Brain correlates of depression, post-traumatic distress, and inflammatory biomarkers in COVID-19 survivors: A multimodal magnetic resonance imaging study.
Brain correlates of depression, post-traumatic distress, and inflammatory biomarkers in COVID-19 survivors: A multimodal magnetic resonance imaging study.
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DOI：
10.1016/j.bbih.2021.100387
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Mazza MG
中科院分区：
文献类型：
--
作者：
Benedetti F;Palladini M;Paolini M;Melloni E;Vai B;De Lorenzo R;Furlan R;Rovere-Querini P;Falini A;Mazza MG
精神后遗症在很大程度上导致了与COVID-19相关的急性后疾病负担，在病毒清除后持续数月。脑成像显示COVID后白色物质（WM）低密度/高密度，以及前额叶、前扣带回（ACC）和岛叶皮质中灰质（GM）的参与，但对持续性精神病理学的脑相关性知之甚少。通过多模式方法，我们研究了基于全脑体素的形态测量、弥散张量成像和静息状态连接，以将MRI测量与42名COVID-19幸存者的抑郁和创伤后抑郁（PTSD）相关联，这些幸存者在COVID后90.59 ± 54.66天没有脑损伤。在急诊室测量的全身免疫炎症指数（SII）反映了基于外周淋巴细胞、中性粒细胞和血小板计数的免疫反应和全身炎症，可预测更严重的自评抑郁症和PTSD、沿WM束主轴的广泛低扩散率沿着以及静息状态网络之间的异常功能连接（FC）。自评抑郁症和PTSD与ACC和ACC中的GM体积、轴向扩散率呈负相关，并与FC相关。我们观察到急性COVID-19期间炎症的严重程度、大脑结构和功能以及幸存者抑郁和创伤后痛苦的严重程度之间存在重叠相关性，因此对进一步研究急性COVID-19后综合征的大脑相关性产生了兴趣。除了COVID-19之外，这些发现支持了区域GM、WM微观结构和FC可以介导医学疾病及其精神病理学后遗症之间关系的假设，并且与当前关于抑郁精神病理学的大脑结构和功能基础的观点一致。
Psychiatric sequelae substantially contribute to the post-acute burden of disease associated with COVID-19, persisting months after clearance of the virus. Brain imaging shows white matter (WM) hypodensities/hyperintensities, and the involvement of grey matter (GM) in prefrontal, anterior cingulate (ACC) and insular cortex after COVID, but little is known about brain correlates of persistent psychopathology. With a multimodal approach, we studied whole brain voxel-based morphometry, diffusion-tensor imaging, and resting-state connectivity, to correlate MRI measures with depression and post-traumatic distress (PTSD) in 42 COVID-19 survivors without brain lesions, at 90.59 ± 54.66 days after COVID. Systemic immune-inflammation index (SII) measured in the emergency department, which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, predicted worse self-rated depression and PTSD, widespread lower diffusivity along the main axis of WM tracts, and abnormal functional connectivity (FC) among resting state networks. Self-rated depression and PTSD inversely correlated with GM volumes in ACC and insula, axial diffusivity, and associated with FC. We observed overlapping associations between severity of inflammation during acute COVID-19, brain structure and function, and severity of depression and post-traumatic distress in survivors, thus warranting interest for further study of brain correlates of the post-acute COVID-19 syndrome. Beyond COVID-19, these findings support the hypothesis that regional GM, WM microstructure, and FC could mediate the relationship between a medical illness and its psychopathological sequelae, and are in agreement with current perspectives on the brain structural and functional underpinnings of depressive psychopathology.
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影响因子：
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