Structural and Metabolic Neuroimaging of ME/CFS Occurring with and without COVID-19 Infection

伴或不伴 COVID-19 感染时发生 ME/CFS 的结构和代谢神经影像

• 批准号: 10577814
• 负责人: Benjamin Natelson
• 金额: $ 21.13万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10577814
• 关键词: Address; Anatomy; Behavior assessment; Blood; Brain; Brain Stem; COVID-19; COVID-19 patient; Cerebrovascular Circulation; Cerebrum; Chronic Fatigue Syndrome; Clinical; Coupled; Data; Deformity; Diagnosis; Dimensions; Disease; Equipment and supply inventories; Exertion; Failure; Fatigue; Hemoglobin; Heterogeneity; Image; Impaired cognition; Individual; Knowledge; Learning; Lesion; Location; Long COVID; Longitudinal Studies; Magnetic Resonance; Magnetic Resonance Imaging; Malaise; Measurement; Measures; Mental Fatigue; Metabolic; Metabolism; Methods; Motivation; Neurologic; Onset of illness; Organ; Oxygen; Patient Self-Report; Patients; Perfusion; Phase; Physical Function; Physiologic pulse; Physiological; Post-Acute Sequelae of SARS-CoV-2 Infection; Property; Questionnaires; Relaxation; Reporting; Research; Resolution; SARS-CoV-2 infection; Sagittal Sinus; Sample Size; Structure; Symptoms; Techniques; Testing; Time; Venous; Virus; Work; brain magnetic resonance imaging; brain volume; burden of illness; cerebral atrophy; clinical diagnostics; coronavirus disease; design; diagnostic criteria; experience; flu; in vivo; magnetic field; metabolic abnormality assessment; metabolic imaging; metabolic rate; neuroimaging; neuroimaging marker; novel; post-pandemic; sedentary; structural imaging

Project Summary A large and increasing number of patients who have been infected with SARS-CoV-2, the virus that causes COVID-19, continue to experience a constellation of symptoms long past the time that they have recovered from the initial illness (long-COVID). The most frequently reported symptoms were fatigue, post exertional malaise and cognitive dysfunction, which are the main symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Clinically, many long-COVID patients fulfill the diagnostic criteria for ME/CFS. Post pandemic, we expect to see an increasing number of individuals with long-COVID ME/CFS. An important question is whether those with COVID ME/CFS are essentially the same as those with non-COVID ME/CFS and should be evaluated and treated similarly. If so, this group of COVID-related patients’ CFS could inform us about the features and mechanisms of ME/CFS in general. Although it was suggested that the brain is the organ responsible for both forms of ME/CFS, currently no specific neuroimaging biomarkers have been identified. In this project, we aim to conduct comprehensive neurological magnetic resonance imaging (MRI) to compare the similarities and differences between long-COVID and classic ME/CFS patients, as well as to individuals not affected by ME/CFS, in terms of brain anatomical and metabolic features. MRI exams at ultra-high field, such as 7 Tesla, offers exquisite resolution and can elucidate subtle abnormalities in the brain structure. We will apply advanced 7 Tesla MRI neuroimaging techniques to exam the cerebrum and brainstem. Beyond structural changes, limited studies have shown altered cerebral blood flow and increased cerebroventricular lactate in ME/CFS patients than sedentary controls suggesting perfusion and oxygen metabolic properties might be altered in ME/CFS. Another research focus of this project is to assess changes in oxygen metabolism of ME/CFS in vivo using MRI based methods. We will be measuring the oxygen level in the venous blood of sagittal sinus and the global cerebral blood flow using advanced MRI techniques. Using these parameters, we can calculate the global cerebral metabolic rate of oxygen in the brain which can inform us on whether energy failure is present in individuals with ME/CFS and long-COVID, as previously postulated. Finally, the structural volumetric and metabolic parameters measured by MRI will be correlated with patients’ self-reported symptom burden and multidimensional fatigue level. Completion of this timely study will provide comparison of COVID and non-COVID ME/CSF in terms of changes in brain anatomical features and oxygen metabolic properties, as well as how these imaging parameters are related to the disease burden. The knowledge learned from the structural and metabolic study will deepen our understanding the ME/CFS/long-COVID disease mechanisms, aid in ME/CFS diagnosis, inform treatment decisions and inspire new treatment targets.

项目摘要 感染SARS-CoV-2病毒的患者数量不断增加，这种病毒导致 新冠肺炎患者在康复后很久仍会出现一系列症状 最初的疾病(长期冠状病毒病)。最常见的症状是疲劳，运动后的不适 和认知功能障碍，这是肌肉痛脑脊髓炎/慢性疲劳的主要症状 综合征(ME/CFS)。临床上，许多长期冠状病毒感染的患者符合ME/CFS的诊断标准。邮政 随着疫情的蔓延，我们预计将看到越来越多的人患有长期冠状病毒ME/CFS。一个重要的 问题是，那些患有COVID ME/CFS的患者是否与那些患有非COVID ME/CFS的患者本质上相同 应该以同样的方式进行评估和对待。如果是这样的话，这群与COVID相关的患者的CFS可以告诉我们 概述了ME/CFS的特点和机制。尽管有人认为大脑是器官 对于这两种形式的ME/CFS，目前还没有明确的神经影像生物标志物。在……里面 这个项目，我们的目标是进行全面的神经磁共振成像(MRI)，以比较 长期冠状病毒感染与典型的ME/CFS患者以及个体之间的异同 在脑部解剖和代谢特征方面，受到ME/CFS的影响。超高场磁共振检查，如 7特斯拉，提供精致的分辨率，可以解释大脑结构中的细微异常。我们会申请 先进的7特斯拉核磁共振神经成像技术，以检查大脑和脑干。超越结构 变化，有限的研究显示脑血流量改变和脑室乳酸增加 Me/CFS患者与静坐对照组相比提示血流灌注和氧代谢特性可能改变 在ME/CFS中。本项目的另一个研究重点是评估ME/CFS在体内的氧代谢变化 使用基于MRI的方法。我们将测量矢状窦和静脉血中的氧气水平 使用先进的核磁共振技术进行全球脑血流研究。使用这些参数，我们可以计算全局 大脑中氧的代谢率，它可以告诉我们能量衰竭是否存在于 如先前假设的，患有ME/CFS和Long-COVID的个人。最后，结构体积和 核磁共振测量的代谢参数将与患者自我报告的症状负担和 多维疲劳水平。这项及时完成的研究将提供COVID和非COVID的比较 ME/CSF在脑解剖特征和氧代谢特性方面的变化，以及这些变化如何 影像参数与疾病负担有关。从结构和代谢学到的知识 研究将加深我们对ME/CFS/Long-CoVID疾病机制的理解，有助于ME/CFS的诊断， 告知治疗决定并激发新的治疗目标。