Structural brain changes in patients with post-COVID fatigue: a prospective observational study.
Josephine Heine1, Katia Schwichtenberg1, Tim J Hartung1
1Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Eclinicalmedicine
|March 6, 2023
Summary
Post-COVID syndrome causes brain changes in the thalamus and basal ganglia, leading to persistent fatigue. These structural alterations correlate with fatigue severity and cognitive issues in patients.
Area of Science:
- Neuroimaging
- Neurology
- Post-COVID Conditions
Background:
- Post-COVID syndrome presents significant long-term complications, with fatigue and cognitive issues being prominent.
- The underlying structural brain changes associated with these symptoms remain largely unclear.
Purpose of the Study:
- To explore clinical characteristics of post-COVID fatigue.
- To identify structural brain imaging changes linked to fatigue.
- To determine factors influencing fatigue severity in post-COVID syndrome.
Main Methods:
- Prospective recruitment of 50 post-COVID syndrome patients and 47 matched healthy controls.
- Utilized diffusion and volumetric MRI, neuropsychiatric, and cognitive testing.
- Included 47 multiple sclerosis patients with fatigue as a clinical control group.
Main Results:
- Aberrant thalamic fractional anisotropy and shape/volume reductions in the left thalamus, putamen, and pallidum were observed.
- Diffusion markers correlated with fatigue severity, daily impairment, and sleepiness.
- Subcortical changes overlapped with those in multiple sclerosis and were linked to impaired short-term memory.
Conclusions:
- Structural changes in the thalamus and basal ganglia are characteristic of persistent fatigue in post-COVID syndrome.
- These subcortical alterations provide insight into post-COVID fatigue and associated neuropsychiatric complications.
