoOntarioCanada
| | - Benjamin Lam
- Rotman Research InstituteBaycrest Academy for Research and EducationTorontoOntarioCanada
- Hurvitz Brain Sciences ProgramSunnybrook Research InstituteTorontoOntarioCanada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoOntarioCanada
| | - Ivy Cheng
- Evaluative Clinical SciencesSunnybrook Research InstituteTorontoOntarioCanada
- Integrated Community ProgramSunnybrook Research InstituteTorontoOntarioCanada
- Department of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Robert Fowler
- Department of MedicineUniversity of TorontoTorontoOntarioCanada
- Emergency & Critical Care Research ProgramSunnybrook Research InstituteTorontoOntarioCanada
| | - Chris Heyn
- Hurvitz Brain Sciences ProgramSunnybrook Research InstituteTorontoOntarioCanada
- Department of Medical ImagingUniversity of TorontoTorontoOntarioCanada
| | - Sandra E. Black
- Rotman Research InstituteBaycrest Academy for Research and EducationTorontoOntarioCanada
- Hurvitz Brain Sciences ProgramSunnybrook Research InstituteTorontoOntarioCanada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoOntarioCanada
| | - Bradley J. MacIntosh
- Department of Medical BiophysicsUniversity of TorontoTorontoOntarioCanada
- Hurvitz Brain Sciences ProgramSunnybrook Research InstituteTorontoOntarioCanada
- Physical Sciences PlatformSunnybrook Research InstituteTorontoOntarioCanada
- Computational Radiology & Artificial Intelligence Unit, Division of Radiology and Nuclear MedicineOslo University HospitalOsloNorway
| | - Simon J. Graham
- Department of Medical BiophysicsUniversity of TorontoTorontoOntarioCanada
- Hurvitz Brain Sciences ProgramSunnybrook Research InstituteTorontoOntarioCanada
- Physical Sciences PlatformSunnybrook Research InstituteTorontoOntarioCanada
| | - Tom A. Schweizer
- Neuroscience Research Program, St. Michael's HospitalTorontoOntarioCanada
- Keenan Research Centre for Biomedical Science, St. Michael's HospitalTorontoOntarioCanada
- Faculty of Medicine (Neurosurgery)University of TorontoTorontoOntarioCanada
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15
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Zorzo C, Solares L, Mendez M, Mendez-Lopez M. Hippocampal alterations after SARS-CoV-2 infection: A systematic review. Behav Brain Res 2023; 455:114662. [PMID: 37703951 DOI: 10.1016/j.bbr.2023.114662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 09/15/2023]
Abstract
SARS-CoV-2 infection produces a wide range of symptoms. Some of the structural changes caused by the virus in the nervous system are found in the medial temporal lobe, and several neuropsychological sequelae of COVID-19 are related to the function of the hippocampus. The main objective of the systematic review is to update and further analyze the existing evidence of hippocampal and related cortices' structural and functional alterations due to SARS-CoV-2 infection. Both clinical and preclinical studies that used different methodologies to explore the effects of this disease at different stages and grades of severity were considered, besides exploring related cognitive and emotional symptomatology. A total of 24 studies were identified by searching in SCOPUS, Web Of Science (WOS), PubMed, and PsycInfo databases up to October 3rd, 2022. Thirteen studies were performed in clinical human samples, 9 included preclinical animal models, 3 were performed post-mortem, and 1 included both post-mortem and preclinical samples. Alterations in the hippocampus were detected in the acute stage and after several months of infection. Clinical studies revealed alterations in hippocampal connectivity and metabolism. Memory alterations correlated with altered metabolic profiles or changes in grey matter volumes. Hippocampal human postmortem and animal studies observed alterations in neurogenesis, dendrites, and immune response, besides high apoptosis and neuroinflammation. Preclinical studies reported the viral load in the hippocampus. Olfactory dysfunction was associated with alterations in brain functionality. Several clinical studies revealed cognitive complaints, neuropsychological alterations, and depressive and anxious symptomatology.
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Affiliation(s)
- Candela Zorzo
- Neuroscience Institute of Principado de Asturias (INEUROPA), Faculty of Psychology, Plaza Feijoo s/n, 33003 Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Av. del Hospital Universitario, s/n, 33011 Oviedo, Asturias, Spain; Department of Psychology, University of Oviedo, Faculty of Psychology, Plaza Feijoo s/n, 33003 Oviedo, Asturias, Spain.
| | - Lucía Solares
- Department of Psychology, University of Oviedo, Faculty of Psychology, Plaza Feijoo s/n, 33003 Oviedo, Asturias, Spain.
| | - Marta Mendez
- Neuroscience Institute of Principado de Asturias (INEUROPA), Faculty of Psychology, Plaza Feijoo s/n, 33003 Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Av. del Hospital Universitario, s/n, 33011 Oviedo, Asturias, Spain; Department of Psychology, University of Oviedo, Faculty of Psychology, Plaza Feijoo s/n, 33003 Oviedo, Asturias, Spain.
| | - Magdalena Mendez-Lopez
- Department of Psychology and Sociology, University of Zaragoza, Pedro Cerbuna 12, 50009 Zaragoza, Aragón, Spain; IIS Aragón, San Juan Bosco, 13, 50009 Zaragoza, Aragón, Spain.
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16
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Bispo DDDC, Brandão PRDP, Pereira DA, Maluf FB, Dias BA, Paranhos HR, von Glehn F, de Oliveira ACP, Soares AADSM, Descoteaux M, Regattieri NAT. Altered structural connectivity in olfactory disfunction after mild COVID-19 using probabilistic tractography. Sci Rep 2023; 13:12886. [PMID: 37558765 PMCID: PMC10412532 DOI: 10.1038/s41598-023-40115-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/04/2023] [Indexed: 08/11/2023] Open
Abstract
We aimed to investigate changes in olfactory bulb volume and brain network in the white matter (WM) in patients with persistent olfactory disfunction (OD) following COVID-19. A cross-sectional study evaluated 38 participants with OD after mild COVID-19 and 24 controls, including Sniffin' Sticks identification test (SS-16), MoCA, and brain magnetic resonance imaging. Network-Based Statistics (NBS) and graph theoretical analysis were used to explore the WM. The COVID-19 group had reduced olfactory bulb volume compared to controls. In NBS, COVID-19 patients showed increased structural connectivity in a subnetwork comprising parietal brain regions. Regarding global network topological properties, patients exhibited lower global and local efficiency and higher assortativity than controls. Concerning local network topological properties, patients had reduced local efficiency (left lateral orbital gyrus and pallidum), increased clustering (left lateral orbital gyrus), increased nodal strength (right anterior orbital gyrus), and reduced nodal strength (left amygdala). SS-16 test score was negatively correlated with clustering of whole-brain WM in the COVID-19 group. Thus, patients with OD after COVID-19 had relevant WM network dysfunction with increased connectivity in the parietal sensory cortex. Reduced integration and increased segregation are observed within olfactory-related brain areas might be due to compensatory plasticity mechanisms devoted to recovering olfactory function.
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Affiliation(s)
- Diógenes Diego de Carvalho Bispo
- Diagnostic Imaging Unit, Brasilia University Hospital, University of Brasilia, Darcy Ribeiro Campus, Asa Norte, Brasilia, Distrito Federal, Brazil.
- Faculty of Medicine, University of Brasilia, Brasilia, Distrito Federal, Brazil.
- Department of Radiology, Hospital Santa Marta, Taguatinga, Distrito Federal, Brazil.
| | - Pedro Renato de Paula Brandão
- Neuroscience and Behavior Lab, University of Brasilia, Brasilia, Distrito Federal, Brazil
- Hospital Sírio-Libanês, Brasilia, Distrito Federal, Brazil
| | - Danilo Assis Pereira
- Advanced Psychometry Laboratory, Brazilian Institute of Neuropsychology and Cognitive Sciences, Brasilia, Distrito Federal, Brazil
| | | | - Bruna Arrais Dias
- Department of Radiology, Hospital Santa Marta, Taguatinga, Distrito Federal, Brazil
| | - Hugo Rafael Paranhos
- Department of Radiology, Hospital Santa Marta, Taguatinga, Distrito Federal, Brazil
| | - Felipe von Glehn
- Faculty of Medicine, University of Brasilia, Brasilia, Distrito Federal, Brazil
- Hospital Sírio-Libanês, Brasilia, Distrito Federal, Brazil
| | | | | | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Lab, University of Sherbrooke, Sherbrooke, QC, Canada
- Imeka Solutions Inc, Sherbrooke, QC, Canada
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17
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Teller N, Chad JA, Wong A, Gunraj H, Ji X, Goubran M, Gilboa A, Roudaia E, Sekuler A, Churchill N, Schweizer T, Gao F, Masellis M, Lam B, Heyn C, Cheng I, Fowler R, Black SE, MacIntosh BJ, Graham SJ, Chen JJ. Feasibility of diffusion-tensor and correlated diffusion imaging for studying white-matter microstructural abnormalities: Application in COVID-19. Hum Brain Mapp 2023; 44:3998-4010. [PMID: 37162380 PMCID: PMC10258529 DOI: 10.1002/hbm.26322] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/06/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023] Open
Abstract
There has been growing attention on the effect of COVID-19 on white-matter microstructure, especially among those that self-isolated after being infected. There is also immense scientific interest and potential clinical utility to evaluate the sensitivity of single-shell diffusion magnetic resonance imaging (MRI) methods for detecting such effects. In this work, the performances of three single-shell-compatible diffusion MRI modeling methods are compared for detecting the effect of COVID-19, including diffusion-tensor imaging, diffusion-tensor decomposition of orthogonal moments and correlated diffusion imaging. Imaging was performed on self-isolated patients at the study initiation and 3-month follow-up, along with age- and sex-matched controls. We demonstrate through simulations and experimental data that correlated diffusion imaging is associated with far greater sensitivity, being the only one of the three single-shell methods to demonstrate COVID-19-related brain effects. Results suggest less restricted diffusion in the frontal lobe in COVID-19 patients, but also more restricted diffusion in the cerebellar white matter, in agreement with several existing studies highlighting the vulnerability of the cerebellum to COVID-19 infection. These results, taken together with the simulation results, suggest that a significant proportion of COVID-19 related white-matter microstructural pathology manifests as a change in tissue diffusivity. Interestingly, different b-values also confer different sensitivities to the effects. No significant difference was observed in patients at the 3-month follow-up, likely due to the limited size of the follow-up cohort. To summarize, correlated diffusion imaging is shown to be a viable single-shell diffusion analysis approach that allows us to uncover opposing patterns of diffusion changes in the frontal and cerebellar regions of COVID-19 patients, suggesting the two regions react differently to viral infection.
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Affiliation(s)
- Nick Teller
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Jordan A Chad
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Alexander Wong
- Department of System Design Engineering, University of Waterloo, Waterloo, Canada
| | - Hayden Gunraj
- Department of System Design Engineering, University of Waterloo, Waterloo, Canada
| | - Xiang Ji
- Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, Canada
| | - Maged Goubran
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, Canada
| | - Asaf Gilboa
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Eugenie Roudaia
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Allison Sekuler
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Nathan Churchill
- Neuroscience Research Program, St. Michael's Hospital, Toronto, Canada
- Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Canada
- Department of Physics, Toronto Metropolitan University, Toronto, Canada
| | - Tom Schweizer
- Neuroscience Research Program, St. Michael's Hospital, Toronto, Canada
- Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Canada
- Department of Neurosurgery, University of Toronto, Toronto, Canada
| | - Fuqiang Gao
- Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, Canada
| | - Mario Masellis
- Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, Canada
| | - Benjamin Lam
- Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, Canada
| | - Chris Heyn
- Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, Canada
| | - Ivy Cheng
- Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, Canada
| | - Robert Fowler
- Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, Canada
| | - Sandra E Black
- Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, Canada
| | - Bradley J MacIntosh
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, Canada
| | - Simon J Graham
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Sunnybrook Health Science Centre, Toronto, Canada
| | - J Jean Chen
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
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18
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Thomasson M, Voruz P, Cionca A, Jacot de Alcântara I, Nuber-Champier A, Allali G, Benzakour L, Lalive PH, Lövblad KO, Braillard O, Nehme M, Coen M, Serratrice J, Reny JL, Pugin J, Guessous I, Landis BN, Griffa A, Van De Ville D, Assal F, Péron JA. Markers of limbic system damage following SARS-CoV-2 infection. Brain Commun 2023; 5:fcad177. [PMID: 37415776 PMCID: PMC10320753 DOI: 10.1093/braincomms/fcad177] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/21/2023] [Accepted: 06/09/2023] [Indexed: 07/08/2023] Open
Abstract
Alterations of the limbic system may be present in the chronic phase of SARS-CoV-2 infection. Our aim was to study the long-term impact of this disease on limbic system-related behaviour and its associated brain functional connectivity, according to the severity of respiratory symptoms in the acute phase. To this end, we investigated the multimodal emotion recognition abilities of 105 patients from the Geneva COVID-COG Cohort 223 days on average after SARS-CoV-2 infection (diagnosed between March 2020 and May 2021), dividing them into three groups (severe, moderate or mild) according to respiratory symptom severity in the acute phase. We used multiple regressions and partial least squares correlation analyses to investigate the relationships between emotion recognition, olfaction, cognition, neuropsychiatric symptoms and functional brain networks. Six to 9 months following SARS-CoV-2 infection, moderate patients exhibited poorer recognition abilities than mild patients for expressions of fear (P = 0.03 corrected), as did severe patients for disgust (P = 0.04 corrected) and irritation (P < 0.01 corrected). In the whole cohort, these performances were associated with decreased episodic memory and anosmia, but not with depressive symptoms, anxiety or post-traumatic stress disorder. Neuroimaging revealed a positive contribution of functional connectivity, notably between the cerebellum and the default mode, somatosensory motor and salience/ventral attention networks. These results highlight the long-term consequences of SARS-Cov-2 infection on the limbic system at both the behavioural and neuroimaging levels.
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Affiliation(s)
| | | | - Alexandre Cionca
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva 1205, Switzerland
| | - Isabele Jacot de Alcântara
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva 1205, Switzerland
- Neurology Department, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva 1205, Switzerland
| | - Anthony Nuber-Champier
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva 1205, Switzerland
| | - Gilles Allali
- Leenaards Memory Centre, Lausanne University Hospital and University of Lausanne, Lausanne 1205, Switzerland
| | - Lamyae Benzakour
- Psychiatry Department, Geneva University Hospitals, Geneva 1205, Switzerland
| | - Patrice H Lalive
- Neurology Department, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva 1205, Switzerland
- Faculty of Medicine, University of Geneva, Geneva 1011, Switzerland
| | - Karl-Olof Lövblad
- Faculty of Medicine, University of Geneva, Geneva 1011, Switzerland
- Diagnostic and Interventional Neuroradiology Department, Geneva University Hospitals, Geneva 1205, Switzerland
| | - Olivia Braillard
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva 1205, Switzerland
| | - Mayssam Nehme
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva 1205, Switzerland
| | - Matteo Coen
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Geneva 1205, Switzerland
| | - Jacques Serratrice
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Geneva 1205, Switzerland
| | - Jean-Luc Reny
- Faculty of Medicine, University of Geneva, Geneva 1011, Switzerland
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Geneva 1205, Switzerland
| | - Jérôme Pugin
- Faculty of Medicine, University of Geneva, Geneva 1011, Switzerland
- Intensive Care Department, Geneva University Hospitals, Geneva 1205, Switzerland
| | - Idris Guessous
- Faculty of Medicine, University of Geneva, Geneva 1011, Switzerland
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva 1205, Switzerland
| | - Basile N Landis
- Faculty of Medicine, University of Geneva, Geneva 1011, Switzerland
- Rhinology-Olfactology Unit, Otorhinolaryngology Department, Geneva University Hospitals, Geneva 1205, Switzerland
| | - Alessandra Griffa
- Leenaards Memory Centre, Lausanne University Hospital and University of Lausanne, Lausanne 1205, Switzerland
- Institute of Bioengineering, Centre for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne 1015, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva, Geneva 1205, Switzerland
| | - Dimitri Van De Ville
- Faculty of Medicine, University of Geneva, Geneva 1011, Switzerland
- Institute of Bioengineering, Centre for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne 1015, Switzerland
| | - Frederic Assal
- Neurology Department, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva 1205, Switzerland
- Faculty of Medicine, University of Geneva, Geneva 1011, Switzerland
| | - Julie A Péron
- Correspondence to: Julie Péron Clinical and Experimental Neuropsychology Laboratory Faculté de Psychologie et des Sciences de l’Education Université de Genève, 40 bd du Pont d’Arve 1205 Geneva, Switzerland E-mail:
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19
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Díez-Cirarda M, Yus M, Gómez-Ruiz N, Polidura C, Gil-Martínez L, Delgado-Alonso C, Jorquera M, Gómez-Pinedo U, Matias-Guiu J, Arrazola J, Matias-Guiu JA. Multimodal neuroimaging in post-COVID syndrome and correlation with cognition. Brain 2023; 146:2142-2152. [PMID: 36288544 PMCID: PMC9620345 DOI: 10.1093/brain/awac384] [Citation(s) in RCA: 59] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/02/2022] [Accepted: 09/23/2022] [Indexed: 11/12/2022] Open
Abstract
Brain changes have been reported in the first weeks after SARS-CoV-2 infection. However, limited literature exists about brain alterations in post-COVID syndrome, a condition increasingly associated with cognitive impairment. The present study aimed to evaluate brain functional and structural alterations in patients with post-COVID syndrome, and assess whether these brain alterations were related to cognitive dysfunction. Eighty-six patients with post-COVID syndrome and 36 healthy controls were recruited and underwent neuroimaging acquisition and a comprehensive neuropsychological assessment. Cognitive and neuroimaging examinations were performed 11 months after the first symptoms of SARS-CoV-2. Whole-brain functional connectivity analysis was performed. Voxel-based morphometry was performed to evaluate grey matter volume, and diffusion tensor imaging was carried out to analyse white-matter alterations. Correlations between cognition and brain changes were conducted and Bonferroni corrected. Post-COVID syndrome patients presented with functional connectivity changes, characterized by hypoconnectivity between left and right parahippocampal areas, and between bilateral orbitofrontal and cerebellar areas compared to controls. These alterations were accompanied by reduced grey matter volume in cortical, limbic and cerebellar areas, and alterations in white matter axial and mean diffusivity. Grey matter volume loss showed significant associations with cognitive dysfunction. These cognitive and brain alterations were more pronounced in hospitalized patients compared to non-hospitalized patients. No associations with vaccination status were found. The present study shows persistent structural and functional brain abnormalities 11 months after the acute infection. These changes are associated with cognitive dysfunction and contribute to a better understanding of the pathophysiology of the post-COVID syndrome.
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Affiliation(s)
- María Díez-Cirarda
- Department of Neurology. Hospital Clínico San Carlos. Health Research Institute “San Carlos” (IdISCC). Universidad Complutense de Madrid. Madrid, Spain
| | - Miguel Yus
- Department of Radiology, Hospital Clínico San Carlos. Health Research Institute “San Carlos” (IdISCC). Universidad Complutense de Madrid. Madrid, Spain
| | - Natividad Gómez-Ruiz
- Department of Radiology, Hospital Clínico San Carlos. Health Research Institute “San Carlos” (IdISCC). Universidad Complutense de Madrid. Madrid, Spain
| | - Carmen Polidura
- Department of Radiology, Hospital Clínico San Carlos. Health Research Institute “San Carlos” (IdISCC). Universidad Complutense de Madrid. Madrid, Spain
| | - Lidia Gil-Martínez
- Department of Radiology, Hospital Clínico San Carlos. Health Research Institute “San Carlos” (IdISCC). Universidad Complutense de Madrid. Madrid, Spain
| | - Cristina Delgado-Alonso
- Department of Neurology. Hospital Clínico San Carlos. Health Research Institute “San Carlos” (IdISCC). Universidad Complutense de Madrid. Madrid, Spain
| | - Manuela Jorquera
- Department of Radiology, Hospital Clínico San Carlos. Health Research Institute “San Carlos” (IdISCC). Universidad Complutense de Madrid. Madrid, Spain
| | - Ulises Gómez-Pinedo
- Department of Neurology. Hospital Clínico San Carlos. Health Research Institute “San Carlos” (IdISCC). Universidad Complutense de Madrid. Madrid, Spain
| | - Jorge Matias-Guiu
- Department of Neurology. Hospital Clínico San Carlos. Health Research Institute “San Carlos” (IdISCC). Universidad Complutense de Madrid. Madrid, Spain
| | - Juan Arrazola
- Department of Radiology, Hospital Clínico San Carlos. Health Research Institute “San Carlos” (IdISCC). Universidad Complutense de Madrid. Madrid, Spain
| | - Jordi A Matias-Guiu
- Department of Neurology. Hospital Clínico San Carlos. Health Research Institute “San Carlos” (IdISCC). Universidad Complutense de Madrid. Madrid, Spain
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20
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Muccioli L, Sighinolfi G, Mitolo M, Ferri L, Jane Rochat M, Pensato U, Taruffi L, Testa C, Masullo M, Cortelli P, Lodi R, Liguori R, Tonon C, Bisulli F. Cognitive and functional connectivity impairment in post-COVID-19 olfactory dysfunction. Neuroimage Clin 2023; 38:103410. [PMID: 37104928 PMCID: PMC10165139 DOI: 10.1016/j.nicl.2023.103410] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVES To explore the neuropsychological profile and the integrity of the olfactory network in patients with COVID-19-related persistent olfactory dysfunction (OD). METHODS Patients with persistent COVID-19-related OD underwent olfactory assessment with Sniffin' Sticks and neuropsychological evaluation. Additionally, both patients and a control group underwent brain MRI, including T1-weighted and resting-state functional MRI (rs-fMRI) sequences on a 3 T scanner. Morphometrical properties were evaluated in olfaction-associated regions; the rs-fMRI data were analysed using graph theory at the whole-brain level and within a standard parcellation of the olfactory functional network. All the MR-derived quantities were compared between the two groups and their correlation with clinical scores in patients were explored. RESULTS We included 23 patients (mean age 37 ± 14 years, 12 females) with persistent (mean duration 11 ± 5 months, range 2-19 months) COVID-19-related OD (mean score 23.63 ± 5.32/48, hyposmia cut-off: 30.75) and 26 sex- and age-matched healthy controls. Applying population-derived cut-off values, the two cognitive domains mainly impaired were visuospatial memory and executive functions (17 % and 13 % of patients). Brain MRI did not show gross morphological abnormalities. The lateral orbital cortex, hippocampus, and amygdala volumes exhibited a reduction trend in patients, not significant after the correction for multiple comparisons. The olfactory bulb volumes did not differ between patients and controls. Graph analysis of the functional olfactory network showed altered global and local properties in the patients' group (n = 19, 4 excluded due to artifacts) compared to controls. Specifically, we detected a reduction in the global modularity coefficient, positively correlated with hyposmia severity, and an increase of the degree and strength of the right thalamus functional connections, negatively correlated with short-term verbal memory scores. DISCUSSION Patients with persistent COVID-19-related OD showed an altered olfactory network connectivity correlated with hyposmia severity and neuropsychological performance. No significant morphological alterations were found in patients compared with controls.
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Affiliation(s)
- Lorenzo Muccioli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Sighinolfi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Micaela Mitolo
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Lorenzo Ferri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | - Umberto Pensato
- Department of Neurology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Lisa Taruffi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Claudia Testa
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Department of Physics and Astronomy, University of Bologna, Bologna, Italy
| | - Marco Masullo
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Pietro Cortelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Raffaele Lodi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Rocco Liguori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Caterina Tonon
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Francesca Bisulli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
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21
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Churchill NW, Roudaia E, Chen JJ, Gilboa A, Sekuler A, Ji X, Gao F, Lin Z, Jegatheesan A, Masellis M, Goubran M, Rabin JS, Lam B, Cheng I, Fowler R, Heyn C, Black SE, MacIntosh BJ, Graham SJ, Schweizer TA. Effects of post-acute COVID-19 syndrome on the functional brain networks of non-hospitalized individuals. Front Neurol 2023; 14:1136408. [PMID: 37051059 PMCID: PMC10083436 DOI: 10.3389/fneur.2023.1136408] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
IntroductionThe long-term impact of COVID-19 on brain function remains poorly understood, despite growing concern surrounding post-acute COVID-19 syndrome (PACS). The goal of this cross-sectional, observational study was to determine whether there are significant alterations in resting brain function among non-hospitalized individuals with PACS, compared to symptomatic individuals with non-COVID infection.MethodsData were collected for 51 individuals who tested positive for COVID-19 (mean age 41±12 yrs., 34 female) and 15 controls who had cold and flu-like symptoms but tested negative for COVID-19 (mean age 41±14 yrs., 9 female), with both groups assessed an average of 4-5 months after COVID testing. None of the participants had prior neurologic, psychiatric, or cardiovascular illness. Resting brain function was assessed via functional magnetic resonance imaging (fMRI), and self-reported symptoms were recorded.ResultsIndividuals with COVID-19 had lower temporal and subcortical functional connectivity relative to controls. A greater number of ongoing post-COVID symptoms was also associated with altered functional connectivity between temporal, parietal, occipital and subcortical regions.DiscussionThese results provide preliminary evidence that patterns of functional connectivity distinguish PACS from non-COVID infection and correlate with the severity of clinical outcome, providing novel insights into this highly prevalent disorder.
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Affiliation(s)
- Nathan W. Churchill
- Neuroscience Research Program, St. Michael’s Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, Toronto, ON, Canada
- Physics Department, Toronto Metropolitan University, Toronto, ON, Canada
- *Correspondence: Nathan W. Churchill,
| | - Eugenie Roudaia
- Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, ON, Canada
| | - J. Jean Chen
- Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Asaf Gilboa
- Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Allison Sekuler
- Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Xiang Ji
- LC Campbell Cognitive Neurology Research Group, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Fuqiang Gao
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Zhongmin Lin
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Aravinthan Jegatheesan
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Mario Masellis
- Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Maged Goubran
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada
- Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Jennifer S. Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Benjamin Lam
- Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Ivy Cheng
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
- Integrated Community Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Robert Fowler
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Emergency and Critical Care Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Chris Heyn
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Sandra E. Black
- Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Bradley J. MacIntosh
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada
- Computational Radiology and Artificial Intelligence Unit, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Simon J. Graham
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Tom A. Schweizer
- Neuroscience Research Program, St. Michael’s Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, Toronto, ON, Canada
- Faculty of Medicine (Neurosurgery), University of Toronto, Toronto, ON, Canada
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22
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Zarachi A, Lianou AD, Pezoulas V, Komnos I, Milionis O, Fotiadis D, Milionis H, Kastanioudakis IG, Liontos A. Visual Analogue Scale for the Evaluation of Olfactory and Gustatory Dysfunction of COVID-19 Patients in Northwestern Greece. Cureus 2023; 15:e36413. [PMID: 37090302 PMCID: PMC10115151 DOI: 10.7759/cureus.36413] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 03/22/2023] Open
Abstract
Background The visual analogue scale (VAS) has been used as a diagnostic tool for the evaluation of the severity of olfactory and gustatory dysfunction (OGD) caused by SARS-CoV2 infection. The main objective of the present study was the evaluation of OGD with VAS in COVID-19-positive patients in Northwestern Greece and its possible association with the patients' self-reported symptoms of olfactory and gustatory dysfunction. Methods The presence of olfactory and gustatory symptoms and their severity were assessed by questionnaire along with the use of specific odorants and tastant ingredients, in three time periods: prior to COVID-19, during COVID-19 (initial diagnosis) and post-COVID-19 disease (at four weeks from disease onset). Three hundred COVID-19-positive patients (home-quarantined and hospitalized) tested with RT-PCR test in the University Hospital of Ioannina Greece were included in this study. Statistical analysis was performed on SPSS Statistics 26.0 (IBM Corp., Armonk, NY) Results Out of a total of 300 patients, 146 and 190 patients had mild hyposmia and hypogeusia respectively, followed by patients with severe hyposmia or hypogeusia (118 and 88 respectively), at the time of COVID-19 onset (initial diagnosis). An increase in the number of patients with recovery of symptoms was observed during the follow-up period, during which only eight patients had non-resolving severe symptoms (six patients with hyposmia and two with hypogeusia). On further analysis, a statistically significant association was found between the severity of symptoms (assessed by VAS score) and the self-reported symptoms of sensory dysfunction by the patients. There was a significant association between the groups of patients with mild hyposmia and patients that reported no loss of smell; between the patients with moderate hyposmia and the patients who reported "loss of smell"; and between the patients with severe hyposmia and the group of patients who reported a loss of smell, at the COVID-19 onset period. Similarly, patients with mild hyposmia were associated with those that reported a loss of smell at the same time. The severity of hyposmia was also associated with the reported symptom of "loss of taste" at the time of COVID-19 diagnosis. Similar findings were observed regarding the severity of hypogeusia and the reported symptom of "loss of taste" among the groups of patients. Finally, the severity of hypogeusia was associated with smell loss at the time of initial diagnosis of the infection. Conclusion Similar to the literature data, our findings indicate that hyposmia and hypogeusia are common symptoms of COVID-19 disease with varying severity. In our study, most of the patients exerted a complete recovery of these OGD symptoms. In addition, we found an association between olfactory dysfunction and self-reported sensory of taste as well as gustatory dysfunction and sensory of smell. Finally, we found that the VAS score was a reliable diagnostic tool in the estimation of OGD in this cohort of patients. However, our results need to be confirmed by larger-scale trials.
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23
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Voruz P, Cionca A, Jacot de Alcântara I, Nuber-Champier A, Allali G, Benzakour L, Lalive PH, Lövblad KO, Braillard O, Nehme M, Coen M, Serratrice J, Reny JL, Pugin J, Guessous I, Ptak R, Landis BN, Adler D, Griffa A, Van De Ville D, Assal F, Péron JA. Brain functional connectivity alterations associated with neuropsychological performance 6-9 months following SARS-CoV-2 infection. Hum Brain Mapp 2023; 44:1629-1646. [PMID: 36458984 PMCID: PMC9878070 DOI: 10.1002/hbm.26163] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
Neuropsychological deficits and brain damage following SARS-CoV-2 infection are not well understood. Then, 116 patients, with either severe, moderate, or mild disease in the acute phase underwent neuropsychological and olfactory tests, as well as completed psychiatric and respiratory questionnaires at 223 ± 42 days postinfection. Additionally, a subgroup of 50 patients underwent functional magnetic resonance imaging. Patients in the severe group displayed poorer verbal episodic memory performances, and moderate patients had reduced mental flexibility. Neuroimaging revealed patterns of hypofunctional and hyperfunctional connectivities in severe patients, while only hyperconnectivity patterns were observed for moderate. The default mode, somatosensory, dorsal attention, subcortical, and cerebellar networks were implicated. Partial least squares correlations analysis confirmed specific association between memory, executive functions performances and brain functional connectivity. The severity of the infection in the acute phase is a predictor of neuropsychological performance 6-9 months following SARS-CoV-2 infection. SARS-CoV-2 infection causes long-term memory and executive dysfunctions, related to large-scale functional brain connectivity alterations.
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Affiliation(s)
- Philippe Voruz
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland.,Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alexandre Cionca
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland
| | - Isabele Jacot de Alcântara
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland.,Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland
| | - Anthony Nuber-Champier
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland
| | - Gilles Allali
- Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Lamyae Benzakour
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Psychiatry Department, Geneva University Hospitals, Geneva, Switzerland
| | - Patrice H Lalive
- Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Karl O Lövblad
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Diagnostic and Interventional Neuroradiology Department, Geneva University Hospitals, Geneva, Switzerland
| | - Olivia Braillard
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Mayssam Nehme
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Matteo Coen
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | - Jacques Serratrice
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | - Jean-Luc Reny
- Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | - Jérôme Pugin
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Intensive Care Department, Geneva University Hospitals, Geneva, Switzerland
| | - Idris Guessous
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Radek Ptak
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Neurorehabilitation Department, Geneva University Hospitals, Geneva, Switzerland
| | - Basile N Landis
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Rhinology-Olfactology Unit, Otorhinolaryngology Department, Geneva University Hospitals, Geneva, Switzerland
| | - Dan Adler
- Division of Pulmonary Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Alessandra Griffa
- Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland.,Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Dimitri Van De Ville
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Frédéric Assal
- Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Julie A Péron
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland.,Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Geneva, Switzerland
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24
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Llana T, Mendez M, Garces-Arilla S, Hidalgo V, Mendez-Lopez M, Juan MC. Association between olfactory dysfunction and mood disturbances with objective and subjective cognitive deficits in long-COVID. Front Psychol 2023; 14:1076743. [PMID: 36818111 PMCID: PMC9932904 DOI: 10.3389/fpsyg.2023.1076743] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
Background and purpose The coronavirus disease 2019 (COVID-19) has been associated with olfactory dysfunction. The persistent symptoms of anosmia or hyposmia were associated in previous studies with the development of memory impairment and mood disturbances. We aimed to investigate the association between the chronicity of reported olfactory dysfunction and subjective and objective cognitive performance in long-COVID patients and to explore whether their emotional symptoms are related to their cognition. Methods One hundred twenty-eight long-COVID participants were recruited. Reported symptomatology, subjective memory complaints, anxiety and depression symptomatology, and trait-anxiety were assessed. Subjective memory complaints and mood disturbances were compared among groups of participants with olfactory dysfunction as an acute (AOD), persistent (POD), or nonexistent (NOD) symptom. Seventy-six of the volunteers also participated in a face-to-face session to assess their objective performance on tests of general cognitive function and verbal declarative memory. Objective cognitive performance and mood disturbances were compared among the AOD, POD, and NOD groups. Results The subjective memory complaints and the anxiety and depression symptoms were similar among the groups, but the score in general cognitive function was lower in the participants with symptoms of acute olfactory dysfunction than in those with no olfactory symptoms at any time. Participants' memory complaints were positively related to their emotional symptoms. The relationship between depressive symptomatology and memory complaints interacted with the olfactory dysfunction, as it only occurred in the participants without symptoms of olfactory dysfunction. Depressive symptomatology and acute olfactory symptoms were negatively associated with general cognitive function and delayed memory performance. The months elapsed from diagnosis to assessment also predicted delayed memory performance. Anxious symptomatology was negatively associated with the immediate ability to recall verbal information in participants who did not present olfactory dysfunction in the acute phase of the infection. Conclusion Olfactory dysfunction in the acute phase of the infection by COVID-19 is related to cognitive deficits in objective tests, and mood disturbances are associated with self-reported and objective memory. These findings may contribute to further understanding the neuropsychological and emotional aspects of long-COVID.
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Affiliation(s)
- Tania Llana
- Department of Psychology, Faculty of Psychology, University of Oviedo, Oviedo, Spain
- Neuroscience Institute of Princedom of Asturias (INEUROPA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Av. del Hospital Universitario, Oviedo, Spain
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Valencia, Spain
| | - Marta Mendez
- Department of Psychology, Faculty of Psychology, University of Oviedo, Oviedo, Spain
- Neuroscience Institute of Princedom of Asturias (INEUROPA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Av. del Hospital Universitario, Oviedo, Spain
| | - Sara Garces-Arilla
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Valencia, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Vanesa Hidalgo
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, University of Valencia, Valencia, Spain
| | - Magdalena Mendez-Lopez
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- IIS Aragon, Zaragoza, Spain
| | - M.-Carmen Juan
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Valencia, Spain
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25
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Schirinzi T, Lattanzi R, Maftei D, Grillo P, Zenuni H, Boffa L, Albanese M, Simonetta C, Bovenzi R, Maurizi R, Loccisano L, Vincenzi M, Greco A, Di Girolamo S, Mercuri NB, Passali FM, Severini C. Substance P and Prokineticin-2 are overexpressed in olfactory neurons and play differential roles in persons with persistent post-COVID-19 olfactory dysfunction. Brain Behav Immun 2023; 108:302-308. [PMID: 36549578 PMCID: PMC9760596 DOI: 10.1016/j.bbi.2022.12.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/08/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
Persistent olfactory dysfunction (OD) is one of the most complaining and worrying complications of long COVID-19 because of the potential long-term neurological consequences. While causes of OD in the acute phases of the SARS-CoV-2 infection have been figured out, reasons for persistent OD are still unclear. Here we investigated the activity of two inflammatory pathways tightly linked with olfaction pathophysiology, namely Substance P (SP) and Prokineticin-2 (PK2), directly within the olfactory neurons (ONs) of patients to understand mechanisms of persistent post-COVID-19 OD. ONs were collected by non-invasive brushing from ten patients with persistent post-COVID-19 OD and ten healthy controls. Gene expression levels of SP, Neurokinin receptor 1, Interleukin-1β (IL-1β), PK2, PK2 receptors type 1 and 2, and Prokineticin-2-long peptide were measured in ONs by Real Time-PCR in both the groups, and correlated with residual olfaction. Immunofluorescence staining was also performed to quantify SP and PK2 proteins. OD patients, compared to controls, exhibited increased levels of both SP and PK2 in ONs, the latter proportional to residual olfaction. This work provided unprecedented, preliminary evidence that both SP and PK2 pathways may have a role in persistent post-COVID-19 OD. Namely, if the sustained activation of SP, lasting months after infection's resolution, might foster chronic inflammation and contribute to hyposmia, the PK2 expression could instead support the smell recovery.
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Affiliation(s)
- Tommaso Schirinzi
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Italy.
| | - Roberta Lattanzi
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Italy
| | - Daniela Maftei
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Italy
| | - Piergiorgio Grillo
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Italy
| | - Henri Zenuni
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Italy
| | - Laura Boffa
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Italy
| | - Maria Albanese
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Italy
| | - Clara Simonetta
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Italy
| | - Roberta Bovenzi
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Italy
| | - Riccardo Maurizi
- Unit of ENT, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Italy
| | - Laura Loccisano
- Unit of ENT, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Italy
| | - Martina Vincenzi
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - Stefano Di Girolamo
- Unit of ENT, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Italy
| | - Nicola B. Mercuri
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, Italy
| | - Francesco M. Passali
- Unit of ENT, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Italy
| | - Cinzia Severini
- Department of Biochemistry and Cell Biology, National Research Council of Italy, Rome, Italy
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26
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Targeting Neuroinflammation to Alleviate Chronic Olfactory Dysfunction in Long COVID: A Role for Investigating Disease-Modifying Therapy (DMT)? LIFE (BASEL, SWITZERLAND) 2023; 13:life13010226. [PMID: 36676175 PMCID: PMC9863729 DOI: 10.3390/life13010226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/07/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Chronic olfactory dysfunction after SARS-CoV-2 infection occurs in approximately 10% of patients with COVID-19-induced anosmia, and it is a growing public health concern. A regimen of olfactory training and anti-neuroinflammatory therapy with co-ultramicronized palmitoylethanolamide with luteolin (um-PEA-LUT) has shown promising results in clinical trials; however, approximately 15% of treated patients do not achieve full recovery of a normal olfactory threshold, and almost 5% have no recovery. Disease-modifying therapies (DMTs), which are used to treat autoimmune neuroinflammation in multiple sclerosis (MS), have not been studied for treating persistent inflammation in refractory post-COVID-19 smell disorder. This study evaluated COVID-19-related smell loss and MS-related smell loss, comparing the responses to different therapies. Forty patients with MS and 45 reporting post-COVID-19 olfactory disorders were included in the study. All patients underwent nasal endoscopy and were evaluated by using validated Sniffin' Sticks testing. The patients with long COVID were treated for three months with um-PEA-LUT plus olfactory training. The patients with MS were treated with DMTs. Olfactory functions before and after treatment were analyzed in both groups. At the experimental endpoint, 13 patients in the COVID-19 group treated with um-PEA-LUT had residual olfactory impairment versus 10 patients in the MS group treated with DMTs. The severity of the persistent olfactory loss was lower in the MS group, and the patients with MS treated with IFN-beta and glatiramer acetate had the preservation of olfactory function. These data provide a rationale for considering prospective trials investigating the efficacy of DMTs for post-COVID-19 olfactory disorders that are refractory to um-PEA-LUT with olfactory training. This study is the first to consider the role of DMT in treating refractory post-viral olfactory loss in patients with long COVID.
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27
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Esposito F, Cirillo M, De Micco R, Caiazzo G, Siciliano M, Russo AG, Monari C, Coppola N, Tedeschi G, Tessitore A. Olfactory Loss and Brain Connectivity after COVID-19: Structural Follow-Up at One Year. Neural Plast 2023; 2023:6496539. [PMID: 37159825 PMCID: PMC10163964 DOI: 10.1155/2023/6496539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/17/2023] [Accepted: 04/23/2023] [Indexed: 05/11/2023] Open
Abstract
The structural connectivity from the primary olfactory cortex to the main secondary olfactory areas was previously reported as relatively increased in the medial orbitofrontal cortex in a cohort of 27 recently SARS-CoV-2-infected (COV+) subjects, of which 23/27 had clinically confirmed olfactory loss, compared to 18 control (COV-) normosmic subjects, who were not previously infected. To complement this finding, here we report the outcome of an identical high angular resolution diffusion MRI analysis on follow-up data sets collected in 18/27 COV+ subjects (10 males, mean age ± SD: 38.7 ± 8.1 years) and 10/18 COV- subjects (5 males, mean age ± SD: 33.1 ± 3.6 years) from the previous samples who repeated both the olfactory functional assessment and the MRI examination after ~1 year. By comparing the newly derived subgroups, we observed that the increase in the structural connectivity index of the medial orbitofrontal cortex was not significant at follow-up, despite 10/18 COV+ subjects were still found hyposmic after ~1 year from SARS-CoV-2 infection. We concluded that the relative hyperconnectivity of the olfactory cortex to the medial orbitofrontal cortex could be, at least in some cases, an acute or reversible phenomenon linked to the recent SARS-CoV-2 infection with associated olfactory loss.
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Affiliation(s)
- Fabrizio Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Napoli, Italy
| | - Mario Cirillo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Napoli, Italy
| | - Rosa De Micco
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Napoli, Italy
| | - Giuseppina Caiazzo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Napoli, Italy
| | - Mattia Siciliano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Napoli, Italy
| | - Andrea G. Russo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Napoli, Italy
| | - Caterina Monari
- Department of Mental and Physical Health and Public Medicine, University of Campania “Luigi Vanvitelli”, Largo Madonna Delle Grazie 1, 80138 Napoli, Italy
| | - Nicola Coppola
- Department of Mental and Physical Health and Public Medicine, University of Campania “Luigi Vanvitelli”, Largo Madonna Delle Grazie 1, 80138 Napoli, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Napoli, Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Napoli, Italy
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28
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Campabadal A, Oltra J, Junqué C, Guillen N, Botí MÁ, Sala‐Llonch R, Monté‐Rubio GC, Lledó G, Bargalló N, Rami L, Sánchez‐Valle R, Segura B. Structural brain changes in post-acute COVID-19 patients with persistent olfactory dysfunction. Ann Clin Transl Neurol 2022; 10:195-203. [PMID: 36525472 PMCID: PMC9878006 DOI: 10.1002/acn3.51710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE This research aims to study structural brain changes in patients with persistent olfactory dysfunctions after coronavirus disease 2019 (COVID-19). METHODS COVID-19 patients were evaluated using T1-weighted and diffusion tensor imaging (DTI) on a 3T MRI scanner, 9.94 ± 3.83 months after COVID-19 diagnosis. Gray matter (GM) voxel-based morphometry was performed using FSL-VBM. Voxelwise statistical analysis of the fractional anisotropy, mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity was carried out with the tract-based spatial statistics in the olfactory system. The smell identification test (UPSIT) was used to classify patients as normal olfaction or olfactory dysfunction groups. Intergroup comparisons between GM and DTI measures were computed, as well as correlations with the UPSIT scores. RESULTS Forty-eight COVID-19 patients were included in the study. Twenty-three were classified as olfactory dysfunction, and 25 as normal olfaction. The olfactory dysfunction group had lower GM volume in a cluster involving the left amygdala, insular cortex, parahippocampal gyrus, frontal superior and inferior orbital gyri, gyrus rectus, olfactory cortex, caudate, and putamen. This group also showed higher MD values in the genu of the corpus callosum, the orbitofrontal area, the anterior thalamic radiation, and the forceps minor; and higher RD values in the anterior corona radiata, the genu of the corpus callosum, and uncinate fasciculus compared with the normal olfaction group. The UPSIT scores for the whole sample were negatively associated with both MD and RD values (p-value ≤0.05 FWE-corrected). INTERPRETATION There is decreased GM volume and increased MD in olfactory-related regions explaining prolonged olfactory deficits in post-acute COVID-19 patients.
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Affiliation(s)
- Anna Campabadal
- Medical Psychology Unit, Department of Medicine, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain,Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaSpain
| | - Javier Oltra
- Medical Psychology Unit, Department of Medicine, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain,Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaSpain
| | - Carme Junqué
- Medical Psychology Unit, Department of Medicine, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain,Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaSpain
| | - Núria Guillen
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - María Ángeles Botí
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - Roser Sala‐Llonch
- Department of Biomedicine, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - Gemma C. Monté‐Rubio
- Medical Psychology Unit, Department of Medicine, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain,Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaSpain
| | - Gema Lledó
- Autoimmune Diseases ServiceHospital Clínic de BarcelonaBarcelonaSpain
| | - Nuria Bargalló
- Centre de Diagnòstic per la Imatge (CDI)Hospital Clínic de BarcelonaBarcelonaSpain
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - Raquel Sánchez‐Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - Bàrbara Segura
- Medical Psychology Unit, Department of Medicine, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain,Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaSpain
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29
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Thunell E, Peter MG, Lenoir V, Andersson P, Landis BN, Becker M, Lundström JN. Effects of COVID-19 on the Human Central Olfactory System: A Natural Pre-Post Experiment. AJNR Am J Neuroradiol 2022; 43:1777-1783. [PMID: 36423956 DOI: 10.3174/ajnr.a7713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 10/11/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Reduced olfactory function is the symptom with the highest prevalence in coronavirus disease 2019 (COVID-19) with nearly 70% of infected individuals experiencing partial or total loss of their sense of smell at some point during the disease. The exact cause is not known, but beyond peripheral damage, studies have demonstrated insults to both the olfactory bulb and central olfactory brain areas. However, these studies often lack both baseline pre-COVID-19 assessments and control groups, and the effects could, therefore, simply reflect pre-existing risk factors. MATERIALS AND METHODS Shortly before the COVID-19 outbreak, we completed an olfactory-focused study, which included structural MR brain images and a full clinical olfactory test. Opportunistically, we invited participants back 1 year later, including 9 participants who had experienced mild-to-moderate COVID-19 (C19+) and 12 who had not (C19-), creating a natural pre-post experiment with a control group. RESULTS Despite C19+ participants reporting subjective olfactory dysfunction, few showed signs of objectively altered function. Critically, all except 1 individual in the C19+ group had reduced olfactory bulb volume (average reduction, 14.3%), but this did not amount to a significant statistical difference compared with the control group (2.3%) using inference statistics. We found no morphologic differences in olfactory brain areas but stronger functional connectivity between olfactory brain areas in the C19+ group at the postmeasure. CONCLUSIONS Our data suggest that COVID-19 might cause long-term reduction in olfactory bulb volume and altered functional connectivity but with no discernible morphologic differences in cerebral olfactory regions.
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Affiliation(s)
- E Thunell
- From the Department of Clinical Neuroscience (E.T., M.G.P., J.N.L.), Karolinska Institutet, Stockholm, Sweden
| | - M G Peter
- From the Department of Clinical Neuroscience (E.T., M.G.P., J.N.L.), Karolinska Institutet, Stockholm, Sweden
| | - V Lenoir
- Diagnostic Department (V.L., M.B.), Division of Radiology
| | - P Andersson
- Stockholm University Brain Imaging Center (P.A., J.N.L.), Stockholm University, Stockholm, Sweden
| | - B N Landis
- Department of Otorhinolaryngology (B.N.L.), Rhinology-Olfactology Unit, Geneva University Hospital, Geneva, Switzerland
| | - M Becker
- Diagnostic Department (V.L., M.B.), Division of Radiology
| | - J N Lundström
- From the Department of Clinical Neuroscience (E.T., M.G.P., J.N.L.), Karolinska Institutet, Stockholm, Sweden .,Stockholm University Brain Imaging Center (P.A., J.N.L.), Stockholm University, Stockholm, Sweden.,Monell Chemical Senses Center (J.N.L.), Philadelphia, Pennsylvania
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30
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Song J, Xu J, Yuan W, Li R, Guo H, Gao H, Gu C, Feng W, Ma Y, Guo H, Sun Z, Zheng L. A potential biomarker of cognitive impairment: The olfactory dysfunction and its genes expression. Ann Clin Transl Neurol 2022; 9:1884-1897. [PMID: 36300915 PMCID: PMC9735362 DOI: 10.1002/acn3.51680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/09/2022] [Accepted: 10/01/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Accumulation evidence has reported that olfactory impairment may be an essential clinical marker and predictor of mild cognitive impairment or Alzheimer's disease. METHOD Participants were enrolled in the population-based, prospective study in Fuxin county, Liaoning province, China between 2019 and 2021. An inverse probability weighting logistic regression and mixed-effect models were performed to explore the association between dysosmia and cognition and rate of change in cognition, respectively. Besides, we utilized the Robust Rank Aggregation method to integrated three eligible datasets from the Gene Expression Omnibus to identify differential expressed genes. RESULTS A total of 4695 participants were enrolled and 4221 of those were eligible for our cross-sectional study. The mean (SD) age was 59.93(9.78) years, 64.8% were men. Over a 2-year follow-up, of the 2088 participants who completed follow-up, 1559 participants were eligible for our longitude cohort study. We observed an association between dysosmia and an increased risk of cognitive impairment (OR, 0.47, [95% CI, 0.35-0.64]; p < 0.001). The OR (95% CI) for cognition in females with dysosmia was higher than (OR, 0.73[0.51, 1.05], p = .007) that for males with dysosmia (OR, 0.25[0.15, 0.42], p < 0.001; P for interaction <0.001). Dysosmia was also associated with more rapid decline in calculation ability (p < 0.001). Besides, several DEGs were identified, which are mainly associated with olfactory transduction, detection of chemical stimulus involved in sensory perception of smell, sensory perception of smell, olfactory receptor activity and odorant binding. INTERPRETATION These findings proved novel insight into identifying olfactory dysfunction as potential biomarker for diagnosis of cognitive impairment.
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Affiliation(s)
- Jiayi Song
- School of Public HealthChina Medical UniversityShenyang110122China,Ministry of Education‐Shanghai Key Laboratory of Children's Environmental Health, School of Public HealthShanghai Jiao Tong University School of MedicineShanghai200025China
| | - Jiahui Xu
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Wei Yuan
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Ruixue Li
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Hui Guo
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Hanshu Gao
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Cuiying Gu
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Wenjing Feng
- School of Public HealthChina Medical UniversityShenyang110122China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public HealthChina Medical UniversityNo.77 Puhe RoadShenyangLiaoning Province110122China,Institute of Health Sciences, China Medical UniversityNo.77 Puhe RoadShenyangLiaoning Province110122China
| | - Haiqiang Guo
- Department of Health StatisticsChina Medical UniversityShenyang110122China
| | - Zhaoqing Sun
- Department of CardiologyShengjing Hospital of China Medical UniversityShenyang110004P. R. China
| | - Liqiang Zheng
- Ministry of Education‐Shanghai Key Laboratory of Children's Environmental Health, School of Public HealthShanghai Jiao Tong University School of MedicineShanghai200025China
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31
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Van Regemorter V, Rombaux P, Dricot L, Kupers R, Grégoire A, Hox V, Huart C. Functional Imaging in Olfactory Disorders. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022; 10:421-426. [PMID: 36276577 PMCID: PMC9579609 DOI: 10.1007/s40136-022-00433-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/06/2022]
Abstract
Purpose of Review The aim was to synthesize key findings regarding the use of functional MRI (fMRI) to assess olfactory dysfunction (OD), and thus, to evaluate whether fMRI could be a reliable clinical diagnostic tool. Recent Findings In response to olfactory stimulation, patients with quantitative OD display reduced activation in olfactory-related brain regions but also stronger activation in non-olfactory brain areas. Parosmic patients also seem to show both weaker and higher brain signals. As to trigeminal chemosensory system, fMRI suggests that central processing may be declined in patients with OD. Functional connectivity studies report a possible correlation between altered neuronal connections within brain networks and olfactory performances. Summary fMRI emerges as a valuable and promising objective method in OD evaluation. Yet, its high inter-individual variability still precludes its routine clinical use for diagnostic purpose. Future research should focus on optimizing stimulation paradigms and analysis methods.
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Affiliation(s)
- V. Van Regemorter
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Ph. Rombaux
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - L. Dricot
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - R. Kupers
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- School of Optometry, University of Montreal, Montreal, QC Canada
- BRAINlab, University of Copenhagen, Copenhagen, Denmark
| | - A. Grégoire
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - V. Hox
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - C. Huart
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium
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32
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Effects of hyperbaric oxygen therapy on functional and structural connectivity in post-COVID-19 condition patients: A randomized, sham-controlled trial. Neuroimage Clin 2022; 36:103218. [PMID: 36208548 PMCID: PMC9528018 DOI: 10.1016/j.nicl.2022.103218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Post-COVID-19 condition refers to a range of persisting physical, neurocognitive, and neuropsychological symptoms after SARS-CoV-2 infection. Abnormalities in brain connectivity were found in recovered patients compared to non-infected controls. This study aims to evaluate the effect of hyperbaric oxygen therapy (HBOT) on brain connectivity in post-COVID-19 patients. METHODS In this randomized, sham-controlled, double-blind trial, 73 patients were randomized to receive 40 daily sessions of HBOT (n = 37) or sham treatment (n = 36). We examined pre- and post-treatment resting-state brain functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) scans to evaluate functional and structural connectivity changes, which were correlated to cognitive and psychological distress measures. RESULTS The ROI-to-ROI analysis revealed decreased internetwork connectivity in the HBOT group which was negatively correlated to improvements in attention and executive function scores (p < 0.001). Significant group-by-time interactions were demonstrated in the right hippocampal resting state function connectivity (rsFC) in the medial prefrontal cortex (PFWE = 0.002). Seed-to-voxel analysis also revealed a negative correlation in the brief symptom inventory (BSI-18) score and in the rsFC between the amygdala seed, the angular gyrus, and the primary sensory motor area (PFWE = 0.012, 0.002). Positive correlations were found between the BSI-18 score and the left insular cortex seed and FPN (angular gyrus) (PFWE < 0.0001). Tractography based structural connectivity analysis showed a significant group-by-time interaction in the fractional anisotropy (FA) of left amygdala tracts (F = 7.81, P = 0.007). The efficacy measure had significant group-by-time interactions (F = 5.98, p = 0.017) in the amygdala circuit. CONCLUSIONS This study indicates that HBOT improves disruptions in white matter tracts and alters the functional connectivity organization of neural pathways attributed to cognitive and emotional recovery in post-COVID-19 patients. This study also highlights the potential of structural and functional connectivity analysis as a promising treatment response monitoring tool.
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Fiorentino J, Payne M, Cancian E, Plonka A, Dumas LÉ, Chirio D, Demonchy É, Risso K, Askenazy-Gittard F, Guevara N, Castillo L, Robert P, Manera V, Vandersteen C, Gros A. Correlations between Persistent Olfactory and Semantic Memory Disorders after SARS-CoV-2 Infection. Brain Sci 2022; 12:brainsci12060714. [PMID: 35741601 PMCID: PMC9221020 DOI: 10.3390/brainsci12060714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/20/2022] [Accepted: 05/27/2022] [Indexed: 12/11/2022] Open
Abstract
Background: One of the main symptoms of COVID-19 is hyposmia or even anosmia. Olfactory identification is most often affected. In addition, some cognitive disorders tend to appear following the infection, particularly regarding executive functions, attention, and memory. Olfaction, and especially olfactory identification, is related to semantic memory which manages general knowledge about the world. The main objective of this study was to determine whether semantic memory is impaired in case of persistent post COVID-19 olfactory disorders. Methods: 84 patients (average age of 42.8 ± 13.6 years) with post COVID-19 olfactory loss were included after consulting to the ENT department. The clinical evaluation was carried out with the Pyramid and Palm Tree Test, the word-retrieval task from the Grémots, the Sniffin’ Sticks Test and the Computerised Olfactory Test for the Diagnosis of Alzheimer’s Disease. Results: Semantic memory was impaired in 20% (n = 17) of patients, especially in the 19–39 age-group. The olfactory threshold was only significantly correlated with the semantic memory scores. Conclusions: Similar to all cognitive disorders, semantic disorders can have a negative impact on quality of life if left untreated. It is essential to carry out specific assessments of post COVID-19 patients to accurately determine their disorders and to put in place the best possible rehabilitation, such as speech and language therapy, to avoid quality-of-life impairment.
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Affiliation(s)
- Julie Fiorentino
- Département d’Orthophonie de Nice, Faculté de Médecine de Nice, 06107 Nice, France; (M.P.); (A.P.); (P.R.); (V.M.); (A.G.)
- Laboratoire CoBTeK, Institut Claude Pompidou, Université Côte d’Azur, 06100 Nice, France; (L.-É.D.); (F.A.-G.); (C.V.)
- Correspondence: ; Tel.: +33-674217791
| | - Magali Payne
- Département d’Orthophonie de Nice, Faculté de Médecine de Nice, 06107 Nice, France; (M.P.); (A.P.); (P.R.); (V.M.); (A.G.)
- Laboratoire CoBTeK, Institut Claude Pompidou, Université Côte d’Azur, 06100 Nice, France; (L.-É.D.); (F.A.-G.); (C.V.)
| | - Elisa Cancian
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 06100 Nice, France;
| | - Alexandra Plonka
- Département d’Orthophonie de Nice, Faculté de Médecine de Nice, 06107 Nice, France; (M.P.); (A.P.); (P.R.); (V.M.); (A.G.)
- Laboratoire CoBTeK, Institut Claude Pompidou, Université Côte d’Azur, 06100 Nice, France; (L.-É.D.); (F.A.-G.); (C.V.)
- Institut NeuroMod, Université Côté d’Azur, 06902 Sophia-Antipolis, France; (N.G.); (L.C.)
| | - Louise-Émilie Dumas
- Laboratoire CoBTeK, Institut Claude Pompidou, Université Côte d’Azur, 06100 Nice, France; (L.-É.D.); (F.A.-G.); (C.V.)
- Hôpitaux Pédiatriques de Nice CHU-LENVAL, 57 Avenue de la Californie, Centre Hospitalier Universitaire, Université Côte d’Azur, 06200 Nice, France
| | - David Chirio
- Département de Médecine Infectiologique, Hôpital de l’Archet, 151 Route de Saint-Antoine, Centre Hospitalier Universitaire, Université Côte d’Azur, 06200 Nice, France; (D.C.); (É.D.); (K.R.)
| | - Élisa Demonchy
- Département de Médecine Infectiologique, Hôpital de l’Archet, 151 Route de Saint-Antoine, Centre Hospitalier Universitaire, Université Côte d’Azur, 06200 Nice, France; (D.C.); (É.D.); (K.R.)
| | - Karine Risso
- Département de Médecine Infectiologique, Hôpital de l’Archet, 151 Route de Saint-Antoine, Centre Hospitalier Universitaire, Université Côte d’Azur, 06200 Nice, France; (D.C.); (É.D.); (K.R.)
| | - Florence Askenazy-Gittard
- Laboratoire CoBTeK, Institut Claude Pompidou, Université Côte d’Azur, 06100 Nice, France; (L.-É.D.); (F.A.-G.); (C.V.)
- Hôpitaux Pédiatriques de Nice CHU-LENVAL, 57 Avenue de la Californie, Centre Hospitalier Universitaire, Université Côte d’Azur, 06200 Nice, France
| | - Nicolas Guevara
- Institut NeuroMod, Université Côté d’Azur, 06902 Sophia-Antipolis, France; (N.G.); (L.C.)
| | - Laurent Castillo
- Institut NeuroMod, Université Côté d’Azur, 06902 Sophia-Antipolis, France; (N.G.); (L.C.)
| | - Philippe Robert
- Département d’Orthophonie de Nice, Faculté de Médecine de Nice, 06107 Nice, France; (M.P.); (A.P.); (P.R.); (V.M.); (A.G.)
- Laboratoire CoBTeK, Institut Claude Pompidou, Université Côte d’Azur, 06100 Nice, France; (L.-É.D.); (F.A.-G.); (C.V.)
| | - Valeria Manera
- Département d’Orthophonie de Nice, Faculté de Médecine de Nice, 06107 Nice, France; (M.P.); (A.P.); (P.R.); (V.M.); (A.G.)
- Laboratoire CoBTeK, Institut Claude Pompidou, Université Côte d’Azur, 06100 Nice, France; (L.-É.D.); (F.A.-G.); (C.V.)
| | - Clair Vandersteen
- Laboratoire CoBTeK, Institut Claude Pompidou, Université Côte d’Azur, 06100 Nice, France; (L.-É.D.); (F.A.-G.); (C.V.)
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 06100 Nice, France;
| | - Auriane Gros
- Département d’Orthophonie de Nice, Faculté de Médecine de Nice, 06107 Nice, France; (M.P.); (A.P.); (P.R.); (V.M.); (A.G.)
- Laboratoire CoBTeK, Institut Claude Pompidou, Université Côte d’Azur, 06100 Nice, France; (L.-É.D.); (F.A.-G.); (C.V.)
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Veldhuizen MG, Cecchetto C, Fjaeldstad AW, Farruggia MC, Hartig R, Nakamura Y, Pellegrino R, Yeung AWK, Fischmeister FPS. Future Directions for Chemosensory Connectomes: Best Practices and Specific Challenges. Front Syst Neurosci 2022; 16:885304. [PMID: 35707745 PMCID: PMC9190244 DOI: 10.3389/fnsys.2022.885304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/13/2022] [Indexed: 01/14/2023] Open
Abstract
Ecological chemosensory stimuli almost always evoke responses in more than one sensory system. Moreover, any sensory processing takes place along a hierarchy of brain regions. So far, the field of chemosensory neuroimaging is dominated by studies that examine the role of brain regions in isolation. However, to completely understand neural processing of chemosensation, we must also examine interactions between regions. In general, the use of connectivity methods has increased in the neuroimaging field, providing important insights to physical sensory processing, such as vision, audition, and touch. A similar trend has been observed in chemosensory neuroimaging, however, these established techniques have largely not been rigorously applied to imaging studies on the chemical senses, leaving network insights overlooked. In this article, we first highlight some recent work in chemosensory connectomics and we summarize different connectomics techniques. Then, we outline specific challenges for chemosensory connectome neuroimaging studies. Finally, we review best practices from the general connectomics and neuroimaging fields. We recommend future studies to develop or use the following methods we perceive as key to improve chemosensory connectomics: (1) optimized study designs, (2) reporting guidelines, (3) consensus on brain parcellations, (4) consortium research, and (5) data sharing.
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Affiliation(s)
- Maria G. Veldhuizen
- Department of Anatomy, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Cinzia Cecchetto
- Department of General Psychology, University of Padova, Padua, Italy
| | - Alexander W. Fjaeldstad
- Flavour Clinic, Department of Otorhinolaryngology, Regional Hospital West Jutland, Holstebro, Denmark
| | - Michael C. Farruggia
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, United States
| | - Renée Hartig
- Department of Psychiatry and Psychotherapy, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany,Max Planck Institute for Biological Cybernetics, Tübingen, Germany,Functional and Comparative Neuroanatomy Laboratory, Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Yuko Nakamura
- The Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | | | - Andy W. K. Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Florian Ph. S. Fischmeister
- Institute of Psychology, University of Graz, Graz, Austria,Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria,BioTechMed-Graz, Graz, Austria,*Correspondence: Florian Ph. S. Fischmeister,
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35
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Yus M, Matias‐Guiu JA, Gil‐Martínez L, Gómez‐Ruiz N, Polidura C, Jorquera M, Delgado‐Alonso C, Díez‐Cirarda M, Matías‐Guiu J, Arrazola J. Persistent olfactory dysfunction after COVID-19 is associated with reduced perfusion in the frontal lobe. Acta Neurol Scand 2022; 146:194-198. [PMID: 35467007 PMCID: PMC9111206 DOI: 10.1111/ane.13627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/06/2022] [Accepted: 04/18/2022] [Indexed: 12/24/2022]
Abstract
Background Olfactory dysfunction is common during SARS‐CoV‐2 infection. The pathophysiology of the persistence of this symptom and the potential relationship with central nervous system involvement is unknown. Aim of the study To evaluate the neural correlates of persistent olfactory dysfunction in a series of patients with post‐COVID syndrome. Methods Eighty‐two patients with post‐COVID syndrome were assessed with the Brief Smell Identification Test and a multimodal MRI study including 3D‐T1, T2‐FLAIR, diffusion‐tensor imaging, and arterial spin labeling. Olfactory and neuroimaging examinations were performed 11.18 ± 3.78 months after the acute infection. Voxel‐based brain mapping analyses were conducted to correlate the olfactory test with brain volumes, white matter microstructure, and brain perfusion. Results Olfactory dysfunction was associated with lower tissue perfusion in the orbital and medial frontal regions in the arterial spin labeling sequence. Conversely, no statistically significant findings were detected in brain volumes and diffusion‐tensor imaging. Mild changes in paranasal sinuses and nasal cavities were detected in 9.75% of cases, with no association with olfactory deficits. Conclusions We provide new insights regarding the pathophysiology of persistent olfactory dysfunction after COVID‐19, involving the main brain regions associated with the olfactory system.
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Affiliation(s)
- Miguel Yus
- Department of Radiology Clínico San Carlos Health Research Institute “San Carlos” (IdISSC) Universidad Complutense de Madrid Madrid Spain
| | - Jordi A. Matias‐Guiu
- Department of Neurology Hospital Clínico San Carlos Health Research Institute “San Carlos” (IdISSC) Universidad Complutense de Madrid Madrid Spain
| | - Lidia Gil‐Martínez
- Department of Radiology Clínico San Carlos Health Research Institute “San Carlos” (IdISSC) Universidad Complutense de Madrid Madrid Spain
| | - Natividad Gómez‐Ruiz
- Department of Radiology Clínico San Carlos Health Research Institute “San Carlos” (IdISSC) Universidad Complutense de Madrid Madrid Spain
| | - Carmen Polidura
- Department of Radiology Clínico San Carlos Health Research Institute “San Carlos” (IdISSC) Universidad Complutense de Madrid Madrid Spain
| | - Manuela Jorquera
- Department of Radiology Clínico San Carlos Health Research Institute “San Carlos” (IdISSC) Universidad Complutense de Madrid Madrid Spain
| | - Cristina Delgado‐Alonso
- Department of Neurology Hospital Clínico San Carlos Health Research Institute “San Carlos” (IdISSC) Universidad Complutense de Madrid Madrid Spain
| | - María Díez‐Cirarda
- Department of Neurology Hospital Clínico San Carlos Health Research Institute “San Carlos” (IdISSC) Universidad Complutense de Madrid Madrid Spain
| | - Jorge Matías‐Guiu
- Department of Neurology Hospital Clínico San Carlos Health Research Institute “San Carlos” (IdISSC) Universidad Complutense de Madrid Madrid Spain
| | - Juan Arrazola
- Department of Radiology Clínico San Carlos Health Research Institute “San Carlos” (IdISSC) Universidad Complutense de Madrid Madrid Spain
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Changes in the Intranetwork and Internetwork Connectivity of the Default Mode Network and Olfactory Network in Patients with COVID-19 and Olfactory Dysfunction. Brain Sci 2022; 12:brainsci12040511. [PMID: 35448042 PMCID: PMC9029634 DOI: 10.3390/brainsci12040511] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 12/21/2022] Open
Abstract
Olfactory dysfunction (OD) is a common symptom in coronavirus disease 2019 (COVID-19) patients. Moreover, many neurological manifestations have been reported in these patients, suggesting central nervous system involvement. The default mode network (DMN) is closely associated with olfactory processing. In this study, we investigated the internetwork and intranetwork connectivity of the DMN and the olfactory network (ON) in 13 healthy controls and 22 patients presenting with COVID-19-related OD using independent component analysis and region of interest functional magnetic resonance imaging (fMRI) analysis. There was a significant correlation between the butanol threshold test (BTT) and the intranetwork connectivity in ON. Meanwhile, the COVID-19 patients with OD showed significantly higher intranetwork connectivity in the DMN, as well as higher internetwork connectivity between ON and DMN. However, no significant difference was found between groups in the intranetwork connectivity within ON. We postulate that higher intranetwork functional connectivities compensate for the deficits in olfactory processing and general well-being in COVID-19 patients. Nevertheless, the compensation process in the ON may not be obvious at this stage. Our results suggest that resting-state fMRI is a potentially valuable tool to evaluate neurosensory dysfunction in COVID-19 patients.
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Ziuzia-Januszewska L, Januszewski M. Pathogenesis of Olfactory Disorders in COVID-19. Brain Sci 2022; 12:brainsci12040449. [PMID: 35447981 PMCID: PMC9029941 DOI: 10.3390/brainsci12040449] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/09/2022] [Accepted: 03/23/2022] [Indexed: 12/11/2022] Open
Abstract
Since the outbreak of the SARS-CoV-2 pandemic, olfactory disorders have been reported as a frequent symptom of COVID-19; however, its pathogenesis is still debated. The aim of this review is to summarize the current understanding of the pathogenesis of smell impairment in the course of COVID-19 and to highlight potential avenues for future research on this issue. Several theories have been proposed to explain the pathogenesis of COVID-19-related anosmia, including nasal obstruction and rhinorrhea, oedema of the olfactory cleft mucosa, olfactory epithelial damage either within the olfactory receptor cells or the supporting non-neural cells (either direct or immune-mediated), damage to the olfactory bulb, and impairment of the central olfactory pathways. Although the pathogenesis of COVID-19-related anosmia is still not fully elucidated, it appears to be mainly due to sensorineural damage, with infection of the olfactory epithelium support cells via the ACE1 receptor and disruption of the OE caused by immense inflammatory reaction, and possibly with direct olfactory sensory neurons infection mediated by the NRP-1 receptor. Involvement of the higher olfactory pathways and a conductive component of olfactory disorders, as well as genetic factors, may also be considered.
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Affiliation(s)
- Laura Ziuzia-Januszewska
- Department of Otolaryngology, Central Clinical Hospital, Ministry of Interior and Administration, 02-507 Warsaw, Poland
- Correspondence: or ; Tel.: +48-477221182
| | - Marcin Januszewski
- Department of Obstetrics and Gynecology, Central Clinical Hospital, Ministry of Interior and Administration, 02-507 Warsaw, Poland;
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