Neuroanatomical signatures associated with dispositional optimism predict COVID-19-related posttraumatic stress symptoms.

The COVID-19 pandemic has been increasingly documented to cause negative impacts on mental health outcomes, e.g. posttraumatic stress symptoms (PTSS). Dispositional optimism ("optimism" hereinafter), a crucial psychological characteristic defined by positive expectancies for future outcomes, is considered to provide remarkable protection against PTSS. Accordingly, this study was designed to identify neuroanatomical signatures of optimism and further examine the mechanism through which optimism protects against COVID-19-specific PTSS. Here, 115 volunteers from a general population of university students completed MRI scans and optimism tests before (October 2019-January 2020) and after (February-April 2020) the onset of the COVID-19 pandemic. Whole-brain voxel-based morphometry analysis showed that a region from the dorsal anterior cingulate cortex (dACC) to the dorsomedial prefrontal cortex (dmPFC) was associated with optimism. Further seed-based structural covariance network (SCN) analysis using partial least-squares correlation found an optimism-linked SCN covarying with the combined dACC and dmPFC (the dACC-dmPFC). Additionally, mediation analyses revealed that the dACC-dmPFC volume and its SCN impacted COVID-19-specific PTSS through optimism. Our findings deepen the understanding of optimism and have the potential to identify vulnerable individuals during the COVID-19 pandemic or similar future events, as well as to guide optimism-related neural interventions to prevent and alleviate PTSS.

OLFACTORY FUNCTION AND BRAIN STRUCTURAL EFFECTS FOLLOWING SARS-CoV-2 INFECTION

Background: SARS-CoV-2 infection is accompanied by acute olfactory disturbance in as high as 70% of cases. This loss is associated with decreased olfactory bulb volume. As time passes, the anosmia tends to subside, but the OB volume decrease does not. Volume reductions in primary and secondary olfactory cortex are also seen following SARS-CoV-2 infection. Nevertheless, concurrent SARS-CoV-2 infection effects on olfactory discrimination, olfactory bulb volume, primary olfactory cortex and its targets have not been investigated. To explore this possibility, we measured olfactory discrimination, olfactory bulb volume, primary olfactory cortex and basal ganglia volume in patients who had SARS-CoV-2 infection more than 12 weeks previously, who were then divided into COVID and long-COVID groups on the basis of selfreported fatigue and concentration complaints. Method(s): This cross-sectional study included 25 post-infection and 19 demographically-matched, no-COVID control participants, we investigated effects on olfaction using NIH Toolbox Odor Identification Test and the Monell Smell Questionnaire. GM structure was assessed with voxel-based morphometry and manual delineation of high resolution (1mm3), T1- and T2-weighted MRI data. Linear regression was used to model group effects on GM structure, adjusting for age, sex, education and total intracranial volume. CAT12/SPM12 and R were used for image processing and statistical modeling. Result(s): Results. The NIH Toolbox Odor Identification Test failed to show differences among the groups. In contrast, the Monell Smell Questionnaire revealed persistently diminished and distorted smell in 50% of the long-COVID sample. Olfactory bulb volume was lower in the long-COVID group (p=0.02). Primary olfactory cortex volume was reduced in the long-COVID group (p=0.004). Caudate volume was also lower in the long-COVID group (p=0.04). Conclusion(s): Conclusions. In the absence of olfactory discrimination problems, long-COVID, but not COVID, patients experience persistent olfactory loss and distortion. These perceptual problems are associated with lower olfactory bulb, primary olfactory cortex, and caudate volume, suggesting that the effects of SARS-CoV-2 infection can extend beyond the olfactory periphery in some cases to affect central targets. (Figure Presented).

Changes in intestinal morphology, number of mucus-producing cells and expression of coronavirus receptors APN, DPP4, ACE2 and TMPRSS2 in pigs with aging.

Porcine enteric viral infections cause high morbidity and mortality in young piglets (<3 weeks). Later, these rates decrease with age. This age-dependent infectivity remains largely unexplored. This study investigated the changes in intestinal morphology, number of mucus-producing cells and expression level of coronavirus receptors in three age groups of pigs. Villus height and crypt depth increased with age from 3 days to 3 months in duodenum and ileum but not in mid-jejunum, where the villus height decreased from 580 µm at 3 days to 430 µm at 3 months. Enterocyte length-to-width ratio increased from 3 days to 3 months in all intestinal regions. The number of mucus-producing cells increased with age in the intestinal villi and crypts. The Brunner's glands of the duodenum contained the highest concentration of mucus-producing cells. The expression of coronavirus receptor APN was highest in the small intestinal villi at all ages. DPP4 expression slightly decreased over time in jejunum and ileum; it was highest in the ileal villi of 3-day-old piglets (70.2% of cells). ACE2 and TMPRSS2 positive cells increased with age in jejunal and ileal crypts and were particularly dominant in the ileal crypts (> 45% of cells). Except for the expression of DPP4 in the jejunum and ileum of young pigs, the expression pattern of the selected coronavirus receptors was very different and not correlated with the age-dependent susceptibility to viral infections. In contrast, the number of mucus-producing cells increased over time and may play an essential role in protecting enteric mucosae against intestinal viruses.

Two-year follow-up of brain structural changes in patients who recovered from COVID-19: A prospective study.

The long-term effects of COVID-19 on brain structure remain unclear. A prospective study was conducted to explore the changes in brain structure in COVID-19 survivors at one and two years after discharge (COVID-19one, COVID-19two). The difference in gray matter volume (GMV) was analyzed using the voxel-based morphometry method, and correlation analyses were conducted. The dynamic changes in clinical sequelae varied. The GMVs in the cerebellum and vermis were reduced in COVID-19one and COVID-19two, positively correlated with lymphocyte count, and negatively correlated with neutrophil count, neutrophil/lymphocyte ratio (COVID-19one), and systemic immune-inflammation index (COVID-19two). The decreased GMVs in the left middle frontal gyrus, inferior frontal gyrus of the operculum, right middle temporal gyrus, and inferior temporal gyrus returned to normal in COVID-19two. The decreased GMV in the left frontal lobe was negatively correlated with the Athens Insomnia Scale (AIS). The GMV in the left temporal lobe was aggravated in COVID-19two and positively correlated with C-reactive protein. In conclusion, GMV recovery coexisted with injury, which was associated with AIS and inflammatory factors. This may shed some light on the dynamic changes in brain structure and the possible predictors that may be related to GMV changes in COVID-19two.

Cortical Grey matter volume depletion links to neurological sequelae in post COVID-19 "long haulers".

OBJECTIVE: COVID-19 (SARS-CoV-2) has been associated with neurological sequelae even in those patients with mild respiratory symptoms. Patients experiencing cognitive symptoms such as "brain fog" and other neurologic sequelae for 8 or more weeks define "long haulers". There is limited information regarding damage to grey matter (GM) structures occurring in COVID-19 "long haulers". Advanced imaging techniques can quantify brain volume depletions related to COVID-19 infection which is important as conventional Brain MRI often fails to identify disease correlates. 3-dimensional voxel-based morphometry (3D VBM) analyzes, segments and quantifies key brain volumes allowing comparisons between COVID-19 "long haulers" and normative data drawn from healthy controls, with values based on percentages of intracranial volume. METHODS: This is a retrospective single center study which analyzed 24 consecutive COVID-19 infected patients with long term neurologic symptoms. Each patient underwent Brain MRI with 3D VBM at median time of 85 days following laboratory confirmation. All patients had relatively mild respiratory symptoms not requiring oxygen supplementation, hospitalization, or assisted ventilation. 3D VBM was obtained for whole brain and forebrain parenchyma, cortical grey matter (CGM), hippocampus, and thalamus. RESULTS: The results demonstrate a statistically significant depletion of CGM volume in 24 COVID-19 infected patients. Reduced CGM volume likely influences their long term neurological sequelae and may impair post COVID-19 patient's quality of life and productivity. CONCLUSION: This study contributes to understanding effects of COVID-19 infection on patient's neurocognitive and neurological function, with potential for producing serious long term personal and economic consequences, and ongoing challenges to public health systems.

Possible Role of Endocannabinoids in Olfactory and Taste Dysfunctions in COVID-19 Patients and Volumetric Changes in the Brain.

Introduction: COVID-19 infection develops neurologic symptoms such as smell and taste loss. We aimed to determine the volumetric changes in the brain and correlation of possible related biochemical parameters and endocannabinoid levels after COVID-19 recovery. Methods: Brain magnetic resonance images of recovered COVID-19 patients and healthy volunteers, whose olfactory and gustatory scores were obtained through a questionnaire, were taken, and the volumes of the brain regions associated with taste and smell were measured by automatic and semiautomatic methods. Endocannabinoids (EC), which are critical in the olfactory system, and vitamin B12, zinc, iron, ferritin, thyroid-stimulating hormone (TSH), and thyroxine (T4) levels, which are reported to have possible roles in olfactory disorders, were measured in peripheral blood. Results: Taste and smell disorder scores and EC levels were found to be higher in recovered COVID-19 patients compared to controls. EC levels were negatively correlated with bilateral entorhinal cortex (ENT) volumes in the COVID-19 group. Subgenual anterior cingulate cortex volumes showed correlations with gustatory complaints and ferritin in recovered COVID-19 patients. Conclusions: The critical finding of our study is the high EC levels and negative correlation between EC levels and left ENT volumes in recovered COVID-19 patients. Implications: It is possible that ECs are potential neuromodulators in many conditions leading to olfactory disorders, including COVID-19.

Placental Morphology and Morphometry: Is It a Prerequisite for Future Pathological Investigations?

Successful pregnancy is dependent on implantation, nutrient and gas exchange, as well as fetal protection from the immunologic attack. Placental pathologies and preterm delivery closely correlate with the size and shape of the placenta. Additionally, normal vaginal microbiota is disturbed during viral insults such as SARS-CoV-2 and HIV, with consequent placental anomalies. This chapter focuses on placental development, morphology, and pathology while also investigating placental bed structure and function. Placental anomalies with regard to HIV-1 and SARS-CoV-2 infection and placental morphometric image analysis and its relevance for verification of placental pathology are explored. Since image analysis remains optional for routine diagnostic purposes, authentication of placental appraisal warrants the use of measurable predefined definitions. Immunohistochemical analyses of placental morphology and angiogenic, epithelial, and apoptotic mechanisms facilitate research into etiopathogenetic pathways involved in placental anomalies with a focus on discovering novel diagnostic foci. Thus, image analyses as an adjunct to complement pathological investigations are recommended.

SARS-CoV-2 Morphometry Analysis and Prediction of Real Virus Levels Based on Full Recurrent Neural Network Using TEM Images.

The SARS-CoV-2 virus is responsible for the rapid global spread of the COVID-19 disease. As a result, it is critical to understand and collect primary data on the virus, infection epidemiology, and treatment. Despite the speed with which the virus was detected, studies of its cell biology and architecture at the ultrastructural level are still in their infancy. Therefore, we investigated and analyzed the viral morphometry of SARS-CoV-2 to extract important key points of the virus's characteristics. Then, we proposed a prediction model to identify the real virus levels based on the optimization of a full recurrent neural network (RNN) using transmission electron microscopy (TEM) images. Consequently, identification of virus levels depends on the size of the morphometry of the area (width, height, circularity, roundness, aspect ratio, and solidity). The results of our model were an error score of training network performance 3.216 × 10-11 at 639 epoch, regression of -1.6 × 10-9, momentum gain (Mu) 1 × 10-9, and gradient value of 9.6852 × 10-8, which represent a network with a high ability to predict virus levels. The fully automated system enables virologists to take a high-accuracy approach to virus diagnosis, prevention of mutations, and life cycle and improvement of diagnostic reagents and drugs, adding a point of view to the advancement of medical virology.

Alternate Special Stains for the Detection of Mycotic Organisms in Oral Cyto-Smears-A Histomorphometric Study.

In the wake of the COVID-19 pandemic, fungal infections of the maxillofacial region have become prevalent, making their accurate diagnosis vital. Histopathological staining remains a simple, cost-effective technique for differentiation and diagnosis of the causative fungal organisms. The present study aims to evaluate the staining efficacy of Periodic Acid-Schiff (PAS), Alcian Blue, Safranin-O and Gomori's Methenamine Silver (GMS) on fungal smears. This research work also attempts to study the morphometric characteristics of Candida albicans, Aspergillus flavus, Rhizopus oryzae. Candida albicans, Aspergillus flavus and Rhizopus oryzae, 10 smears each, were stained using PAS, Alcian Blue, Safranin-O and GMS. The morphological characteristics and staining efficacy were examined, and semi-quantitative scoring was performed. Candida albicans, Aspergillus flavus and Rhizopus oryzae were stained for the first time with Safranin-O. The morphometric traits were then analyzed using an image analysis software. Safranin-O provided the most reliable staining efficacy amongst the stains and optimum morphological definition for all three organisms. Safranin-O was found to be superior to PAS and GMS, ensuring detection of even the most minute mycotic colonies. The hyphae of Aspergillus flavus to be the largest, and the spores and fruiting body of Rhizopus oryzae were found to be the largest amongst the three organisms compared. Early and accurate diagnosis of fungal infections can significantly reduce morbidity in orofacial fungal infections.

NEUROPSYCHOLOGIE A JEJÍ PŘESAH DO JINÝCH VĚD - LITERÁRNÍ RECENZE

In the form of a literary review, this work set itself the task of examining the professional literature published on this topic and selecting representative literary sources that document the interdisciplinary nature of this scientific discipline. Do této kategorie spadá mimo jiné publikace Ratio of serum pro BDNF to BDNF and its association with cognitive performance and brain morphometry in mild cognitive impairment, autorů Čechová a kol. (2020) Gray matter atrophy, but not vascular brain injury is related to cognitive impairment in patients with heart failure, článek Comparison of brain atrophy and cognitive performance in individuals with low and high cardiovascular riskautorů Restrepo a kol. (2020) publikovali v časopise Archives of clinical neuropsychology: the official journal of the National Academy of Neuropsychologists studii s názvem Return on Investment and Value Research in Neuropsychology: A Call to Arms.

Detailed Anatomical Volumetric Study of Deep Nuclei of Brain and Other Structures Between Parkinson's Disease Patients Who Had Deep Brain Stimulation and Control Group.

BACKGROUND: Deep brain stimulation (DBS) was pioneered by Neuroscience team of Hospital Universiti Sains Malaysia (HUSM) nearly a decade ago to treat advanced medically refractory idiopathic Parkinson's disease (IPD) patients. OBJECTIVES: Brain volume reduction occurs with age, especially in Parkinson plus syndrome or psychiatric disorders. We searched to define the degree of volume discrepancy in advanced IPD patients and correlate the anatomical volumetric changes to motor symptoms and cognitive function. METHODS: We determined the magnetic resonance imaging (MRI)-based volumetry of deep brain nuclei and brain structures of DBS-IPD group and matched controls. RESULTS: DBS-IPD group had significant deep nuclei atrophy and volume discrepancy, yet none had cognitive or psychobehavioural disturbances. Globus pallidus volume showed positive correlation to higher mental function. CONCLUSION: The morphometric changes and clinical severity discrepancy in IPD may imply a more complex degenerative mechanism involving multiple neural pathways. Such alteration could be early changes before clinical manifestation.

Organ and tissue damage related to SARS-CoV-2: the biological model for experimental (preclinical) trials on golden hamsters Mesocricetus auratus

Introduction. Amid the pandemic of the new coronavirus infection COVID-19, experimental models for screening both newly developed vaccines and drugs, and the already registered active pharmaceutical ingredients tested for new indications are in high demand. The registration of changes in biometric and morphological parameters that are significant for the investigative pathology can be an optimal screening tool for antiviral drugs and vaccines to treat COVID-19. In this regard, the purpose of this study was to describe the changes over time of organ and tissue changes using a biological model of a SARS-CoV-2-associated infection in the golden hamsters Mesocricetus auratus. Materials and methods. We performed the study in golden hamsters Mesocricetus auratus weighing 80–100 g. The animals were infected through intranasal administration of a culture of SARS-CoV-2 virus containing 4 × 104 TCID50 /mL. We recorded the animals’ weight before the infection and during the next 14 days and measured the specific gravity of the internal organs and the degree of their moisture saturation on days 3, 7, and 14 after the infection. Additionally, tissue samples were fixed in 10% neutral formalin;the preparation of histological specimens was performed according to the standard procedure. Statistical data processing was carried out using non-parametric tests. Results. In the model of SARS-CoV-2 infection in Mesocricetus auratus, we observed the manifestation of the infectious disease after 3 days. The most pronounced pathological changes in the overall health status of the animals and in the histology of internal organs were seen 7 days after the infection. We determined the weight loss and significant deviations in gravimetric coefficients of lungs, heart, spleen, and kidneys to be the indicators revealing the infectious disease course changes over time. Histologic evaluation showed typical changes in the SARS-CoV-2-associated visceral damage: the formation of polymorphonuclear cell infiltrates in the lung interalveolar septa and patchy dystrophic changes in the neurocytes of the brain screen-type centers with the demyelination of the commissural nerve guides. The detected pathological manifestations corresponded in time to an increase in the virus replicative activity in the lungs. Conclusion. The experimental model of the SARS-CoV-2-associated infection in golden hamsters Mesocricetus auratus can be recommended for screening experimental (preclinical) studies of the promising drugs’ efficacy for pathogenetic and etiotropic therapy of COVID-19. © 2021, MDV Group. All rights reserved.

P.0279 Neural underpinnings of depressive and post-traumatic symptomatology in covid-19 survivors: a voxel-based morphometry study

Background: A high prevalence of depression, anxiety, insomnia and PTSD has been reported in COVID-19 survivors [1]. This is similar to what previously observed in other Coronavirus-related diseases such as SARS and MERS [2]. The pathophysiology of post-infection neuropsychiatric symptoms is likely to be multifactorial, with a role played by inflammatory and immunological factors [3], but it is still largely unknown;we thus investigated COVID-19 survivors via 3T MRI imaging to identify neural underpinnings of post-infection neuropsychiatric symptoms in order to further elucidate their complex pathophysiology. Methods: Covid-19 survivors were recruited during an ongoing prospective cohort study at IRCCS San Raffaele Hospital in Milan;psychopathology was initially measured via several self-report questionnaires (Impact of Events Scale-Revised (IES-R), Zung Self-Rating Depression Scale (ZSDS), 13-item Beck's Depression Inventory (BDI));subsequently patients (n=28) underwent 3T MRI scanning (Philips 3T Ingenia CX scanner with 32-channel sensitivity encoding SENSE head coil). T1 weighted images were processed using Computational Anatomy Toolbox (CAT12) for Statistical Parametric Mapping 12 (SPM12) in Matlab R2016b;segmentation into Gray Matter, White Matter and cerebrospinal fluid, bias regularization, non-linear modulation and normalization to MNI space were performed;measures of Total Intracranial Volume (TIV) were obtained and images were smoothed with an 8-mm full width at half maximum Gaussian filter. Multiple regressions were performed using SPM12 software package: with no a priori regions of interest selected, whole-brain gray matter volumes were used as dependent variables, psychometric scales scores as independent variables, and age, sex and TIV as nuisance covariates. Results: After VBM regression analysis covarying for age, sex and TIV, ZSDS Index scores were inversely correlated with gray matter volume in the Bilateral Anterior Cingulate Cortex (MNI 2, 24, 28, cluster level pFWE = 0.045, k=767);furthermore 3 cluster were identified comprising again the anterior cingulate cortex and the insular cortex bilaterally in which IES-R scores were inversely correlated with gray matter volumes (Cluster 1: MNI -30, 9, 3, cluster level pFWE = 0.005, k=1284;Cluster 2: MNI 36, -3, -3, cluster level pFWE = 0.037, k=773;Cluster 3: MNI 9, 30, 28, cluster level pFWE = 0.038, k=766). No other statistical significant result was found. Conclusions: Our study identified an inverse correlation between anterior cingulate cortex volumes and depressive symptomatology, measured via ZSDS, and between bilateral insulae and anterior cingulate cortex volumes and the degree of distress in response to the traumatic event, measured via the IES-R. Analogous findings have already been reported in patients with Major depression [4] and PTSD [5], and our study confirms the role of volumetric reductions of these brain regions in depressive and post-traumatic symptomatology. Given the nature of our study it is not possible to infer whether the reduction of gray matter volume is a consequence of the Covid-19 infection itself or, as it appears more likely, precede the infection acting as predisposing factor for the subsequent development of depressive and post-traumatic symptomatology. No conflict of interest

Sonographic assessment of low muscle quantity identifies mortality risk during COVID-19: a prospective single-centre study.

BACKGROUND: Assessment of muscle quantity by sonographic muscle indices could help identify patients at risk for fatal outcome during coronavirus disease-2019 (COVID-19). The aim of this study was to explore sonographic muscle indices as predictors of COVID-19 outcome and to test the feasibility of sonographic muscle measurement in an isolation context. METHODS: Muscle indices, derived from the psoas muscle or thigh muscles, were quantified by sonography in a cohort of patients without COVID-19 to obtain reference values for low muscle quantity. Gender-specific median of different muscle indices were defined as threshold value for low muscle quantity. The prognostic relevance of low muscle quantity, was prospectively explored in two cohorts of hospitalized COVID-19 patients. Optimal muscle index cutoff values predictive for 30 day mortality during COVID-19 were determined by receiver operating characteristic-area under the curve and Youden index calculation. Muscle quantity and known prognostic factors of COVID-19 were analysed by multivariable log-regression. RESULTS: Compared with other muscle indices, the psoas muscle area index (PMAI) showed the most favourable characteristics to predict outcome of COVID-19 disease. Sonographic morphometry of patients without COVID-19 (n = 136) revealed a gender-specific median for PMAI (male: 291.1 mm2 /m2 , female 260.6 mm2 /m2 ) as threshold value of low muscle quantity. Subsequently, COVID-19 patients (Cohort I: n = 58; Cohort II: n = 55) were prospectively assessed by bedside sonography. The studied COVID-19 patients developed a critical course of disease in 22.4% (Cohort I: n = 13/58) and 34.5% (Cohort II: n = 20/55). Mortality rate reached 12.1% (Cohort I: n = 7/58) and 20.0% (Cohort I: n = 11/55) within 30 days of follow up. COVID-19 patients with a PMAI below the gender-specific median showed a higher 30 day mortality in both COVID-19 cohorts (log rank, P < 0.05). The optimal PMAI cutoff value (206 mm2 /m2 ) predicted 30 day mortality of hospitalized COVID-19 patients with a sensitivity of 72% and specificity of 78.5% (receiver operating characteristic-area under the curve: 0.793, 95% confidence interval 0.671-0.914, P = 0.008). Multivariable log-regression analysis of PMAI, age, gender, BMI and comorbidities confirmed an independent association of low PMAI with 30 day mortality of COVID-19 patients (P = 0.018). CONCLUSIONS: Sonographic morphometry provides reliable muscle quantification under hygienic precautions and allows risk stratification of patients with COVID-19.

Morphometric Parameters of Placental Villi in Parturient Women with COVID-19.

We performed a comparative morphological analysis of placental villi in parturient women with mild and moderate COVID-19 infection. The area and perimeter of terminal villi, their capillaries, and syncytiotrophoblast were assessed on immunohistochemical preparations with antibodies to CD31 using an image analysis system; the parameters of fetal vascular component in the placental villi were also assessed. Changes in the studied parameters differed in parturient women with mild and moderate COVID-19 infection. The observed increase in the total perimeter with a simultaneous decrease in the total capillary area and the degree of vascularization of the placental villi in parturient women with COVID-19 indicates impairment of circulation in the fetal compartment and the development of placental hypoxia, which can be the cause of unfavorable neonatal outcomes.

Morphometry and Contents of the Suprascapular Notch with Potential Clinical Implications: Α Cadaveric Study.

Background The suprascapular notch (SN) represents the point along the route of the suprascapular nerve (SSN) with the greatest potential risk for injury and compression. Thus, factors reducing the area of the notch have been postulated for suprascapular neuropathy development. Methods Thirty-one fresh-frozen shoulders were dissected. The contents of the SN were described according to four types as classified by Polguj et al and the middle-transverse diameter of the notch was measured. Also, the presence of an ossified superior transverse scapular ligament (STSL) was identified. Results The ligament was partially ossified in 8 specimens (25.8%), fully ossified in 6 (19.35%), and not ossified in the remaining 17 (54.85%). The mean middle-transverse diameter of the SN was 9.06 mm (standard deviation [SD] = 3.45). The corresponding for type-I notches was 8.64 mm (SD = 3.34), 8.86 mm (SD = 3.12) was for type-II, and 14.5 mm (SD = 1.02) was for type III. Middle-transverse diameter was shorter when an ossified ligament was present (mean = 5.10 mm, SD = 0.88 mm), comparing with a partially ossified ligament (mean =7.67 mm, SD = 2.24 mm) and a nonossified one (mean = 11.12 mm, SD = 2.92 mm). No statistically significant evidence was found that the middle-transverse diameter depends on the number of the elements, passing below the STSL. Conclusion Our results suggest that SSN compression could be more likely to occur when both suprascapular vessels pass through the notch. Compression of the nerve may also occur when an ossified transverse scapular ligament is present, resulting to significant reduction of the notch's area.

Cerebral Micro-Structural Changes in COVID-19 Patients - An MRI-based 3-month Follow-up Study.

BACKGROUND: Increasing evidence supported the possible neuro-invasion potential of SARS-CoV-2. However, no studies were conducted to explore the existence of the micro-structural changes in the central nervous system after infection. We aimed to identify the existence of potential brain micro-structural changes related to SARS-CoV-2. METHODS: In this prospective study, diffusion tensor imaging (DTI) and 3D high-resolution T1WI sequences were acquired in 60 recovered COVID-19 patients (56.67% male; age: 44.10 ± 16.00) and 39 age- and sex-matched non-COVID-19 controls (56.41% male; age: 45.88 ± 13.90). Registered fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were quantified for DTI, and an index score system was introduced. Regional volumes derived from Voxel-based Morphometry (VBM) and DTI metrics were compared using analysis of covariance (ANCOVA). Two sample t-test and Spearman correlation were conducted to assess the relationships among imaging indices, index scores and clinical information. FINDINGS: In this follow-up stage, neurological symptoms were presented in 55% COVID-19 patients. COVID-19 patients had statistically significantly higher bilateral gray matter volumes (GMV) in olfactory cortices, hippocampi, insulas, left Rolandic operculum, left Heschl's gyrus and right cingulate gyrus and a general decline of MD, AD, RD accompanied with an increase of FA in white matter, especially AD in the right CR, EC and SFF, and MD in SFF compared with non-COVID-19 volunteers (corrected p value <0.05). Global GMV, GMVs in left Rolandic operculum, right cingulate, bilateral hippocampi, left Heschl's gyrus, and Global MD of WM were found to correlate with memory loss (p value <0.05). GMVs in the right cingulate gyrus and left hippocampus were related to smell loss (p value <0.05). MD-GM score, global GMV, and GMV in right cingulate gyrus were correlated with LDH level (p value <0.05). INTERPRETATION: Study findings revealed possible disruption to micro-structural and functional brain integrity in the recovery stages of COVID-19, suggesting the long-term consequences of SARS-CoV-2. FUNDING: Shanghai Natural Science Foundation, Youth Program of National Natural Science Foundation of China, Shanghai Sailing Program, Shanghai Science and Technology Development, Shanghai Municipal Science and Technology Major Project and ZJ Lab.

Alterations of frontal-temporal gray matter volume associate with clinical measures of older adults with COVID-19.

COVID-19, the infectious disease caused by the most recently discovered severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has become a global pandemic. It dramatically affects people's health and daily life. Neurological complications are increasingly documented for patients with COVID-19. However, the effect of COVID-19 on the brain is less studied, and existing quantitative neuroimaging analyses of COVID-19 were mainly based on the univariate voxel-based morphometry analysis (VBM) that requires corrections for a large number of tests for statistical significance, multivariate approaches that can reduce the number of tests to be corrected have not been applied to study COVID-19 effect on the brain yet. In this study, we leveraged source-based morphometry (SBM) analysis, a multivariate extension of VBM, to identify changes derived from computed tomography scans in covarying gray matter volume patterns underlying COVID-19 in 120 neurological patients (including 58 cases with COVID-19 and 62 patients without COVID-19 matched for age, gender and diseases). SBM identified that lower gray matter volume (GMV) in superior/medial/middle frontal gyri was significantly associated with a higher level of disability (modified Rankin Scale) at both discharge and six months follow-up phases even when controlling for cerebrovascular diseases. GMV in superior/medial/middle frontal gyri was also significantly reduced in patients receiving oxygen therapy compared to patients not receiving oxygen therapy. Patients with fever presented significant GMV reduction in inferior/middle temporal gyri and fusiform gyrus compared to patients without fever. Patients with agitation showed GMV reduction in superior/medial/middle frontal gyri compared to patients without agitation. Patients with COVID-19 showed no significant GMV differences from patients without COVID-19 in any brain region. Results suggest that COVID-19 may affect the frontal-temporal network in a secondary manner through fever or lack of oxygen.