SARS-CoV2 evokes structural brain changes resulting in declined executive function

PLoS One. 2024 Mar 12;19(3):e0298837. doi: 10.1371/journal.pone.0298837. eCollection 2024.

Abstract

Background: Several research has underlined the multi-system character of COVID-19. Though effects on the Central Nervous System are mainly discussed as disease-specific affections due to the virus' neurotropism, no comprehensive disease model of COVID-19 exists on a neurofunctional base by now. We aimed to investigate neuroplastic grey- and white matter changes related to COVID-19 and to link these changes to neurocognitive testings leading towards a multi-dimensional disease model.

Methods: Groups of acutely ill COVID-19 patients (n = 16), recovered COVID-19 patients (n = 21) and healthy controls (n = 13) were prospectively included into this study. MR-imaging included T1-weighted sequences for analysis of grey matter using voxel-based morphometry and diffusion-weighted sequences to investigate white matter tracts using probabilistic tractography. Comprehensive neurocognitive testing for verbal and non-verbal domains was performed.

Results: Alterations strongly focused on grey matter of the frontal-basal ganglia-thalamus network and temporal areas, as well as fiber tracts connecting these areas. In acute COVID-19 patients, a decline of grey matter volume was found with an accompanying diminution of white matter tracts. A decline in executive function and especially verbal fluency was found in acute patients, partially persisting in recovered.

Conclusion: Changes in gray matter volume and white matter tracts included mainly areas involved in networks of executive control and language. Deeper understanding of these alterations is necessary especially with respect to long-term impairments, often referred to as 'Post-COVID'.

MeSH terms

  • Brain
  • COVID-19*
  • Executive Function / physiology
  • Gray Matter
  • Humans
  • Magnetic Resonance Imaging / methods
  • RNA, Viral
  • SARS-CoV-2
  • White Matter*

Substances

  • RNA, Viral

Grants and funding

The authors received funding from the Bavarian Ministry for Science and Arts (Bayerisches Staatsministerium für Wissenschaft und Kunst) for the promotion of Corona research projects (“Förderung von Corona-Forschungsprojekten”). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.