Cerebral Micro-Structural Changes in COVID-19 Patients - An MRI-based 3-month Follow-up Study
Cerebral Micro-Structural Changes in COVID-19 Patients - An MRI-based 3-month Follow-up Study
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DOI：
10.1016/j.eclinm.2020.100484
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发表时间：
2020-08-01
影响因子：
15.1
通讯作者：
Yin, Bo
中科院分区：
文献类型：
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作者：
Lu, Yiping;Li, Xuanxuan;Yin, Bo
背景：越来越多的证据支持SARS-CoV-2可能的神经侵袭潜力。然而，尚未有研究探讨感染后中枢神经系统是否存在微观结构变化。我们的目的是确定是否存在与SARS-CoV-2相关的潜在脑微观结构变化。方法：本前瞻性研究采用弥散张量成像（DTI）和3D高分辨率T1WI序列对60例康复的COVID-19患者（56.67%男性，年龄44.10 +/- 16.00）和39例年龄和性别匹配的非COVID-19对照组（56.41%男性，年龄45.88 +/- 13.90）进行分析。对DTI的注册分数各向异性（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD）进行了量化，并引入了指标评分体系。使用协方差分析（ANCOVA）对基于体素的形态测量法（VBM）和DTI指标得出的区域体积进行比较。采用两样本t检验和Spearman相关分析影像学指标、指标得分与临床信息的关系。结果：在该随访阶段，55%的COVID-19患者出现神经系统症状。与非COVID-19志愿者相比，患者双侧嗅皮质、海马、脑岛、左roland盖、左Heschl回和右扣带回的灰质体积（GMV）均有统计学意义显著升高，MD、AD、RD普遍下降，白质FA增加，尤其是右侧CR、EC和SFF的AD和SFF的MD（校正p值）
Background: Increasing evidence supported the possible neuro-invasion potential of SARS-CoV-2. However, no studies were conducted to explore the existence of the micro-structural changes in the central nervous system after infection. We aimed to identify the existence of potential brain micro-structural changes related to SARS-CoV-2.Methods: In this prospective study, diffusion tensor imaging (DTI) and 3D high-resolution T1WI sequences were acquired in 60 recovered COVID-19 patients (56.67% male; age: 44.10 +/- 16.00) and 39 age- and sex-matched non-COVID-19 controls (56.41% male; age: 45.88 +/- 13.90). Registered fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were quantified for DTI, and an index score system was introduced. Regional volumes derived from Voxel-based Morphometry (VBM) and DTI metrics were compared using analysis of covariance (ANCOVA). Two sample t-test and Spearman correlation were conducted to assess the relationships among imaging indices, index scores and clinical information.Findings: In this follow-up stage, neurological symptoms were presented in 55% COVID-19 patients. COVID-19 patients had statistically significantly higher bilateral gray matter volumes (GMV) in olfactory cortices, hippocampi, insulas, left Rolandic operculum, left Heschl's gyrus and right cingulate gyrus and a general decline of MD, AD, RD accompanied with an increase of FA in white matter, especially AD in the right CR, EC and SFF, and MD in SFF compared with non-COVID-19 volunteers (corrected p value