Time-dependent recovery of brain hypometabolism in neuro-COVID-19 patients.
Purpose: We evaluated brain metabolic dysfunctions and associations with neurological and biological parameters in acute, subacute and chronic COVID-19 phases to provide deeper insights into the pathophysiology of the disease. Methods: Twenty-six patients with neurological symptoms (neuro-COVID-19)...
| Published in: | European Journal of Nuclear Medicine & Molecular Imaging Vol. 50; no. 1; pp. 90 - 103 |
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| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Published: |
Springer Nature
Dec2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=160255973&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 160255973 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16197070 NPC jtl: European Journal of Nuclear Medicine & Molecular Imaging issn: 16197070 maglogo: N pubinfo: dt: Dec2022 vid: 50 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 160255973 10.1007/s00259-022-05942-2 160255973 ppf: 90 ppct: 13 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Time-dependent recovery of brain hypometabolism in neuro-COVID-19 patients. aug: au: Martini, Anna Lisa Carli, Giulia Kiferle, Lorenzo Piersanti, Patrizia Palumbo, Pasquale Morbelli, Silvia Calcagni, Maria Lucia Perani, Daniela Sestini, Stelvio affil: Nuclear Medicine Unit, Department of Diagnostic Imaging, N.O.P. - S. Stefano, U.S.L. Toscana Centro, Prato, Italy sug: ab: Purpose: We evaluated brain metabolic dysfunctions and associations with neurological and biological parameters in acute, subacute and chronic COVID-19 phases to provide deeper insights into the pathophysiology of the disease. Methods: Twenty-six patients with neurological symptoms (neuro-COVID-19) and [18F]FDG-PET were included. Seven patients were acute (< 1 month (m) after onset), 12 subacute (4 ≥ 1-m, 4 ≥ 2-m and 4 ≥ 3-m) and 7 with neuro-post-COVID-19 (3 ≥ 5-m and 4 ≥ 7–9-m). One patient was evaluated longitudinally (acute and 5-m). Brain hypo- and hypermetabolism were analysed at single-subject and group levels. Correlations between severity/extent of brain hypo- and hypermetabolism and biological (oxygen saturation and C-reactive protein) and clinical variables (global cognition and Body Mass Index) were assessed. Results: The "fronto-insular cortex" emerged as the hypometabolic hallmark of neuro-COVID-19. Acute patients showed the most severe hypometabolism affecting several cortical regions. Three-m and 5-m patients showed a progressive reduction of hypometabolism, with limited frontal clusters. After 7–9 months, no brain hypometabolism was detected. The patient evaluated longitudinally showed a diffuse brain hypometabolism in the acute phase, almost recovered after 5 months. Brain hypometabolism correlated with cognitive dysfunction, low blood saturation and high inflammatory status. Hypermetabolism in the brainstem, cerebellum, hippocampus and amygdala persisted over time and correlated with inflammation status. Conclusion: Synergistic effects of systemic virus-mediated inflammation and transient hypoxia yield a dysfunction of the fronto-insular cortex, a signature of CNS involvement in neuro-COVID-19. This brain dysfunction is likely to be transient and almost reversible. The long-lasting brain hypermetabolism seems to reflect persistent inflammation processes. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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