Post COVID-19 condition is associated with altered regional cerebral blood volume as revealed by dynamic susceptibility contrast MRI, 2026, MacIntosh+

[SNT Gatchaman]

Post COVID-19 condition is associated with altered regional cerebral blood volume as revealed by dynamic susceptibility contrast MRI

Spoiler: Authors

MacIntosh, Bradley J; Lin, S Shirley; O’Hara, Finn; Churchill, Nathan W; Tam, Fred; Pavel, Alexandra; Roudaia, Eugenie; Sekuler, Allison B; Cheng, Ivy; Gao, Fuqiang; Lam, Benjamin; Heyn, Chris; Masellis, Mario; Chen, J Jean; Schweizer, Tom A; Black, Sandra E; Graham, Simon J

BACKGROUND
Coronavirus disease 2019 (COVID-19) has been associated with central nervous system dysfunction implicating cerebrovascular and neurovascular units, as reflected in lower regional cerebral blood flow among non-hospitalized individuals that experienced post COVID-19 condition (PCC). This study investigates whether PCC is associated with altered regional cerebral blood volume assessed using Dynamic Susceptibility Contrast (DSC) Magnetic Resonance Imaging (MRI). The comparison control group are individuals without PCC who previously experienced cold or flu-like symptoms, or COVID-19.

METHODS
Fifty-seven participants were recruited: 36 with PCC (mean age: 42.7, standard deviation: 10.4, 26 females) and 21 controls (mean age: 41.6, standard deviation: 14.7, 13 females). T2*-weighted DSC MRI was performed at 3 Tesla to image the first passage of the bolus. A total of 22 regions of interest (ROIs) were considered. Group differences in DSC-derived cerebral blood volume (rCBV) and cerebral blood flow (rCBF) were evaluated using Bayesian regression, providing median group differences, highest density interval (HDI), and the probability of direction (PD) estimates.

RESULTS
The two groups (PCC and controls) were matched for age, sex, days from symptom onset, and number of previous vaccines, but had different degrees of self-report illness severity. The rCBV analysis showed median group differences (range: −0.05 to −0.13), with PD > 0.90, indicating a high probability of decreased rCBV in the PCC group, involving the superior frontal gyrus, thalamus, paracentral lobule, cingulate gyrus, postcentral gyrus, middle frontal gyrus, inferior frontal gyrus, and superior temporal gyrus ROIs. By comparison, group differences in rCBF were muted and did not reach PD > 0.90.

DISCUSSION
We found group-level differences that were reflected by lower regional rCBV in PCC relative to controls. The imaging findings are suggestive of cerebrovascular alterations several months after the initial illness.

Web | DOI | PDF | Frontiers in Neuroimaging | Open Access

 

[SNT Gatchaman]

rCBV = regional cerebral blood volume
rCBF = regional cerebral blood flow

The rCBV values were consistently lower in PCC compared to controls. Affected regions included the superior frontal gyrus, thalamus, paracentral lobule, cingulate gyrus, postcentral gyrus, middle frontal gyrus, inferior frontal gyrus, and superior temporal gyrus. These decreases were predominantly located in anterior frontal and cingulate areas, with some involvement of temporal and subcortical ROIs.

Anterior cingulate cortex in that list.

the PCC group had a slightly higher AIF [Arterial Input Function] peak compared to controls, which could have influenced rCBV and rCBF values. It would be interesting to better understand the intraluminal factors that could have influenced the arterial hemodynamics and/or AIF, as noted with acute perfusion imaging in COVID-19

The current study adds to the growing body of COVID-19 and brain imaging literature by revealing group-level rCBV differences, capitalizing on DSC-MRI in a substantial sample of individuals with PCC or well-matched controls. Participants from both groups were assessed with DSC-MRI several months after self-isolation for acute COVID-19 infection or a non-COVID-19 illness. The findings revealed a pattern of lower rCBV in the PCC group relative to controls in ROIs that have previously been reported in analogous structural and perfusion neuroimaging studies. The group level differences in rCBV reached a high degree of statistical certainty, whereas the rCBF showed a similar trend but lower statistical certainty.