Altered brain regional homogeneity is associated with depressive symptoms in COVID-19, 2022, Cattarinussi et al

Highlights

• COVID-19 is associated to depression, anxiety and fatigue.
• COVID-19 presents functional connectivity alterations in parieto-temporal regions.
• There alterations are associated with the severity of depressive symptoms.

Abstract
Background
COVID-19 is an infectious disease that has spread worldwide in 2020, causing a severe pandemic. In addition to respiratory symptoms, neuropsychiatric manifestations are commonly observed, including chronic fatigue, depression, and anxiety. The neural correlates of neuropsychiatric symptoms in COVID-19 are still largely unknown.

Methods
A total of 79 patients with COVID-19 (COV) and 17 healthy controls (HC) underwent 3 T functional magnetic resonance imaging at rest as well as structural imaging. Regional homogeneity (ReHo) was calculated. We also measured anxiety using the General Anxiety Disorder 7-item scale, depressive symptoms with the Patient Health Questionnaire (PHQ-9), and fatigue with the Multidimension Fatigue Inventory, respectively.

Results
In comparison with HC, COV showed significantly higher depressive scores. Moreover, COV presented reduced ReHo in the left angular gyrus, the right superior/middle temporal gyrus and the left inferior temporal gyrus, and higher ReHo in the right hippocampus. No differences in gray matter were detected in these areas. Furthermore, we observed a negative correlation between ReHo in the left angular gyrus and PHQ-9 score and a trend toward a positive correlation between ReHo in the right hippocampus and the PHQ-9 scores.

Limitations
Heterogeneity in the clinical presentation in COV, the different timing from the first positive molecular swab test to the MRI, and the cross-sectional design of the study limit the generalization of our findings.

Conclusions
Our results suggest that COVID-19 infection may contribute to depressive symptoms via a modulation of local functional connectivity in cortico-limbic circuits.

Open access, https://www.sciencedirect.com/science/article/pii/S0165032722007224

 

"Clinical assessment
We evaluated depressive symptoms using the Patient Health Questionnaire (PHQ-9) (Kroenke et al., 2001) and anxiety symptomatology with the 7-item General Anxiety Disorder Scale (GAD-7) (Spitzer et al., 2006) at the time of the scan. Moreover, we assessed fatigue using the total score of the Multidimension Fatigue Inventory (MFI) to measure the overall impact of general, physical and mental fatigue, reduced motivation, and reduced activity (Smets et al., 1995)."

The PHQ-9 questions, available from https://onlinelibrary.wiley.com/doi/full/10.1046/j.1525-1497.2001.016009606.x

1. Little interest or pleasure in doing things
2. Feeling down, depressed, or hopeless
3. Trouble falling or staying asleep, or sleeping too much
4. Feeling tired or having little energy
5. Poor appetite or overeating
6. Feeling bad about yourself—or that you are a failure or have let yourself or your family down
7. Trouble concentrating on things, such as reading the newspaper or watching television
8. Moving or speaking so slowly that other people could have noticed? Or the opposite—being so fidgety or restless that you have been moving around a lot more than usual
9. Thoughts that you would be better off dead or of hurting yourself in some way

The GAD-7 questions, available from https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/410326



so for people ill with Covid, I think it's unsurprising that their answers will qualify them as 'depressed' or 'anxious'.