tetano
Editor, Senior Moderator
J Infect Dis
. 2023 Aug 4;jiad309.
doi: 10.1093/infdis/jiad309. Online ahead of print. Neuronal and Glial Metabolite Abnormalities in Participants with Persistent Neuropsychiatric Symptoms After COVID-19: A Brain Proton MR Spectroscopy Study
Thomas Ernst[SUP] 1 2 [/SUP], Meghann C Ryan[SUP] 1 3 [/SUP], Hua-Jun Liang[SUP] 1 [/SUP], Justin P Wang[SUP] 1 [/SUP], Eric Cunningham[SUP] 1 [/SUP], Muhammad G Saleh[SUP] 1 [/SUP], Shyamasundaran Kottilil[SUP] 4 [/SUP], Linda Chang[SUP] 1 2 5 [/SUP]
Affiliations
Background: To determine whether neurometabolite abnormalities indicating neuroinflammation and neuronal injury are detectable in post-Coronavirus disease 2019 (COVID-19) individuals with persistent neuropsychiatric symptoms.
Methods: All participants were studied with proton magnetic resonance spectroscopy at 3-Tesla to assess neurometabolite concentrations (point-resolved spectroscopy, relaxation-time/echo-time = 3000/30 ms) in frontal white matter (FWM) and anterior cingulate cortex-gray matter (ACC-GM). Participants also completed National Institute of Health (NIH)-Toolbox® Cognition and Motor Batteries, and selected modules from the Patient-Reported Outcomes Measurement Information System.
Results: 54 participants were evaluated: 29 Post-COVID (42.4 ± 12.3 years, average ∼8 months from COVID-19 diagnosis, 19 women); 25 controls (44.1 ± 12.3 years, 14 women). Compared to controls, the Post-COVID group had lower total N-acetyl compounds [tNAA] (ACC-GM: -5.0%, p = 0.015; FWM: -4.4%, p = 0.13), FWM glutamate + glutamine ([Glu + Gln]: -9.5%, p = 0.001), and ACC-GM myo-inositol ([mI]: -6.2%, p = 0.024). Additionally, only hospitalized Post-COVID participants showed age-related increases in [mI], choline compounds [Cho] and total creatine [tCr] (interaction-p = 0.029-<0.001). Across all participants, lower FWM [tNAA] and higher ACC-GM [mI] predicted poorer performance on several cognitive measures (p = 0.001-0.009), while lower ACC-GM [tNAA] predicted lower endurance on the 2-Minute Walk (p = 0.005).
Conclusions: The lower-than-normal [tNAA] and [Glu + Gln] indicate neuronal injury while lower-than-normal [mI] reflects glial dysfunction or oxidative stress in Post-COVID participants with persistent neuropsychiatric symptoms.
Keywords: COVID-19; N-acetylaspartate; NIH-Toolbox; myo-inositol; neuropsychiatric symptoms; proton magnetic resonance spectroscopy.
. 2023 Aug 4;jiad309.
doi: 10.1093/infdis/jiad309. Online ahead of print. Neuronal and Glial Metabolite Abnormalities in Participants with Persistent Neuropsychiatric Symptoms After COVID-19: A Brain Proton MR Spectroscopy Study
Thomas Ernst[SUP] 1 2 [/SUP], Meghann C Ryan[SUP] 1 3 [/SUP], Hua-Jun Liang[SUP] 1 [/SUP], Justin P Wang[SUP] 1 [/SUP], Eric Cunningham[SUP] 1 [/SUP], Muhammad G Saleh[SUP] 1 [/SUP], Shyamasundaran Kottilil[SUP] 4 [/SUP], Linda Chang[SUP] 1 2 5 [/SUP]
Affiliations
- PMID: 37540098
- DOI: 10.1093/infdis/jiad309
Background: To determine whether neurometabolite abnormalities indicating neuroinflammation and neuronal injury are detectable in post-Coronavirus disease 2019 (COVID-19) individuals with persistent neuropsychiatric symptoms.
Methods: All participants were studied with proton magnetic resonance spectroscopy at 3-Tesla to assess neurometabolite concentrations (point-resolved spectroscopy, relaxation-time/echo-time = 3000/30 ms) in frontal white matter (FWM) and anterior cingulate cortex-gray matter (ACC-GM). Participants also completed National Institute of Health (NIH)-Toolbox® Cognition and Motor Batteries, and selected modules from the Patient-Reported Outcomes Measurement Information System.
Results: 54 participants were evaluated: 29 Post-COVID (42.4 ± 12.3 years, average ∼8 months from COVID-19 diagnosis, 19 women); 25 controls (44.1 ± 12.3 years, 14 women). Compared to controls, the Post-COVID group had lower total N-acetyl compounds [tNAA] (ACC-GM: -5.0%, p = 0.015; FWM: -4.4%, p = 0.13), FWM glutamate + glutamine ([Glu + Gln]: -9.5%, p = 0.001), and ACC-GM myo-inositol ([mI]: -6.2%, p = 0.024). Additionally, only hospitalized Post-COVID participants showed age-related increases in [mI], choline compounds [Cho] and total creatine [tCr] (interaction-p = 0.029-<0.001). Across all participants, lower FWM [tNAA] and higher ACC-GM [mI] predicted poorer performance on several cognitive measures (p = 0.001-0.009), while lower ACC-GM [tNAA] predicted lower endurance on the 2-Minute Walk (p = 0.005).
Conclusions: The lower-than-normal [tNAA] and [Glu + Gln] indicate neuronal injury while lower-than-normal [mI] reflects glial dysfunction or oxidative stress in Post-COVID participants with persistent neuropsychiatric symptoms.
Keywords: COVID-19; N-acetylaspartate; NIH-Toolbox; myo-inositol; neuropsychiatric symptoms; proton magnetic resonance spectroscopy.