急性COVID-19患者脑容量及皮层结构变化与疲惫及焦虑的相关性研究

Study on the Relationship between Brain Volume,Cortical Structure and Fatigue and Anxiety in Patients with Acute COVID-19

目的 通过纵向研究分析COVID-19大脑各脑区容积及皮层结构进行定量分析,并分析差异脑区与疲惫、抑郁及焦虑相关性,探讨大脑结构改变与新冠后认知障碍、焦虑及疲惫的关系。方法前瞻性收集31名急性COVID-19患者1个月内神经影像学及神经心理学信息,并在3个月后再次采集相关数据。基于AI后处理技术全自动分割106个脑区并计算各脑区容积(cm^(3))及全脑占比(%)、皮层厚度(cm)及表面积(cm^(2))及曲率。比较大脑容积及皮层结构的变化并分析大脑结构参数与疲惫、焦虑、创伤后应激的相关性。结果3个月后新冠痊愈患者部分脑区容积、皮层厚度、表面积及曲率存在显著差异,脑区变化主要以左侧额顶颞叶及海马为主。精神疲惫与右侧海马体、左侧颞上回坡部皮层曲率有关,创伤后应激与左侧盖部%有关,焦虑与左侧楔前叶、左侧楔叶皮层曲率、左侧楔前叶皮层厚度、左侧皮层曲率有关。结论本研究表明,急性COVID-19患者感染后脑容积及皮层结构均存在异常变化,并且与精神疲惫及焦虑相关,将有助于更好地了解急性感染COVID-19的病理生理学。

Objective The novel coronavirus can impact the structure of the brain,but the specific characteristics of cortical structural changes and their relationship with fatigu e,depressio n,and anxiety remain undear.This study aims to conduct a comprehensive analysis of lo ngitudinal changes in cortical thickness,surface area,and curvature in the brains of COVID-19 patients.Additionally,we will explore the association between these changes and cognitive impairment,anxiety,and fatigue experienced by the patients.Methods A prospective cohort of 31 COVID-19 patients was enrolled within one month of infection and underwent neuroimaging scans as well as neuropsychological assessments.Follow-up data were collected three months later to track the progression.Advanced AI-based post-processing techniques were employed for automated segmentation,enabling the measurement of volume(cm~3) and percentage of each specific brain region,as well as cortical thickness(cm),su rface area(cm^(2)),and curvature.Comparative analyses were conducted to dete rmine changes in brain volume and cortical structure,while co rrelations between brain structural parameters and cognition,fatigue,and depression were evaluated.Results At the three month mark following the acute infection,statistically significant differences were observed in brain volume,cortical thickness,surface area,and curvature in select brain regions,predominantly within the left frontal-temporal lobe and hippocampus.Notably,fatigue correlated with the curvature of the right hippocam pus and the left temporal pole,whe reas depression was linked to the curvatu re of the left insula.Anxiety was found to be associated with the curvature of the left prefrontal cortex,left occipital lobe,left inferior parietal lobule,and left anterior cingulate gyrus.Furthermore,anxiety showed connections with cortical thickn ess in the left prefrontal co rtex and curvature in the left temporal pole.Conclusion This study reveals that three months post-infection,COVID-19 survivors exhibit notable abnormalities in cortical structure.These changes,particularly in the left frontal-temporal lobe and hippocampus,appear to be associated with fatigue,depression,and anxiety symptoms.By shedding light on the pathophysiology of acute COVID-19 infection,these findings contribute to a dee per understanding of its impact on the brain.