Neuroinflammation After COVID-19 With Persistent Depressive and Cognitive Symptoms
SOURCE: Journal of the American Medical Association in Psychiatry
STUDY AUTHORS Joeffre Braga, BSc; Mariel Lepra, BSc; Stephen J. Kish, PhD; Pablo. M. Rusjan, PhD; Zahra Nasser; Natasha Verhoeff, BHSc; Neil Vasdev, PhD; Michael Bagby, PhD; Isabelle Boileau, PhD; M. Ishrat Husain, MBBS, MD; Nathan Kolla, MD, PhD; Armando Garcia, BSc; Thomas Chao, PhD; Romina Mizrahi, PhD; Khunsa Faiz, MD; Erica L. Vieira, PhD; Jeffrey H. Meyer, MD, PhD
IMPORTANCE Persistent depressive symptoms, often accompanied by cognitive symptoms, commonly occur after COVID-19 illness (hereinafter termed COVID-DC, DC for depressive and/or cognitive symptoms). In patients with COVID-DC, gliosis, an inflammatory change, was suspected, but measurements of gliosis had not been studied in the brain for this condition.
OBJECTIVE To determine whether translocator protein total distribution volume (TSPO VT), a marker of gliosis that is quantifiable with positron emission tomography (PET), is elevated in the dorsal putamen, ventral striatum, prefrontal cortex, anterior cingulate cortex, and hippocampus of persons with COVID-DC.
METHOD Symptoms were measured with neuropsychological and psychological tests, prioritizing outcomes related to striatal function.
CONCLUSIONS AND RELEVANCE In this case-control study, TSPO VT was higher in patients with COVID-DC. Greater TSPO VT is evidence for an inflammatory change of elevated gliosis in the brain of an individual with COVID-DC. Gliosis may be consequent to inflammation, injury, or both, particularly in the ventral striatum and dorsal putamen, which may explain some persistent depressive and cognitive symptoms, including slowed motor speed, low motivation or energy, and anhedonia, after initially mild to moderate COVID-19 illness.
MEANING These findings suggest that gliosis, especially in the ventral striatum and dorsal putamen, may reflect injury, ongoing inflammation, or both and provide directions for further therapeutic development.
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