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Macro- and Microstructural White Matter Differences in Neurologic Postacute Sequelae of SARS-CoV-2 Infection
Erin E O'Connor1, Rosangela Salerno-Goncalves2, Nikita Rednam3
1From the Department of Diagnostic Radiology & Nuclear Medicine (E.E.O., N.R., T.A.Z.), University of Maryland School of Medicine, Baltimore, Maryland erin.oconnor@umm.edu.
Neurologic postacute sequelae of SARS-CoV-2 infection (NeuroPASC) is linked to white matter (WM) changes and cognitive deficits. This study found increased WM volume and neuroinflammation markers in NeuroPASC patients, suggesting immune dysregulation impacts brain structure and function.
Area of Science:
- Neuroscience
- Immunology
- Radiology
Background:
- Neuropsychiatric complications of SARS-CoV-2 infection (NeuroPASC) affect a significant portion of infected individuals.
- Evidence suggests NeuroPASC involves immune dysregulation impacting the brain, with behavioral changes indicating widespread white matter (WM) involvement.
Purpose of the Study:
- To investigate macrostructural and microstructural WM differences in NeuroPASC participants.
- To correlate WM changes with cognitive function and peripheral immune markers.
Main Methods:
- A cross-sectional study enrolled 72 participants (31 NeuroPASC, 41 asymptomatic controls).
- Assessments included clinical questionnaires, psychometric tests, brain MRI (WM volume, microstructure), and peripheral cytokine levels.
- Multivariable regression analyses were used to compare groups.
Main Results:
- NeuroPASC participants showed larger cerebral WM volume and higher WM mean kurtosis, indicating neuroinflammation.
- Cognitive impairments in attention, concentration, verbal learning, and processing speed were observed in the NeuroPASC group.
- Elevated interferon (IFN)-λ1 and IFN-λ2/3 levels were found in NeuroPASC participants.
Conclusions:
- NeuroPASC is associated with WM syndrome, characterized by increased WM volume and neuroinflammation.
- These WM changes correlate with cognitive deficits and headaches in NeuroPASC patients.
- Immune dysregulation is implicated in the observed WM alterations and cognitive effects.
