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SARS-CoV-2 is associated with changes in brain structure in UK Biobank
medRxiv - Neurology Pub Date : 2022-03-02 , DOI: 10.1101/2021.06.11.21258690
Gwenaëlle Douaud , Soojin Lee , Fidel Alfaro-Almagro , Christoph Arthofer , Chaoyue Wang , Frederik Lange , Jesper L.R. Andersson , Ludovica Griffanti , Eugene Duff , Saad Jbabdi , Bernd Taschler , Anderson Winkler , Thomas E. Nichols , Rory Collins , Paul M. Matthews , Naomi Allen , Karla L. Miller , Stephen M. Smith

There is strong evidence for brain-related abnormalities in COVID-191–13. It remains unknown however whether the impact of SARS-CoV-2 infection can be detected in milder cases, and whether this can reveal possible mechanisms contributing to brain pathology. Here, we investigated brain changes in 785 UK Biobank participants (aged 51–81) imaged twice, including 401 cases who tested positive for infection with SARS-CoV-2 between their two scans, with 141 days on average separating their diagnosis and second scan, and 384 controls. The availability of pre-infection imaging data reduces the likelihood of pre-existing risk factors being misinterpreted as disease effects. We identified significant longitudinal effects when comparing the two groups, including: (i) greater reduction in grey matter thickness and tissue-contrast in the orbitofrontal cortex and parahippocampal gyrus, (ii) greater changes in markers of tissue damage in regions functionally-connected to the primary olfactory cortex, and (iii) greater reduction in global brain size. The infected participants also showed on average larger cognitive decline between the two timepoints. Importantly, these imaging and cognitive longitudinal effects were still seen after excluding the 15 cases who had been hospitalised. These mainly limbic brain imaging results may be the in vivo hallmarks of a degenerative spread of the disease via olfactory pathways, of neuroinflammatory events, or of the loss of sensory input due to anosmia. Whether this deleterious impact can be partially reversed, or whether these effects will persist in the long term, remains to be investigated with additional follow up.

中文翻译:

SARS-CoV-2 与英国生物银行中大脑结构的变化有关

有强有力的证据表明 COVID-19 中存在与大脑相关的异常1-13. 然而,尚不清楚是否可以在较轻的病例中检测到 SARS-CoV-2 感染的影响,以及这是否可以揭示导致脑病理的可能机制。在这里,我们调查了 785 名英国生物银行参与者(年龄 51-81 岁)的大脑变化两次成像,其中包括 401 名在两次扫描之间检测出 SARS-CoV-2 感染呈阳性的病例,他们的诊断和第二次扫描平均间隔 141 天, 和 384 个控件。感染前成像数据的可用性降低了预先存在的风险因素被误解为疾病影响的可能性。在比较两组时,我们发现了显着的纵向效应,包括:(i)眶额皮质和海马旁回的灰质厚度和组织对比度减少更大,(ii) 与初级嗅觉皮层功能相关的区域的组织损伤标志物发生更大变化,以及 (iii) 大脑整体尺寸更小。受感染的参与者在两个时间点之间平均还表现出更大的认知下降。重要的是,在排除了 15 例住院病例后,仍然可以看到这些影像学和认知纵向效应。这些主要是边缘脑成像结果可能是疾病通过嗅觉途径退行性传播、神经炎症事件或由于嗅觉丧失引起的感觉输入丧失的体内标志。这种有害影响是否可以部分逆转,或者这些影响是否会长期持续存在,仍有待进一步跟进调查。(iii) 更大程度地减少全球大脑的大小。受感染的参与者在两个时间点之间平均还表现出更大的认知下降。重要的是,在排除了 15 例住院病例后,仍然可以看到这些影像学和认知纵向效应。这些主要是边缘脑成像结果可能是疾病通过嗅觉途径退行性传播、神经炎症事件或由于嗅觉丧失引起的感觉输入丧失的体内标志。这种有害影响是否可以部分逆转,或者这些影响是否会长期持续存在,仍有待进一步跟进调查。(iii) 更大程度地减少全球大脑的大小。受感染的参与者在两个时间点之间平均还表现出更大的认知下降。重要的是,在排除了 15 例住院病例后,仍然可以看到这些影像学和认知纵向效应。这些主要是边缘脑成像结果可能是疾病通过嗅觉途径退行性传播、神经炎症事件或由于嗅觉丧失引起的感觉输入丧失的体内标志。这种有害影响是否可以部分逆转,或者这些影响是否会长期持续存在,仍有待进一步跟进调查。在排除 15 例住院病例后,这些影像学和认知纵向效应仍然存在。这些主要是边缘脑成像结果可能是疾病通过嗅觉途径退行性传播、神经炎症事件或由于嗅觉丧失引起的感觉输入丧失的体内标志。这种有害影响是否可以部分逆转,或者这些影响是否会长期持续存在,仍有待进一步跟进调查。在排除 15 例住院病例后,这些影像学和认知纵向效应仍然存在。这些主要是边缘脑成像结果可能是疾病通过嗅觉途径退行性传播、神经炎症事件或由于嗅觉丧失引起的感觉输入丧失的体内标志。这种有害影响是否可以部分逆转,或者这些影响是否会长期持续存在,仍有待进一步跟进调查。
更新日期:2022-03-02
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