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Diffusion tensor imaging after COVID-19 infection: A systematic review.

Breanna K Nelson1, Lea N Farah1, Sidney A Saint1

  • 1University of British Columbia, Department of Psychiatry, 2255 Wesbrook Mall Vancouver, BC Canada; British Columbia Children's Hospital Research Institute, 938 West 28th Ave Vancouver, BC Canada; British Columbia Mental Health and Substance Use Services Research Institute, 938 West 28th Ave Vancouver, BC Canada.

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Chronic COVID-19 brain changes are unclear. Diffusion MRI (dMRI) studies show mixed results, with severity and timing influencing white matter integrity differences post-infection.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Infectious Diseases

Background:

  • Limited understanding of chronic neurological effects of COVID-19 on brain structure.
  • Inconsistent findings in advanced neuroimaging, specifically diffusion MRI (dMRI), regarding white matter integrity post-COVID-19.

Purpose of the Study:

  • Systematically review the advanced neuroimaging literature.
  • Focus on dMRI abnormalities after the acute phase of COVID-19 illness.

Main Methods:

  • Comprehensive literature search (PubMed, Embase, Scopus) updated September 2024.
  • Inclusion criteria: quantitative dMRI comparison, COVID-19 vs. controls, MRI >6 weeks post-infection.
  • Exclusion criteria: specific symptom subgroups, case reports, post-mortem studies.

Main Results:

  • 11 studies met inclusion criteria; most involved hospitalized patients with MRI 2-6 months post-infection.
  • Majority reported lower fractional anisotropy and higher mean diffusivity in post-COVID-19 cohorts.
  • Findings varied; severe illness and shorter follow-up correlated with greater dMRI differences.

Conclusions:

  • Heterogeneity in dMRI findings likely due to COVID-19 severity and time to MRI.
  • Future research should explore SARS-CoV-2 variant impact on structural brain differences.