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Shahsavar P, Ghazvineh S, Raoufy MR. From nasal respiration to brain dynamic. Rev Neurosci 2024; 35:639-650. [PMID: 38579456 DOI: 10.1515/revneuro-2023-0152] [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: 12/11/2023] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Abstract
While breathing is a vital, involuntary physiological function, the mode of respiration, particularly nasal breathing, exerts a profound influence on brain activity and cognitive processes. This review synthesizes existing research on the interactions between nasal respiration and the entrainment of oscillations across brain regions involved in cognition. The rhythmic activation of olfactory sensory neurons during nasal respiration is linked to oscillations in widespread brain regions, including the prefrontal cortex, entorhinal cortex, hippocampus, amygdala, and parietal cortex, as well as the piriform cortex. The phase-locking of neural oscillations to the respiratory cycle, through nasal breathing, enhances brain inter-regional communication and is associated with cognitive abilities like memory. Understanding the nasal breathing impact on brain networks offers opportunities to explore novel methods for targeting the olfactory pathway as a means to enhance emotional and cognitive functions.
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Affiliation(s)
- Payam Shahsavar
- Department of Physiology, Faculty of Medical Sciences, 41616 Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
| | - Sepideh Ghazvineh
- Department of Physiology, Faculty of Medical Sciences, 41616 Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
| | - Mohammad Reza Raoufy
- Department of Physiology, Faculty of Medical Sciences, 41616 Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
- Faculty of Medical Sciences, 41616 Institute for Brain Sciences and Cognition, Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
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Sun D, Shi Z, Chen H, Du Q, Zhang Y, Wang R, Kong L, Luo W, Lang Y, Wang X, Zhou H. COVID-19 susceptibility, hospitalization and severity and the risk of brain cortical structure: a Mendelian randomization study. QJM 2024; 117:413-421. [PMID: 38195890 DOI: 10.1093/qjmed/hcad291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/18/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Observational studies have reported structural changes in the brains of patients with coronavirus disease 2019 (COVID-19); it remains unclear whether these associations are causal. AIM We evaluated the causal effects of COVID-19 susceptibility, hospitalization and severity on cortical structures. DESIGN Mendelian randomization (MR) study. METHODS Data on the different COVID-19 phenotypes were obtained from the latest large-scale genome-wide association study (R7) of the COVID-19 Host Genetics Initiative. Brain structure data, including cortical thickness (TH) and surface area (SA), were obtained from the ENIGMA Consortium. Additionally, we employed the round 5 dataset released in January 2021 as the validation cohort. The inverse-variance weighted (IVW) method was used as the primary analysis in MR. Sensitivity analyses were conducted to evaluate heterogeneity and pleiotropy. We performed enrichment analysis on the MR analyses that passed the sensitivity analysis filtering. RESULTS After IVW and sensitivity analyses, we observed causal associations between COVID-19 susceptibility and rostral middle frontal SAw (P = 0.0308, β = -39.1236), cuneus THw (P = 0.0170, β = -0.0121), medial orbitofrontal THw (P = 0.0002, β = 0.0225), postcentral THw (P = 0.0217, β = -0.0106), temporal pole THw (P = 0.0077, β = 0.0359), medial orbitofrontal SAnw (P = 0.0106, β = -24.0397), medial orbitofrontal THnw (P = 0.0007, β = 0.0232), paracentral SAnw (P = 0.0483, β = -20.1442), rostral middle frontal SAnw (P = 0.0368, β = -81.9719) and temporal pole THnw (P = 0.0429, β = 0.0353). COVID-19 hospitalization had causal effects on medial orbitofrontal THw (P = 0.0053, β = 0.0063), postcentral THw (P = 0.0143, β = -0.0042), entorhinal THnw (P = 0.0142, β = 0.0142), medial orbitofrontal THnw (P = 0.0147, β = 0.0065) and paracentral SAnw (P = 0.0119, β = -7.9970). COVID-19 severity had causal effects on rostral middle frontal SAw (P = 0.0122, β = -11.8296), medial orbitofrontal THw (P = 0.0155, β = 0.0038), superior parietal THw (P = 0.0291, β = -0.0021), lingual SAnw (P = 0.0202, β = -11.5270), medial orbitofrontal THnw (P = 0.0290, β = 0.0039), paracentral SAnw (P = 0.0180, β = -5.7744) and pars triangularis SAnw (P = 0.0151, β = -5.4520). CONCLUSION Our MR results demonstrate a causal relationship between different COVID-19 phenotypes and cortical structures.
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Affiliation(s)
- D Sun
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Z Shi
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - H Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Q Du
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Y Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - R Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - L Kong
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - W Luo
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Y Lang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - X Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - H Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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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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Vandersteen C, Plonka A, Manera V, Sawchuk K, Lafontaine C, Galery K, Rouaud O, Bengaied N, Launay C, Guérin O, Robert P, Allali G, Beauchet O, Gros A. Alzheimer's early detection in post-acute COVID-19 syndrome: a systematic review and expert consensus on preclinical assessments. Front Aging Neurosci 2023; 15:1206123. [PMID: 37416323 PMCID: PMC10320294 DOI: 10.3389/fnagi.2023.1206123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/31/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction The risk of developing Alzheimer's disease (AD) in older adults increasingly is being discussed in the literature on Post-Acute COVID-19 Syndrome (PACS). Remote digital Assessments for Preclinical AD (RAPAs) are becoming more important in screening for early AD, and should always be available for PACS patients, especially for patients at risk of AD. This systematic review examines the potential for using RAPA to identify impairments in PACS patients, scrutinizes the supporting evidence, and describes the recommendations of experts regarding their use. Methods We conducted a thorough search using the PubMed and Embase databases. Systematic reviews (with or without meta-analysis), narrative reviews, and observational studies that assessed patients with PACS on specific RAPAs were included. The RAPAs that were identified looked for impairments in olfactory, eye-tracking, graphical, speech and language, central auditory, or spatial navigation abilities. The recommendations' final grades were determined by evaluating the strength of the evidence and by having a consensus discussion about the results of the Delphi rounds among an international Delphi consensus panel called IMPACT, sponsored by the French National Research Agency. The consensus panel included 11 international experts from France, Switzerland, and Canada. Results Based on the available evidence, olfaction is the most long-lasting impairment found in PACS patients. However, while olfaction is the most prevalent impairment, expert consensus statements recommend that AD olfactory screening should not be used on patients with a history of PACS at this point in time. Experts recommend that olfactory screenings can only be recommended once those under study have reported full recovery. This is particularly important for the deployment of the olfactory identification subdimension. The expert assessment that more long-term studies are needed after a period of full recovery, suggests that this consensus statement requires an update in a few years. Conclusion Based on available evidence, olfaction could be long-lasting in PACS patients. However, according to expert consensus statements, AD olfactory screening is not recommended for patients with a history of PACS until complete recovery has been confirmed in the literature, particularly for the identification sub-dimension. This consensus statement may require an update in a few years.
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Affiliation(s)
- Clair Vandersteen
- Institut Universitaire de la Face et du Cou, ENT Department, Centre Hospitalier Universitaire, Nice, France
- Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
| | - Alexandra Plonka
- Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
- Département d'Orthophonie, UFR Médecine, Université Côte d'Azur, Nice, France
- Institut NeuroMod, Université Côte d'Azur, Sophia Antipolis, France
| | - Valeria Manera
- Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
- Département d'Orthophonie, UFR Médecine, Université Côte d'Azur, Nice, France
- Institut NeuroMod, Université Côte d'Azur, Sophia Antipolis, France
| | - Kim Sawchuk
- ACTLab, engAGE: Centre for Research on Aging, Concordia University Montreal, Montreal, QC, Canada
| | - Constance Lafontaine
- ACTLab, engAGE: Centre for Research on Aging, Concordia University Montreal, Montreal, QC, Canada
| | - Kevin Galery
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
| | - Olivier Rouaud
- Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nouha Bengaied
- Federation of Quebec Alzheimer Societies, Montreal, QC, Canada
| | - Cyrille Launay
- Mc Gill University Jewish General Hospital, Montreal, QC, Canada
| | - Olivier Guérin
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
- Université Côte d'Azur, CNRS UMR 7284/INSERM U108, Institute for Research on Cancer and Aging Nice, UFR de Médecine, Nice, France
| | - Philippe Robert
- Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
- Département d'Orthophonie, UFR Médecine, Université Côte d'Azur, Nice, France
| | - Gilles Allali
- Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Olivier Beauchet
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
- Mc Gill University Jewish General Hospital, Montreal, QC, Canada
- Departments of Medicine and Geriatric, University of Montreal, Montreal, QC, Canada
| | - Auriane Gros
- Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
- Département d'Orthophonie, UFR Médecine, Université Côte d'Azur, Nice, France
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De Luca P, Camaioni A, Marra P, Salzano G, Carriere G, Ricciardi L, Pucci R, Montemurro N, Brenner MJ, Di Stadio A. Effect of Ultra-Micronized Palmitoylethanolamide and Luteolin on Olfaction and Memory in Patients with Long COVID: Results of a Longitudinal Study. Cells 2022; 11:cells11162552. [PMID: 36010630 PMCID: PMC9406356 DOI: 10.3390/cells11162552] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022] Open
Abstract
In this study, we investigated whether treatment with palmitoylethanolamide and luteolin (PEA-LUT) leads to improvement in the quantitative or qualitative measures of olfactory dysfunction or relief from mental clouding in patients affected by long COVID. Patients with long COVID olfactory dysfunction were allocated to different groups based on the presence (“previously treated”) or absence (“naïve”) of prior exposure to olfactory training. Patients were then randomized to receive PEA-LUT alone or in combination with olfactory training. Olfactory function and memory were assessed at monthly intervals using self-report measures and quantitative thresholds. A total of 69 patients (43 women, 26 men) with an age average of 40.6 + 10.5 were recruited. PEA-LUT therapy was associated with a significant improvement in validated odor identification scores at the baseline versus each subsequent month; assessment at 3 months showed an average improvement of 10.7 + 2.6, CI 95%: 6–14 (p < 0.0001). The overall prevalence of parosmia was 79.7% (55 patients), with a significant improvement from the baseline to 3 months (p < 0.0001), namely in 31 patients from the Naïve 1 group (72%), 15 from the Naïve 2 group (93.7%), and 9 from the remaining group (90%). Overall, mental clouding was detected in 37.7% (26 subjects) of the cases, with a reduction in severity from the baseline to three months (p = 0.02), namely in 15 patients from the Naïve 1 group (34.8%), 7 from the Naïve 2 group (43.7%), and 4 from the remaining group (40%). Conclusions. In patients with long COVID and chronic olfactory loss, a regimen including oral PEA-LUT and olfactory training ameliorated olfactory dysfunction and memory. Further investigations are necessary to discern biomarkers, mechanisms, and long-term outcomes.
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Affiliation(s)
- Pietro De Luca
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy
- Otolaryngology Department, San Giovanni-Addolorata Hospital, 00184 Rome, Italy
| | - Angelo Camaioni
- Otolaryngology Department, San Giovanni-Addolorata Hospital, 00184 Rome, Italy
| | - Pasquale Marra
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy
| | - Giovanni Salzano
- ENT and Maxillofacial Surgery Unit, Istituto Tumori G. Pascale of Naples, 80131 Naples, Italy
| | | | - Luca Ricciardi
- Division of Neurosurgery, Sant’Andrea Hospital, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
| | - Resi Pucci
- Oral and Maxillofacial, San Camillo Hospital, 00152 Rome, Italy
- Department of Oral and Maxillofacial Science, Sapienza University of Rome, 00185 Rome, Italy
| | - Nicola Montemurro
- Department of Neurosurgery, Pisana University Hospital, University of Pisa, 56124 Pisa, Italy
| | - Michael J. Brenner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Arianna Di Stadio
- Department of GF Ingrassia, Via di Santa Sofia 87, University of Catania, 95123 Catania, Italy
- Neuroinflammation Lab, UCL Queen Square Neurology, London WC1N 1PJ, UK
- Correspondence:
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