Cognitive and brain connectivity trajectories in critically ill COVID-19 patients

Article type: Research Article

Authors: Ramos-Usuga, Daniela^{a; b; 1} | Jimenez-Marin, Antonio^{a; b; 1} | Cabrera-Zubizarreta, Alberto^c | Benito-Sanchez, Itziar^b | Rivera, Diego^{d; e} | Martínez-Gutiérrez, Endika^{a; f} | Panera, Elena^g | Boado, Victoria^g | Labayen, Fermín^g | Cortes, Jesus M.^{a; h; i; 2} | Arango-Lasprilla, Juan C.^{j; 2; *}

Affiliations: [a] Biobizkaia Health Research Institute, Barakaldo, Spain | [b] Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), Leioa, Spain | [c] Osatek, Vitoria-Gasteiz, Spain | [d] Department of Health Sciences, Public University of Navarre, Pamplona, Spain | [e] Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain | [f] Dipartamento Interateneo di Fisica, National Institute for Nuclear Physics – Bari, Bari, Italy | [g] Intensive Care Unit, Cruces University Hospital, Barakaldo, Spain | [h] IKERBASQUE, The Basque Foundation for Science, Bilbao, Spain | [i] Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Spain | [j] Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA

Correspondence: [*] Address for correspondence: Juan Carlos Arango-Lasprilla, PhD, Department of Psychology, Virginia Commonwealth University, 907 Floyd Ave, Richmond, VA 23284, USA, Tel.: +34 68888406. E-mails: jcarangolasp@vcu.edu, jcalasprilla@gmail.com.

Note: [1] Equal first author contribution.

Note: [2] Equal last author contribution.

Abstract: BACKGROUND: Multiple Organ failure (MOF) is one of the main causes of admission to the Intensive Care Unit (ICU) of patients infected with COVID-19 and can cause short- and long-term neurological deficits. OBJECTIVE: To compare the cognitive functioning and functional brain connectivity at 6–12 months after discharge in two groups of individuals with MOF, one due to COVID-19 and the other due to another cause (MOF-group), with a group of Healthy Controls (HC). METHODS: Thirty-six participants, 12 from each group, underwent a neuropsychological and neuroimaging assessment at both time-points. Functional connectivity of the resting state networks was compared between COVID-19 and HC while controlling for the effect of MOF. The association between functional connectivity and neuropsychological performance was also investigated. RESULTS: Compared to the HC, COVID-19 group demonstrated hypoconnectivity between the Default Mode Network and Salience Network. This pattern was associated with worse performance on tests of attention and information processing speed, at both time-points. CONCLUSION: The study of the association between cognitive function and brain functional connectivity in COVID-19 allows the understanding of the short- and long-term neurological alterations of this disease and promotes the development of intervention programs to improve the quality of life for this understudied population.

Keywords: COVID-19, neuropsychology, cognition, neuroimaging, intensive care, brain

DOI: 10.3233/NRE-230216

Journal: NeuroRehabilitation, vol. 54, no. 3, pp. 359-371, 2024