Effects of post-acute COVID-19 syndrome on the functional brain networks of non-hospitalized individuals

Nathan W Churchill; Eugenie Roudaia; J Jean Chen; Asaf Gilboa; Allison Sekuler; Xiang Ji; Fuqiang Gao; Zhongmin Lin; Aravinthan Jegatheesan; Mario Masellis; Maged Goubran; Jennifer S Rabin; Benjamin Lam; Ivy Cheng; Robert Fowler; Chris Heyn; Sandra E Black; Bradley J MacIntosh; Simon J Graham; Tom A Schweizer

doi:10.3389/fneur.2023.1136408

Effects of post-acute COVID-19 syndrome on the functional brain networks of non-hospitalized individuals

Front Neurol. 2023 Mar 27:14:1136408. doi: 10.3389/fneur.2023.1136408. eCollection 2023.

Authors

Nathan W Churchill^{1

2

3}, Eugenie Roudaia⁴, J Jean Chen^{4

5

6}, Asaf Gilboa^{4

7}, Allison Sekuler^{4

7

8}, Xiang Ji⁹, Fuqiang Gao¹⁰, Zhongmin Lin^{5

11}, Aravinthan Jegatheesan^{6

11}, Mario Masellis^{4

10

12}, Maged Goubran^{6

10

11

13}, Jennifer S Rabin^{12

13

14}, Benjamin Lam^{4

10

12}, Ivy Cheng^{15

16

17}, Robert Fowler^{17

18}, Chris Heyn^{10

19}, Sandra E Black^{4

10

12}, Bradley J MacIntosh^{5

10

11

20}, Simon J Graham^{5

10

11}, Tom A Schweizer^{1

2

21}

Affiliations

¹ Neuroscience Research Program, St. Michael's Hospital, Toronto, ON, Canada.
² Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada.
³ Physics Department, Toronto Metropolitan University, Toronto, ON, Canada.
⁴ Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, ON, Canada.
⁵ Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
⁶ Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
⁷ Department of Psychology, University of Toronto, Toronto, ON, Canada.
⁸ Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada.
⁹ LC Campbell Cognitive Neurology Research Group, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
¹⁰ Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.
¹¹ Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada.
¹² Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
¹³ Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, ON, Canada.
¹⁴ Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
¹⁵ Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.
¹⁶ Integrated Community Program, Sunnybrook Research Institute, Toronto, ON, Canada.
¹⁷ Department of Medicine, University of Toronto, Toronto, ON, Canada.
¹⁸ Emergency and Critical Care Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.
¹⁹ Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
²⁰ Computational Radiology and Artificial Intelligence Unit, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
²¹ Faculty of Medicine (Neurosurgery), University of Toronto, Toronto, ON, Canada.

Abstract

Introduction: The long-term impact of COVID-19 on brain function remains poorly understood, despite growing concern surrounding post-acute COVID-19 syndrome (PACS). The goal of this cross-sectional, observational study was to determine whether there are significant alterations in resting brain function among non-hospitalized individuals with PACS, compared to symptomatic individuals with non-COVID infection.

Methods: Data were collected for 51 individuals who tested positive for COVID-19 (mean age 41±12 yrs., 34 female) and 15 controls who had cold and flu-like symptoms but tested negative for COVID-19 (mean age 41±14 yrs., 9 female), with both groups assessed an average of 4-5 months after COVID testing. None of the participants had prior neurologic, psychiatric, or cardiovascular illness. Resting brain function was assessed via functional magnetic resonance imaging (fMRI), and self-reported symptoms were recorded.

Results: Individuals with COVID-19 had lower temporal and subcortical functional connectivity relative to controls. A greater number of ongoing post-COVID symptoms was also associated with altered functional connectivity between temporal, parietal, occipital and subcortical regions.

Discussion: These results provide preliminary evidence that patterns of functional connectivity distinguish PACS from non-COVID infection and correlate with the severity of clinical outcome, providing novel insights into this highly prevalent disorder.

Keywords: COVID-19; brain function; fMRI; functional connectivity; symptoms.

Associated data

figshare/10.6084/m9.figshare.21797735