Neural basis of fatigue in post-COVID syndrome and relationships with cognitive complaints and cognition

• Published in: Psychiatry research Vol. 340; p. 116113
• Main Authors: Diez-Cirarda, Maria, Yus-Fuertes, Miguel, Polidura, Carmen, Gil-Martinez, Lidia, Delgado-Alonso, Cristina, Delgado-Álvarez, Alfonso, Gomez-Ruiz, Natividad, Gil-Moreno, Maria José, Jorquera, Manuela, Oliver-Mas, Silvia, Gómez-Pinedo, Ulises, Matias-Guiu, Jorge, Arrazola, Juan, Matias-Guiu, Jordi A.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.10.2024
• Subjects: Adult; Aged; Brain - diagnostic imaging; Brain - physiopathology; Cognition - physiology; Cognitive complaints; Cognitive Dysfunction - diagnostic imaging; Cognitive Dysfunction - etiology; Cognitive Dysfunction - physiopathology; COVID-19 - complications; COVID-19 - psychology; Fatigue; Fatigue - diagnostic imaging; Fatigue - physiopathology; Female; Functional connectivity; Gray Matter - diagnostic imaging; Gray Matter - pathology; Gray Matter - physiopathology; Humans; Magnetic Resonance Imaging; Male; Mental Fatigue - diagnostic imaging; Mental Fatigue - physiopathology; Middle Aged; Neuropsychological Tests; Post-Acute COVID-19 Syndrome; Post-COVID syndrome; White matter; White Matter - diagnostic imaging; White Matter - pathology; Functional connectivity; Fatigue; Cognitive complaints; Post-COVID syndrome; White matter
• ISSN: 0165-1781; 1872-7123; 1872-7123
• DOI: 10.1016/j.psychres.2024.116113

•To evaluate structural and functional connectivity correlates of fatigue in patients with post-COVID syndrome.•Fatigue symptoms correlated with functional connectivity and white matter integrity and diffusivity in frontal, temporal and cerebellar areas in patients with post-COVID syndrome.•Mental and physical fatigue differed in the functional connectivity patterns in post-COVID syndrome.•Fatigue was associated with subjective cognitive complaints. The main objective was to evaluate structural and functional connectivity correlates of fatigue in post-COVID syndrome, and to investigate the relationships with an objective measure of mental fatigue and with subjective cognitive complaints. One-hundred and twenty-nine patients were recruited after 14.79 ± 7.17 months. Patients were evaluated with fatigue, neuropsychological, and subjective cognitive complaints assessments. Structural and functional magnetic resonance imaging were acquired, and functional connectivity, white matter diffusivity and grey matter volume were evaluated. Fatigue was present in 86 % of patients, and was highly correlated to subjective cognitive complaints. Fatigue was associated with structural and functional connectivity mostly in frontal areas but also temporal, and cerebellar areas, showing mental fatigue different pattern of functional connectivity correlates compared to physical fatigue. White matter diffusivity correlates were similar in fatigue and subjective cognitive complaints, located in the forceps minor, anterior corona radiata and anterior cingulum. Findings confirm that fatigue in post-COVID syndrome is related to cerebral connectivity patterns, evidencing its brain substrates. Moreover, results highlight the relationship between fatigue and subjective cognitive complaints. These findings point out the relevance of the multidisciplinary assessment of post-COVID syndrome patients with subjective cognitive complaints, in order to unravel the symptomatology beneath the patient's complaints.