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Título

BRAIN FUNCTIONAL CONNECTIVITY IS SEVERELY DISRUPTED IN THE PRESENCE OF ANXIETY AND DEPRESSION SYMPTOMS AFTER MILD COVID-19 INFECTION

RESUMO

Introduction: Although most individuals with post-COVID syndrome present symptoms of anxiety and depression, little is known about the associated brain dysfunction. So far, fewer studies have analyzed brain connectivity abnormalities in post-covid syndrome.
Objective: To investigate the impact of symptoms of anxiety and depression on functional brain connectivity (FC) after mild COVID-19 infection, analyzing 12 large-scale brain networks (NW) with resting-state fMRI (rs-FMRI).
Methods: We analyzed 154 post-covid subjects who had a mild infection and confirmed RT-PCR test and 90 healthy controls. All individuals were evaluated with BDI (Beck Depression Inventory) and BAI (Beck anxiety inventory) for quantification of symptoms. Patients were divided into asymptomatic-group (ASYMP-Group, no symptoms of depression or anxiety) (84 individuals, 54 women, median age of 36 years), and DOUBLE-group (combined symptoms of anxiety and depression) (70 subjects, 55 women, median age of 41 years).All individuals underwent rs-fMRI scan (along with 3D T1-weighted) on a 3T scanner. Each group was compared to a specific control group paired for age and sex. Images were analyzed with UF2C/SPM12 (http://www.lni.hc.unicamp.br/aoo/uf2c/) running on MATLAB2019b. The protocol includes steps of pre-processing (normalization and smoothing) and extraction of time series from 70 Regions of Interest (ROIs) (from 12 resting-state networks: Anterior and Posterior Salience, Basal Ganglia, Dorsal and Ventral Default Mode, Left and Right Executive Control, Auditory, Visual, Language, Sensorimotor and Visuospatial/Dorsal Attention) used to construct Pearson’s Cross-Correlation Matrix. Results were considered significant after correction for multiple comparisons at p<0.05.
Results: While the DOUBLE-group exhibited a widespread, bilateral pattern of hyperconnectivity involving the 12 networks and most of 70 ROIs, the ASYMP-group showed fewer alterations, with hyperconnectivity involving only five networks (posterior salience, ventral and dorsal DMN, and right and left executive control) and nine ROIs. (p<0.05).
Conclusion: Our results suggest a severe pattern of abnormal cerebral functional connectivity, mainly in individuals with persisting symptoms of anxiety and depression. These abnormalities may be associated with cognitive dysfunction in post-covid syndrome. Symptomatic treatment should be available for these individuals to improve their quality of life.

Palavras Chave

Neuroimaging, COVID-19, Neurology, Neuroinfection