Dynamic brain glymphatic changes and cognitive function in COVID-19 recovered patients: a DTI-ALPS prospective cohort...

Area of Science:

• Neuroscience
• Radiology
• Immunology

Background:

• Long COVID is associated with persistent neurological symptoms, including cognitive impairment and fatigue.
• The brain's glymphatic system plays a crucial role in waste clearance and maintaining brain homeostasis.
• Dysfunction of the glymphatic system has been implicated in various neurological disorders.

Purpose of the Study:

• To evaluate brain glymphatic function in COVID-19 recovered patients using Diffusion Tensor Imaging-Analysis Along the Perivascular Space (DTI-ALPS).
• To investigate the correlation between glymphatic function, cognitive status, and mental fatigue in these patients.
• To assess the longitudinal changes in glymphatic function post-COVID-19 recovery.

Main Methods:

• Utilized the non-invasive DTI-ALPS technique to measure brain glymphatic function.
• Recruited 31 COVID-19 recovered patients and 30 healthy controls (HCs).
• Conducted follow-up assessments at 1, 3, and 12 months post-recovery, including cognitive tests (MoCA) and fatigue assessments (FAS).

Main Results:

• COVID-19 patients exhibited significantly lower MoCA scores at 3 months and higher mental fatigue at all follow-up points compared to HCs.
• DTI-ALPS index showed significant differences in both hemispheres at 3 months post-recovery, indicating increased glymphatic activity.
• A peak in DTI-ALPS index was observed at 3 months, with a subsequent decrease by 12 months. Negative correlation found between DTI-ALPS index and MoCA scores, and positive correlation with mental fatigue.

Conclusions:

• Brain glymphatic function undergoes dynamic changes post-COVID-19, with peak activity at 3 months.
• Altered glymphatic function is linked to cognitive deficits and mental fatigue in COVID-19 survivors.
• DTI-ALPS is a valuable non-invasive tool for assessing glymphatic system changes in long COVID patients.