Abstract #0634

Microstructural and susceptibility alterations in white matter and cerebellum are linked to fatigue and cognitive dysfunction in long COVID

Elena Grosso¹, Nargiza Kozhanova¹, Marta Gaviraghi¹, Eleonora Lupi¹, Anita Monteverdi², Marios C. Yiannakas³, Antonio Ricciardi³, Marco Battiston³, Francesco Grussu^3,4, Rebecca S. Samson³, Ferran Prados^3,5,6, Baris Kanber^3,5, Madiha Shatila³, Michael S. Zandi⁷, Carmen Tur⁸, Egidio D'Angelo^1,2, Fulvia Palesi¹, and Claudia AM Gandini Wheeler-Kingshott^1,2,3

¹Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy, ²Digital Neuroscience Centre, IRCCS Mondino Foundation, Pavia, Italy, ³NMR Research unit, Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom, ⁴Radiomics Group, Vall d’Hebron Institute of Oncology, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain, ⁵Department of Medical Physics and Biomedical Engineering, UCL Hawkes Institute, University College London, London, United Kingdom, ⁶E-Health Center, Universitat Oberta de Catalunya, Barcelona, Spain, ⁷Dept of Neuroinflammation, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom, ⁸Neurology-Neuroimmunology Department Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain

Synopsis

Keywords: White Matter, Multimodal, COVID-19, long COVID, QSM, chi-separation, diffusion, DTI, NODDI

Motivation: The biological mechanisms of impactful symptoms of the long-COVID syndrome such as fatigue and cognitive dysfunction, are still unknown.

Goal(s): The goal of this study was to understand the correlation between microstructural and susceptibility MRI metrics with fatigue and cognitive scores voxel-wise to identify the most involved regions and networks.

Approach: A multimodal MRI protocol was acquired in healthy controls, people recovered from COVID19 or with long-COVID, together with clinical assessments.

Results: The relationship between MRI metrics and the clinical scores was analyzed. Results showed that white matter and cerebellar regions are the most involved, with inflammation and iron-myelin dysregulation explaining the symptoms.

Impact: This work impacts on our understanding of fatigue and cognitive impairment, impactful symptoms of the long-COVID syndrome, emphasizing the role of diffusion MRI and susceptibility mapping models in detecting microstructural and susceptibility alterations voxel-wise.

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