tetano
Editor, Senior Moderator
Brain Behav Immun Health
. 2025 Jan 16:44:100945.
doi: 10.1016/j.bbih.2025.100945. eCollection 2025 Mar. Glial activation among individuals with neurological post-acute sequelae of coronavirus disease 2019: A positron emission tomography study of brain fog using [[SUP]18[/SUP]F]-FEPPA
Sean A P Clouston[SUP] 1 2 [/SUP], Paul Vaska[SUP] 3 4 [/SUP], Tesleem Babalola[SUP] 1 [/SUP], John Gardus 3rd[SUP] 5 [/SUP], Chuan Huang[SUP] 6 7 [/SUP], Nicola Soriolo[SUP] 1 [/SUP], Ashley Fontana[SUP] 8 [/SUP], Christine DeLorenzo[SUP] 5 [/SUP], Ramin Parsey[SUP] 5 [/SUP], Benjamin J Luft[SUP] 8 [/SUP]
Affiliations
Background: This study examined the regional distribution of glial activation in essential workers with neurological post-acute sequelae of coronavirus disease 2019 (COVID-19) infections (N-PASC).
Methods: We injected ≤185 MBq of [[SUP]18[/SUP]F]-FEPPA as an intravenous bolus and positron-emission tomography over 2 h. To measure distribution volume (V[SUB]T[/SUB]) we recruited 24 essential workers (14 N-PASC, 10 Never-COVID-19 Controls, of whom 22 successfully placed arterial lines). Individuals with low binding affinity were excluded from this study, and V[SUB]T[/SUB] was adjusted for translocator protein genotype. Analyses that passed the false discovery rate are reported.
Results: Participants at midlife survived mild to moderate COVID-19 without hospitalization but reported onset of post-acute sequelae of COVID-19 (PASC) for, on average, 22 months before undergoing neuroimaging. Hippocampal V[SUB]T[/SUB] was higher (V[SUB]T[/SUB] = 1.70, 95% C.I. = [1.30-2.21], p = 0.001) in participants with persistent brain fog after COVID-19, reflecting an increase of 10.58 mL/cm[SUP]3[/SUP] in V[SUB]T[/SUB] (area under the receiver-operating curve, AUC = 0.95 [0.85-1.00]). At a cutoff of 10.6, sensitivity/specificity/accuracy were 0.88/0.93/0.91.
Conclusion: The results from this study imply that neuroimmune response is a distinct and identifiable characteristic of brain fog after COVID-19. Results suggest that [[SUP]18[/SUP]F]-FEPPA could be used to support N-PASC diagnosis.
Keywords: Brain Fog; COVID-19; Essential Workers; FEPPA; Glial activation; Positron emission tomography; Post-acute sequelae of COVID-19; Respiratory infection; Translocator protein.
. 2025 Jan 16:44:100945.
doi: 10.1016/j.bbih.2025.100945. eCollection 2025 Mar. Glial activation among individuals with neurological post-acute sequelae of coronavirus disease 2019: A positron emission tomography study of brain fog using [[SUP]18[/SUP]F]-FEPPA
Sean A P Clouston[SUP] 1 2 [/SUP], Paul Vaska[SUP] 3 4 [/SUP], Tesleem Babalola[SUP] 1 [/SUP], John Gardus 3rd[SUP] 5 [/SUP], Chuan Huang[SUP] 6 7 [/SUP], Nicola Soriolo[SUP] 1 [/SUP], Ashley Fontana[SUP] 8 [/SUP], Christine DeLorenzo[SUP] 5 [/SUP], Ramin Parsey[SUP] 5 [/SUP], Benjamin J Luft[SUP] 8 [/SUP]
Affiliations
- PMID: 39897172
- PMCID: PMC11786203
- DOI: 10.1016/j.bbih.2025.100945
Background: This study examined the regional distribution of glial activation in essential workers with neurological post-acute sequelae of coronavirus disease 2019 (COVID-19) infections (N-PASC).
Methods: We injected ≤185 MBq of [[SUP]18[/SUP]F]-FEPPA as an intravenous bolus and positron-emission tomography over 2 h. To measure distribution volume (V[SUB]T[/SUB]) we recruited 24 essential workers (14 N-PASC, 10 Never-COVID-19 Controls, of whom 22 successfully placed arterial lines). Individuals with low binding affinity were excluded from this study, and V[SUB]T[/SUB] was adjusted for translocator protein genotype. Analyses that passed the false discovery rate are reported.
Results: Participants at midlife survived mild to moderate COVID-19 without hospitalization but reported onset of post-acute sequelae of COVID-19 (PASC) for, on average, 22 months before undergoing neuroimaging. Hippocampal V[SUB]T[/SUB] was higher (V[SUB]T[/SUB] = 1.70, 95% C.I. = [1.30-2.21], p = 0.001) in participants with persistent brain fog after COVID-19, reflecting an increase of 10.58 mL/cm[SUP]3[/SUP] in V[SUB]T[/SUB] (area under the receiver-operating curve, AUC = 0.95 [0.85-1.00]). At a cutoff of 10.6, sensitivity/specificity/accuracy were 0.88/0.93/0.91.
Conclusion: The results from this study imply that neuroimmune response is a distinct and identifiable characteristic of brain fog after COVID-19. Results suggest that [[SUP]18[/SUP]F]-FEPPA could be used to support N-PASC diagnosis.
Keywords: Brain Fog; COVID-19; Essential Workers; FEPPA; Glial activation; Positron emission tomography; Post-acute sequelae of COVID-19; Respiratory infection; Translocator protein.