https://doi.org/10.1140/epjs/s11734-024-01444-4
Regular Article
Biochemical changes in subregions of the cingulate gyrus in patients with post-COVID syndrome
1
Department of Neurology and Manual Medicine, Faculty of Postgraduate Education, Pavlov First Saint Petersburg State Medical University, L’va Tolstogo Str. 6-8, 197022, Saint Petersburg, Russia
2
Department of Computer Science, LETI Saint Petersburg Electrotechnical University, Professora Popova Str. 5, 197022, Saint Petersburg, Russia
3
Department of Neurology, Pavlov First Saint Petersburg State Medical University, L’va Tolstogo Str. 6-8, 197022, Saint Petersburg, Russia
4
Saint Petersburg State Pediatric Medical University, Ministry of Health of the Russian Federation, 2 Litovskaya Str, 194100, Saint Petersburg, Russia
5
Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine, Budapestskaya Str., 3, Lit. A, 192242, Saint Petersburg, Russia
6
Department of Radiology and Medical Imaging, Almazov National Medical Research Centre, 2 Akkuratova Street, 197341, Saint Petersburg, Russia
7
Immanuel Kant Baltic Federal University, 14 A. Nevskogo Ul., 236016, Kaliningrad, Russia
8
Hospital for Veterans of Wars, 21, K. 2 Narodnaya Str., 193079, Saint Petersburg, Russia
Received:
23
September
2024
Accepted:
10
December
2024
Published online:
7
January
2025
Cognitive impairments of various aetiologies are amongst frequent causes of disability, which lead to social maladaptation, loss of working capacity, limitations of activities of daily living, diminished capacity for personal care and finally dependence on others. Post-COVID-19 cognitive impairments are identified in 33–60% of observed cases, highlighting the relevance of this issue. Non-invasive assessments of the metabolic state of the cingulate gyrus by MR-spectroscopy in patients with post-COVID syndrome. In our study, we investigate changes in metabolites in the cingulate gyrus in patients with post-COVID syndrome and how these changes correlate with the clinical picture. The principal metabolite to consider when diagnosing post-COVID syndrome is NAA, whose levels decreased in the examined subregions of the cingulate gyrus, tallying with the results of all administered clinical scales. Moreover, antioxidant system impairment took place in the form of reduced glutathione in the midcingulate cortex and posterior cingulate cortex. There was also a diffuse decrease in metabolites such as Cr fractions, which is indicative of neuronal energy deprivation, especially in the simultaneous presence of Lac. Overall, the findings obtained suggest that the region showing the most substantial metabolic deviations was the posterior cingulate gyrus, which, besides reduced levels of NAA, Cr1, Cr2 and GSH, also demonstrated elevated levels of both lipid fractions, the presence of Ins, and a decrease in Glu. The latter, in our opinion, makes the greatest contribution to the dysfunction and is largely responsible for the post-COVID syndrome. Thus, the study showed significant hypofunction in all subregions of the cingulate gyrus in patients with post-COVID syndrome. The wide diversity of roles performed by this brain structure accounts for the vast variety of clinical pictures covering not only cognitive impairments but also psychological and emotional consequences, as well as pronounced asthenisation. The use of artificial intelligence to more automatically and accurately highlight metabolic abnormalities in the cingulate gyrus in patients with post-COVID syndrome may greatly facilitate and improve diagnostic accuracy and speed.
Supplementary Information The online version contains supplementary material available at https://doi.org/10.1140/epjs/s11734-024-01444-4.
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© The Author(s), under exclusive licence to EDP Sciences, Springer-Verlag GmbH Germany, part of Springer Nature 2024
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
