White matter sufferance and obsessive symptomatology in post-COVID-19 cognitive dysfunction

Poster Session C - Sunday, April 14, 2024, 5:00 – 7:00 pm EDT, Sheraton Hall ABC

Mariagrazia Palladini^1,2 (palladini.mariagrazia@hsr.it), Mario Gennaro Mazza¹, Margherita Bessi¹, Beatrice Bravi^1,2, Rebecca De Lorenzo², Patrizia Rovere-Querini^2,3, Francesco Benedetti^1,2; ¹Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute,, ²Vita-Salute San Raffaele University, ³Unit of Innate Immunity and Tissue Remodeling, Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute

Post-COVID-19 neurocognitive dysfunction afflicts an impressive rate of survivors up to one-year after infection, encompassing difficulties in attention and memory, altogether worsening their psychosocial functioning. Literature suggests they stem from viral-induced brain insult via systemic inflammation, with evidence of demyelinating lesions, abnormal metabolism in wide-ranging areas, and altered functional connectivity. However, neurobiological signature of specific cognitive deficits is still undefined. This study explores the association of white matter (WM) integrity with verbal memory (VM) performance in COVID-19 survivors previously admitted to emergency department six-month after infection. We gathered VM measure through Brief Assessment of Cognition in Schizophrenia (BACS), providing equivalent scores, to distinguish good and poor performer (VM < 2). Obsessive-Compulsive Inventory (OCI-R) was implemented to evaluate potential association of obsessive symptoms with VM. Total WM lesion volumes (TLV) were extracted through the SPM12 toolbox LST. We then compared low-performer survivors (N=11) with the good ones (N=61) in VM task on whole-brain Diffusion Tensor Imaging (DTI) using TBSS (FSL), correcting for age, sex, BMI, and OCI symptoms. Verbal memory scores were significantly lower in previously hospitalized patients (t=-2.30, p=0.02), and negatively predicted by TLV (r=-0.36, p=0.002). Additionally, verbal memory performance worsens as obsessive symptoms increase (r=-2.55, p=0.031). DTI analysis revealed that poor-performers exhibit lower Fractional Anisotropy in several projective and inter-hemispheric fibres while enhanced Radial Diffusivity emerged in overlapping tracts compared to their counterpart. Overall, we suggest WM microstructure as a valid biomarker for long-lasting VM difficulties in COVID-19 survivors, thus informing potential treatment options targeting specific brain damages.

Topic Area: METHODS: Neuroimaging