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1.
Embase; 2021.
Preprint in English | EMBASE | ID: ppcovidwho-335728

ABSTRACT

There is strong evidence for brain-related abnormalities in COVID-191-13. It remains unknown however whether the impact of SARS-CoV-2 infection can be detected in milder cases, and whether this can reveal possible mechanisms contributing to brain pathology. Here, we investigated brain changes in 785 UK Biobank participants (aged 51-81) imaged twice, including 401 cases who tested positive for infection with SARS-CoV-2 between their two scans, with 141 days on average separating their diagnosis and second scan, and 384 controls. The availability of pre-infection imaging data reduces the likelihood of pre-existing risk factors being misinterpreted as disease effects. We identified significant longitudinal effects when comparing the two groups, including: (i) greater reduction in grey matter thickness and tissue-contrast in the orbitofrontal cortex and parahippocampal gyrus, (ii) greater changes in markers of tissue damage in regions functionally-connected to the primary olfactory cortex, and (iii) greater reduction in global brain size. The infected participants also showed on average larger cognitive decline between the two timepoints. Importantly, these imaging and cognitive longitudinal effects were still seen after excluding the 15 cases who had been hospitalised. These mainly limbic brain imaging results may be the in vivo hallmarks of a degenerative spread of the disease via olfactory pathways, of neuroinflammatory events, or of the loss of sensory input due to anosmia. Whether this deleterious impact can be partially reversed, or whether these effects will persist in the long term, remains to be investigated with additional follow up.

2.
Insights into Imaging ; 13(1), 2022.
Article in English | ProQuest Central | ID: covidwho-1837549

ABSTRACT

BackgroundBrain abnormalities are a concern in COVID-19, so we used minimally invasive autopsy (MIA) to investigate it, consisting of brain 7T MR and CT images and tissue sampling via transethmoidal route with at least three fragments: the first one for reverse transcription polymerase chain reaction (RT-PCR) analysis and the remaining fixed and stained with hematoxylin and eosin. Two mouse monoclonal anti-coronavirus (SARS-CoV-2) antibodies were employed in immunohistochemical (IHC) reactions.ResultsSeven deceased COVID-19 patients underwent MIA with brain MR and CT images, six of them with tissue sampling. Imaging findings included infarcts, punctate brain hemorrhagic foci, subarachnoid hemorrhage and signal abnormalities in the splenium, basal ganglia, white matter, hippocampi and posterior cortico-subcortical. Punctate brain hemorrhage was the most common finding (three out of seven cases). Brain histological analysis revealed reactive gliosis, congestion, cortical neuron eosinophilic degeneration and axonal disruption in all six cases. Other findings included edema (5 cases), discrete perivascular hemorrhages (5), cerebral small vessel disease (3), perivascular hemosiderin deposits (3), Alzheimer type II glia (3), abundant corpora amylacea (3), ischemic foci (1), periventricular encephalitis foci (1), periventricular vascular ectasia (1) and fibrin thrombi (1). SARS-CoV-2 RNA was detected with RT-PCR in 5 out of 5 and IHC in 6 out 6 patients (100%).ConclusionsDespite limited sampling, MIA was an effective tool to evaluate underlying pathological brain changes in deceased COVID-19 patients. Imaging findings were varied, and pathological features corroborated signs of hypoxia, alterations related to systemic critically ill and SARS-CoV-2 brain invasion.

3.
International Journal of Environmental Research and Public Health ; 19(9):5480, 2022.
Article in English | ProQuest Central | ID: covidwho-1837148

ABSTRACT

In 2021, over 100,000 people died prematurely from opioid overdoses. Neuropsychiatric and cognitive impairments are underreported comorbidities of reward dysregulation due to genetic antecedents and epigenetic insults. Recent genome-wide association studies involving millions of subjects revealed frequent comorbidity with substance use disorder (SUD) in a sizeable meta-analysis of depression. It found significant associations with the expression of NEGR1 in the hypothalamus and DRD2 in the nucleus accumbens, among others. However, despite the rise in SUD and neuropsychiatric illness, there are currently no standard objective brain assessments being performed on a routine basis. The rationale for encouraging a standard objective Brain Health Check (BHC) is to have extensive data available to treat clinical syndromes in psychiatric patients. The BHC would consist of a group of reliable, accurate, cost-effective, objective assessments involving the following domains: Memory, Attention, Neuropsychiatry, and Neurological Imaging. Utilizing primarily PUBMED, over 36 years of virtually all the computerized and written-based assessments of Memory, Attention, Psychiatric, and Neurological imaging were reviewed, and the following assessments are recommended for use in the BHC: Central Nervous System Vital Signs (Memory), Test of Variables of Attention (Attention), Millon Clinical Multiaxial Inventory III (Neuropsychiatric), and Quantitative Electroencephalogram/P300/Evoked Potential (Neurological Imaging). Finally, we suggest continuing research into incorporating a new standard BHC coupled with qEEG/P300/Evoked Potentials and genetically guided precision induction of “dopamine homeostasis” to diagnose and treat reward dysregulation to prevent the consequences of dopamine dysregulation from being epigenetically passed on to generations of our children.

4.
Akademik Acil Tip Olgu Sunumlari Dergisi ; 12(3):91-93, 2021.
Article in English | EMBASE | ID: covidwho-1822752

ABSTRACT

Introduction: Many studies have shown that coagulation disorders and increased risk of thrombosis may occur during coronavirus disease 2019 (COVID-19) infection. Although cardiac or pulmonary vascular pathologies has been detected in most cases, cerebral sinus thrombosis are rare. During COVID-19 infection patients rarely present with neurological symptoms. Case Report: A 19-year-old man was admitted to our emergency department with neurological symptoms. Cerebral venous sinus thrombosis (CVST) was detected in Brain Computerized Tomography and Magnetic Resonance Imaging examinations. Our patient was hospitalized in the neurology department of our hospital for medical treatment and was discharged after clinical recovery. Discussion: In this case report we wanted to draw attention to cerebral venous sinus thrombosis which is a rare but treatable complication of COVID-19 infection in a young patient. We examined our patient in the light of literature. Conclusion: Clinicians should keep in mind the diagnosis of CVST that may occur due to infection associated thrombosis in COVID-19 patients presenting with neurological symptoms and consider adding anticoagulants to the treatment if necessary.

5.
Clinical Neurosurgery ; 67(SUPPL 1):138, 2020.
Article in English | EMBASE | ID: covidwho-1816191

ABSTRACT

INTRODUCTION: Neuroimaging in the intensive care unit (ICU) may be difficult to acquire given the safety concerns and challenges involved in moving critically ill patients. We report on the safety and clinical findings of a portable magnetic resonance imager (MRI) in a cohort of ICU patients who had Covid 19 with suspected neurologic injury. METHODS: This is a prospective, non-randomized, observational study at one institution utilizing portable MRI in patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, known as Covid-19. Patients selected for imaging had any of the following: 1) unexplained encephalopathy or coma, 2) seizures, 3) focal neurologic deficit, and 4) abnormal head CT. Imaging was performed in each patient's ICU room with a portable, selfshielding, 0.064 Tesla (T) MRI. RESULTS: Among 19 patients, a total of 20 MRI scans in seven ICUs were acquired between April 13 and April 23, 2020. No adverse events to patients or staff from MRI acquisition were reported. In 12 patients, abnormal findings were seen, which included increased fluid attenuated inversion recovery (FLAIR) signal (n = 12), hemorrhage (n = 3), and diffusion-weighted imaging (DWI) positivity (n = 3). Imaging led to a change in clinical management in five patients, including 3 lumbar punctures, a resumption of anticoagulation therapy, and one previously unplanned move to palliative care. CONCLUSION: This study provides the first report on the use of a novel, portable, self-shielding MRI to image patients. In critically ill patients, the use of portable MRI is safe, feasible, and leads to changes in clinical management. This technique can be applied to any ICU patients whose care requires imaging of the brain.

6.
Crit Care ; 26(1): 119, 2022 04 30.
Article in English | MEDLINE | ID: covidwho-1813362

ABSTRACT

BACKGROUND: To assess the safety and feasibility of imaging of the brain with a point-of-care (POC) magnetic resonance imaging (MRI) system in patients on extracorporeal membrane oxygenation (ECMO). Early detection of acute brain injury (ABI) is critical in improving survival for patients with ECMO support. METHODS: Patients from a single tertiary academic ECMO center who underwent head CT (HCT), followed by POC brain MRI examinations within 24 h following HCT while on ECMO. Primary outcomes were safety and feasibility, defined as completion of MRI examination without serious adverse events (SAEs). Secondary outcome was the quality of MR images in assessing ABIs. RESULTS: We report 3 consecutive adult patients (median age 47 years; 67% male) with veno-arterial (n = 1) and veno-venous ECMO (n = 2) (VA- and VV-ECMO) support. All patients were imaged successfully without SAEs. Times to complete POC brain MRI examinations were 34, 40, and 43 min. Two patients had ECMO suction events, resolved with fluid and repositioning. Two patients were found to have an unsuspected acute stroke, well visualized with MRI. CONCLUSIONS: Adult patients with VA- or VV-ECMO support can be safely imaged with low-field POC brain MRI in the intensive care unit, allowing for the assessment of presence and timing of ABI.


Subject(s)
Extracorporeal Membrane Oxygenation , Adult , Brain/diagnostic imaging , Extracorporeal Membrane Oxygenation/methods , Feasibility Studies , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Retrospective Studies
7.
Neuroepidemiology ; 56(SUPPL 1):69, 2022.
Article in English | EMBASE | ID: covidwho-1812949

ABSTRACT

Background: Severe Acute Respiratory Syndrome Corona Virus 2(SARS-Cov2) is well known to cause a multitude of neurologic conditions out of which remains the rather rare condition of Acute Necrotizing Encephalopathy. It's a devastating condition with early immunotherapy bringing a more favorable outcome. Pathophysiology suggests the dysregulation of the blood brain barrier secondary to the cytokine storm. Pituitary apoplexy is an unrelated acute condition in which there is either hemorrhagic or non- hemorrhagic necrosis of the pituitary gland. It again has multiple predisposing factors including changes in intracranial pressure and underlying coagulation disorders. Case Presentation: A thirty-five-year-old male patient with poorly controlled diabetes presented to our emergency department with fever, cough and progressive respiratory distress for three days. He was drowsy with clinical features of bronchopneumonia and his COVID PCR was positive (He had taken only the first dose of Sinopharm nearly a month before). Within twenty-four hours, he was sent to the ICU for ventilatory support mainly due to low GCS. His HRCT Chest revealed severe COVID pneumonia. MRI brain revealed high signal intensities involving cerebellum, brainstem, bilateral thalami and mesial temporal lobes compatible with acute necrotizing encephalopathy with a pituitary macroadenoma and bleeding into it. He received high dose steroids followed by plasma exchange leading to resolution of the above changes within a month but passed away at the end of six weeks due to secondary bacterial sepsis. Discussion: Here the pituitary macroadema was an incidental finding and the bleeding was postulated to be secondary to changes in intra cranial pressure. Both the Necrotizing encephalopathy and the pituitary apoplexy might have resulted in the reduced conscious level in the above patient in the background of severe COVID pneumonia. The immunotherapy was successful in resolution of the radiologic changes though the patient deteriorated clinically following a transient improvement due to bacterial sepsis.

8.
Neuroepidemiology ; 56(SUPPL 1):43, 2022.
Article in English | EMBASE | ID: covidwho-1812821

ABSTRACT

Objectives: The Auckland Regional Community Stroke Studies (ARCOS) are population-based studies conducted in Auckland, New Zealand in adults (<15 yrs). In 2020, the SARS-CoV-2 pandemic disrupted the health system and potentially affected the presentation and care of stroke patients. We aimed to utilise this opportunity to study the impact of the pandemic on stroke incidence, and hospitalisation during this extended phase of the ARCOS V study. Methods: Between 1st March and 31st August 2020, stroke cases were identified through multiple case ascertainment methods, including public hospitals and emergency departments;CT/MRI records;hospital discharge registers;private hospitals, rest homes, and community health services. During this time, the Auckland (population 1,257,690) was in various phases of lockdown, including Level 4 during which everything except essential services was shut down. Completion of case ascertainment from the death registry is currently underway, hence preliminary findings are presented. Results: Of the 1198 registered stroke cases, 50.8% were women, 29.4% were aged between 15-64 years 84.1% were first-ever strokes. The age standardised attack rate of stroke in the 6-month period was 72 [95% CI 72 to 80] per 100,000 and the incidence of first ever stroke was 64 [95% CI 60 to 68] per 100,000. The majority (81%) presented to hospital via ambulance, and 96.1% received brain imaging within 24 hours of admission. While the majority sought attention within minutes or hours of symptom onset, 22% delayed seeking attention by a day or more. Conclusions: Robust and well-established online data collection protocols allowed the continuation of the ARCOS V study during the peak of the SARS-CoV-2 pandemic. The number of people presenting to hospital with stroke was close to expected levels. However, a significant number of people delayed seeking medical attention. Learnings from this study will be important to plan for stroke services during future pandemics.

9.
Applied Sciences ; 12(8):3773, 2022.
Article in English | ProQuest Central | ID: covidwho-1809667

ABSTRACT

Brain tumor is a severe cancer and a life-threatening disease. Thus, early detection is crucial in the process of treatment. Recent progress in the field of deep learning has contributed enormously to the health industry medical diagnosis. Convolutional neural networks (CNNs) have been intensively used as a deep learning approach to detect brain tumors using MRI images. Due to the limited dataset, deep learning algorithms and CNNs should be improved to be more efficient. Thus, one of the most known techniques used to improve model performance is Data Augmentation. This paper presents a detailed review of various CNN architectures and highlights the characteristics of particular models such as ResNet, AlexNet, and VGG. After that, we provide an efficient method for detecting brain tumors using magnetic resonance imaging (MRI) datasets based on CNN and data augmentation. Evaluation metrics values of the proposed solution prove that it succeeded in being a contribution to previous studies in terms of both deep architectural design and high detection success.

10.
Acta Neurol Scand ; 2022 Apr 25.
Article in English | MEDLINE | ID: covidwho-1807012

ABSTRACT

BACKGROUND: Olfactory dysfunction is common during SARS-CoV-2 infection. The pathophysiology of the persistence of this symptom and the potential relationship with central nervous system involvement is unknown. AIM OF THE STUDY: To evaluate the neural correlates of persistent olfactory dysfunction in a series of patients with post-COVID syndrome. METHODS: Eighty-two patients with post-COVID syndrome were assessed with the Brief Smell Identification Test and a multimodal MRI study including 3D-T1, T2-FLAIR, diffusion-tensor imaging, and arterial spin labeling. Olfactory and neuroimaging examinations were performed 11.18 ± 3.78 months after the acute infection. Voxel-based brain mapping analyses were conducted to correlate the olfactory test with brain volumes, white matter microstructure, and brain perfusion. RESULTS: Olfactory dysfunction was associated with lower tissue perfusion in the orbital and medial frontal regions in the arterial spin labeling sequence. Conversely, no statistically significant findings were detected in brain volumes and diffusion-tensor imaging. Mild changes in paranasal sinuses and nasal cavities were detected in 9.75% of cases, with no association with olfactory deficits. CONCLUSIONS: We provide new insights regarding the pathophysiology of persistent olfactory dysfunction after COVID-19, involving the main brain regions associated with the olfactory system.

11.
Curr Neurol Neurosci Rep ; 22(5): 305-311, 2022 05.
Article in English | MEDLINE | ID: covidwho-1800311

ABSTRACT

PURPOSE OF REVIEW: This review discusses advances in functional movement disorders (FMD) over the past 3 years, with a focus on risk factors, diagnosis, pathophysiology, neuroimaging studies, and treatment. RECENT FINDINGS: The past decade has brought a revived interest in functional movement disorders, with a growing number of studies exploring pathophysiological mechanisms. Here, we review recent studies demonstrating changes in attention, emotional and sensorimotor function in FMD. Through international collaborative efforts, progress has been made in defining biomarkers and outcome measures, an important prerequisite towards standardization of diagnosis and reporting of outcomes in clinical trials. Of particular interest are neuroimaging studies demonstrating functional and structural changes in motor and emotional brain circuits, deepening our understanding of FMD as a neurocircuit disorder and potentially paving the way towards new treatments. Currently available treatment modalities have shown successful outcomes via outpatient, inpatient, and virtual delivery. The last 3 years have seen tremendous efforts to better understand, diagnose, and treat FMD. The disease model has been broadened to include a biopsychosocial formulation, and insights on the pathophysiology on FMD are informing treatment efforts. Several international multidisciplinary research collaborations are underway to define biomarkers and best outcome measures, highlighting the path towards improved standardization of future treatment trials. Additionally, the rise of telemedicine during the COVID-19 pandemic has reduced geographic barriers and paved the way for virtual therapy sessions and self-guided programs.


Subject(s)
COVID-19 , Conversion Disorder , Movement Disorders , Humans , Movement Disorders/diagnosis , Movement Disorders/therapy , Neuroimaging , Pandemics
12.
Egyptian Journal of Radiology and Nuclear Medicine ; 53(1), 2022.
Article in English | EMBASE | ID: covidwho-1799082

ABSTRACT

Background: Variable neuroimaging findings have been reported in patients with coronavirus disease 2019 (COVID-19). In addition to respiratory symptoms, many neurologic manifestations of COVID-19 are increasingly reported and variable neuroimaging findings have been observed in patients with COVID-19. Our aim was to describe findings observed in hospitalized patients with COVID-19, presenting with acute neurologic manifestations and undergoing computed tomography (CT) or magnetic resonance imaging (MRI) of the brain. Methods: We performed a retrospective study involving patients with laboratory-confirmed SARS-COV-2 infection, admitted to our hospital between July 1 and December 30, 2020. Patients who presented with acute neurologic symptoms and required neuroimaging were only included in the study. Neuroimaging examinations were evaluated for the presence of, infarction, hemorrhage and encephalopathy. The frequency of these findings was correlated with clinical variables, including presence of comorbidities, requirement for intensive care unit admission, and duration between admission and onset of neurologic signs and symptoms as documented in the hospital medical records. Results: A total of 135 patients underwent at least one cross-sectional imaging of the brain, the median age of these patients was 63 years, and 72% were men. Disturbed level of consciousness was the most common neurologic symptom (80.7%). Acute neuroimaging findings were found in 34 patients (25.2%) including;acute ischemic infarcts (16/135;11.9%), intracranial hemorrhages (9/135, 6.7%), cerebral venous thrombosis (2/135;1.5%), posterior reversible encephalopathy syndrome (1/135;0.7%), and hypoxic-ischemic encephalopathy (6/135, 4.4%). There was no statistically significant difference in patient age (p = 0.062), sex (0.257), presence of comorbidities (p = 0.204), intensive care unit admission (p = 0.326) and duration between admission and onset of neurologic signs and symptoms (p = 0.755), in patients with positive versus negative neuroimaging studies. Conclusions: Our study showed that cerebrovascular complications, ischemic and hemorrhagic were the most frequent imaging finding in hospitalized patients with COVID-19. Knowledge about these potentially serious complications can help optimize management for these patients.

13.
Respiratory Case Reports ; 11(1):9-12, 2022.
Article in English | EMBASE | ID: covidwho-1798781

ABSTRACT

Coronavirus disease 2019 (COVID-19) usually presents as a respiratory infection, and may progress to multiple organ failure and eventually death. In COVID-19 patients, kidney dysfunctions reported proteinuria, elevated markers of blood urea nitrogen, plasma creatinine, uric acids, and D-dimer. We present here the case of a 49-year-old male who was admitted to the intensive care unit (ICU) with COVID-19 pneumonia and respiratory failure. Diabetes insipidus (DI) developed during intensive care follow-up without electrolyte imbalance or kidney failure. A contrast-enhanced brain and pituitary MRI was performed to identify the etiology of the central DI, but revealed no pathological findings. The drugs used to treat our patient had no polyuria side effects. No electrolyte imbalance was identified from a blood test of our patient, and there were no findings of other diseases in the differential diagnosis that could lead to nephrogenic DI. We present here a case of COVID-19 infection complicated by nephrogenic diabetes insipidus, given the lack of reports in literature indicating the occurrence of diabetes insipidus alongside COVID-19 infection.

14.
Neuroforum ; 2022.
Article in English | EMBASE | ID: covidwho-1793453

ABSTRACT

According to best current estimates, approximately 10% of those infected with SARS-CoV-2-virus experience long-term clinical and nonspecific neurological symptoms that may last for several weeks or months. This is currently referred to as "Long-COVID"or "Post-COVID-Syndrome". Based on current knowledge, the most common long-term symptoms of COVID-19 disease include fatigue and poor concentration, but particularly also headache and musculoskeletal pain. However, given the novelty of COVID-19, only a few studies have systematically evaluated the central nervous alterations in the pain processing structures of our brain. Those first insights are yet important in order to offer patients adequate therapeutic options. Based on a systematic review of the literature, we will therefore provide an overview of the central nervous alterations in the brain described in the context of SARS-CoV-2 infection, focusing on findings with brain imaging.

15.
Pakistan Journal of Medical and Health Sciences ; 16(2):753-755, 2022.
Article in English | EMBASE | ID: covidwho-1791222

ABSTRACT

Background: COVID 19, which can lead to neurological complications including intracerebral hemorrhage (ICH), has caused a challenging worldwide pandemic. We aim to highlight the clinical, radiologic and laboratory characteristics, as well as functional outcomes of patients with COVID-19, who either presented with ICH or subsequently developed ICH. Methods: Related PubMed articles and studies on ICH and COVID-19 (published from January 2020 to October 2021, were searched. Our inclusion criteria included all articles written in English, involving COVID-19 patients confirmed via PCR test and admitted to hospital or ICU, and large ICH on neuroimaging. Results: We collected 23 published studies with an association between COVID-19 and ICH, focusing on the clinical profile, neuroimaging findings and management. The risks for ICH includes comorbidities like hypertension, diabetes, chronic kidney disease and malignancy, and anticoagulation therapy. In one study parenchymal haemorrhages with mass effect and herniation showed a very high mortality rate and most of those patients received either a therapeutic or prophylactic dose of anticoagulates prior to ICH discovery. Conclusion: ICH and COVID-19 are rare but with high morbidity and mortality. Thus, it is important to recognize early those patients at high risk of having ICH, mainly those patients with comorbidities and on anticoagulation therapy, to improve health care outcomes.

16.
BMJ Case Rep ; 15(4)2022 Apr 08.
Article in English | MEDLINE | ID: covidwho-1784786

ABSTRACT

A previously healthy and active middle-aged woman acquired COVID-19 as an occupational exposure with subsequent persistent post-COVID-19 symptoms including headache, dyspnoea on exertion, chest pressure, tachycardia, anosmia, parosmia, persistent myalgia, vertigo, cognitive decline and fatigue. She presented to a tertiary medical centre for further evaluation after 9 months of persistent symptoms and had a largely unremarkable workup with the exception of a persistently elevated monocyte chemoattractant protein 1, blunted cardiovagal response and non-specific scattered areas of low-level hypometabolism at the bilateral frontal, left precuneus, occipital and parietal regions on PET scan.


Subject(s)
COVID-19 , COVID-19/complications , Female , Headache/etiology , Humans , Middle Aged , Neuroimaging , SARS-CoV-2 , Syndrome
17.
Biological Psychiatry ; 91(9):S27, 2022.
Article in English | EMBASE | ID: covidwho-1777993

ABSTRACT

Drug addiction is on the rise during these COVID-19 times that intensify the factors contributing to relapse and overdose across drugs of abuse and continents. Using a multimodal approach (neuropsychology, fMRI, ERP), human neuroimaging studies in my lab have elucidated core mechanisms underlying drug addiction, with a focus on the role of the dopaminergic mesocorticolimbic circuit, especially the prefrontal cortex, in higher-order cognitive and emotional dysfunction in this population. Our theoretical model is called iRISA (Impaired Response Inhibition and Salience Attribution), postulating that abnormalities in the orbitofrontal cortex and anterior cingulate cortex (and other cortical regions underlying higher order executive function), contribute to the core clinical symptoms in addiction. Specifically, our program of research is guided by the working hypothesis that drug addicted individuals disproportionately attribute salience and value to their drug of choice at the expense of other reinforcing stimuli, with a concomitant decrease in the ability to inhibit maladaptive drug use. Our complex and multifaceted dataset has allowed us to study the impact of abstinence on recovery in these brain-behavior compromises in treatment-seeking addicted individuals, where non-linear relationships exemplify incubation of craving while other trajectories of change, including in white matter tracks and for small subcortical regions (such as the habenula), are also explored. Novel paradigm shifts in the lab include the use of naturalistic and dynamic stimuli for enhanced generalizability and validity, in addition to development of effective neurorehabilitation strategies (including cognitive reappraisal, mindfulness, and transcranial direct current stimulation) in drug addiction. Keywords: Neuroimaging, drug addiction

18.
Biological Psychiatry ; 91(9):S26, 2022.
Article in English | EMBASE | ID: covidwho-1777992

ABSTRACT

Background: Since the first reports of the novel coronavirus in the US in early 2020, public health organizations have advocated preventative policies including stay-at-home orders that closed businesses, daycares, schools, playgrounds, and limited child learning activities. The impact of these policies on child neurodevelopment is unknown but may have significant long-term consequences. Methods: Leveraging a large and ongoing longitudinal study of child neurodevelopment, we examined general childhood cognitive scores (assessed using the Mullen Scales of Early Learning) in 672 children between 0 and 3 years of age born between 2020 and 2021 (n-118) vs. the preceding decade from 2011 to 2019 (n=554). Brain neuroimaging (MRI) was also performed on each child. Using longitudinal mixed-effects models, we compared longitudinal trends of voxel-wise brain cognitive domain measures before and during the pandemic. Results: We find that children born during the pandemic (Since July 2020) have significantly reduced verbal, motor, and overall cognitive performance compared to children born pre-pandemic;and that skills have continued to decline as the pandemic has progressed. Moreover, we find that children from lower socioeconomic families have been most affected. These neurocognitive findings are supported by neuroimaging data, which also shows reduced brain white matter development in children born since July 2020 compared to their counterparts from 2011 to 2019. Conclusions: Results highlight that even in the absence of direct SARS-CoV-2 infection and COVID-19 illness, the environmental changes associated COVID-19 pandemic is negatively affecting infant and child development. Funding Source: UG3 ODO23313 Keywords: COVID-19 Pandemic, Child Cognition, Early Neurocognitive Development, Longitudinal Neuroimaging, Developmental Neuroimaging

19.
Brain Behav Immun ; 103: 63-72, 2022 Apr 02.
Article in English | MEDLINE | ID: covidwho-1767916

ABSTRACT

IMPORTANCE: Animal studies show that Maternal Immune Activation (MIA) may have detrimental effects on fetal brain development. Clinical studies provide evidence for structural brain abnormalities in human neonates following MIA, but no study has investigated the long-term effects of MIA (as measured with biomarkers) on human brain morphology ten years after the exposure. OBJECTIVE: Our aim was to evaluate the long-term impact of MIA on brain morphology in 10-year-old children, including the possible mediating role of gestational age at birth. DESIGN: We leveraged data from Generation R, a large-scale prospective pregnancy cohort study. Pregnant women were included between 2002 and 2006, and their children were invited to participate in the MRI study between 2013 and 2015. To be included, mother-child dyads had to have data on maternal C-reactive protein levels during gestation and a good quality MRI-scan of the child's brain at age 10 years. Of the 3,992 children scanned, a total of 2,053 10-year-old children were included in this study. EXPOSURE: Maternal C-reactive protein was measured in the first 18 weeks of gestation. For the analyses we used both a continuous approach as well as a categorical approach based on clinical cut-offs to determine if there was a dose-response relationship. MAIN OUTCOMES AND MEASURES: High-resolution MRI brain morphology measures were used as the primary outcome. Gestational age at birth, established using ultrasound, was included as a mediator using a causal mediation analysis. Corrections were made for relevant confounders and multiple comparisons. Biological sex was investigated as moderator. RESULTS: We found a direct association between continuous MIA and lower cerebellar volume. In girls, we demonstrated a negative indirect association between continuous MIA and total brain volume, through the mediator gestational age at birth. We observed no associations with categorical MIA after multiple testing correction. CONCLUSION AND RELEVANCE: Our results suggest sex-specific long-term effects in brain morphology after MIA. Categorical analyses suggest that this association might be driven by acute infections or other sources of severe inflammation, which is of clinical relevance given that the COVID-19 pandemic is currently affecting millions of pregnant women worldwide.

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