Distinguished multimodal imaging features affected by COVID-19 in major depressive disorder patients

Growing attention has been directed toward the structural and functional alterations among individuals infected with COVID-19. However, data on its impact on patients with Major Depressive Disorder (MDD) remain limited.

This study investigates the effects of COVID-19 on patients with MDD and healthy controls (HCs) using MRI scans. Participants were categorized into four groups: MDD patients before (n = 165) and after COVID-19 infection (n = 70), HCs before (n = 108) and after COVID-19 infection (n = 57). All participants underwent T1-weighted imaging, diffusion tensor imaging (DTI), and resting-state functional MRI from January 2022 to August 2023.

Structural alterations associated with COVID-19 were predominantly observed in the white matter (WM) rather than the gray matter (GM), with specific involvement noted in the superior longitudinal fasciculus tract, Forceps minor tract, and cingulum-cingulate gyrus tract among patients with MDD. Functional changes were spread from GM to WM. The bilateral supplementary motor area, the left angular gyrus, the left subcortical regions (amygdala and parahippocampal gyrus), and various WM tracts showed significant infection-related changes across groups.

COVID-19 infection induces significant microstructural damage of WM in healthy individuals and exacerbates white matter microstructural injury of MDD. These findings suggest that WM might be more susceptible to COVID-19 effects than GM in both MDD patients and HCs.