The cerebral network of COVID-19-related encephalopathy: a longitudinal voxel-based 18F-FDG-PET study.
The cerebral network of COVID-19-related encephalopathy: a longitudinal voxel-based 18F-FDG-PET study.
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DOI：
10.1007/s00259-020-05178-y
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发表时间：
2021-07
影响因子：
9.1
通讯作者：
on the behalf of CoCo-Neurosciences study group and COVID SMIT PSL study group
中科院分区：
文献类型：
--
作者：
Kas A;Soret M;Pyatigoskaya N;Habert MO;Hesters A;Le Guennec L;Paccoud O;Bombois S;Delorme C;on the behalf of CoCo-Neurosciences study group and COVID SMIT PSL study group
关于新冠肺炎相关神经精神症状的神经基础及其在疾病过程中的演变，人们知之甚少。我们的目的是利用18F-FDG-PET/CT描述新冠肺炎相关脑病患者的纵向脑代谢模式。对7例不同临床表现的新冠肺炎相关性脑病患者进行了3次脑18F-FDG-PET/CT检查，分别于急性期、1个月后和新冠肺炎起病6个月后进行。用体素和感兴趣区的方法分析了宠物图像，并与32名健康对照组进行了比较。急性脑病患者的神经学表现具有异质性。然而，他们都表现出主要的认知和行为额叶障碍。所有患者脑脊液中SARS-CoV-2 RT-PCR均为阴性。核磁共振显示，大多数受试者没有特殊的异常。所有患者在广泛的大脑网络中都有一致的低代谢模式，包括额叶皮质、前扣带回、岛核和尾状核。发病6个月后，大多数患者的临床症状有所改善，但仍有不同程度的认知和情绪障碍，并伴有注意力/执行障碍和焦虑抑郁症状，以及持续的额叶、岛叶和皮质下18F-FDG-PET/CT异常。这一广泛网络的含义可能是观察到新冠肺炎患者临床特征的神经基础，如额叶综合征、情绪障碍和呼吸衰竭感知的放松调节。这项研究表明，这种网络在发病6个月后仍有轻微到严重的损害。
Little is known about the neuronal substrates of neuropsychiatric symptoms associated with COVID-19 and their evolution during the course of the disease. We aimed at describing the longitudinal brain metabolic pattern in COVID-19-related encephalopathy using 18F-FDG-PET/CT. Seven patients with variable clinical presentations of COVID-19-related encephalopathy were explored thrice with brain 18F-FDG-PET/CT, once in the acute phase, 1 month later and 6 months after COVID-19 onset. PET images were analysed with voxel-wise and regions-of-interest approaches in comparison with 32 healthy controls. Patients’ neurological manifestations during acute encephalopathy were heterogeneous. However, all of them presented with predominant cognitive and behavioural frontal disorders. SARS-CoV-2 RT-PCR in the CSF was negative for all patients. MRI revealed no specific abnormalities for most of the subjects. All patients had a consistent pattern of hypometabolism in a widespread cerebral network including the frontal cortex, anterior cingulate, insula and caudate nucleus. Six months after COVID-19 onset, the majority of patients clinically had improved but cognitive and emotional disorders of varying severity remained with attention/executive disabilities and anxio-depressive symptoms, and lasting prefrontal, insular and subcortical 18F-FDG-PET/CT abnormalities. The implication of this widespread network could be the neural substrate of clinical features observed in patients with COVID-19, such as frontal lobe syndrome, emotional disturbances and deregulation of respiratory failure perception. This study suggests that this network remains mildly to severely impaired 6 months after disease onset.
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