Abstract Details

Title Distinct Brain Structural Alterations And Neurodegenerative Processes In Cognitive Impairment Among Post-Acute Sequelae Of COVID-19

Topic General Neurology

Presentation(s) S13 - General Neurology 1 (11:27 AM-11:39 AM)

Poster/Presentation
Number 002

Objective

This study aimed to investigate the brain structural alterations and neurodegenerative changes according to the cognitive phenotype of post-acute sequelae of SARS-CoV-2 infection (PASC).

Background Brain alterations have been reported in post-acute sequelae of SARS-CoV-2 (PASC) or long COVID. However, it is unclear whether these brain changes represent previous injury or are accompanied by ongoing neurodegenerative processes, and whether such processes are universal across PASC patients, particularly in individuals who experienced mild COVID-19.

Design/Methods A total of 169 participants who mostly experienced mild COVID-19 about a year ago assessed and categorized into three groups: PASC with cognitive impairment (Cog-PASC, n = 28), PASC without cognitive impairment (Other-PASC, n = 55), and no significant PASC (n = 77). Brain magnetic resonance imaging (MRI) were used to measure cortical thickness, iron deposition, choroid plexus (CP) volume, and glymphatic function (Diffusion Tensor Imaging analysis along the perivascular space, DTI-ALPS index). Blood samples were analyzed with a Single Molecule array for brain damage and neurodegeneration: neuronal (Neurofilament Light chain, NfL), astroglial (Glial Fibrillary Acidic Protein, GFAP) damage, and Alzheimer’s disease-related degeneration (Amyloid beta 42/40, phosphorylated tau). High-throughput proteomics (Olink) were also conducted to measure 3,072 proteins to identify important biological pathways underlying the brain disease processes.

Results In the Cog-PASC group, we identified elevated levels of neuronal/astroglial damage proteins without significant changes in b-amyloid or phosphorylated tau proteins. Brain imaging further revealed increased paramagnetic susceptibility, indicating iron deposition, particularly in the cingulate and hippocampus. We also demonstrated increased choroid plexus volume in Cog-PASC compared to Other-PASC patients, associated with neuronal/astroglial damage and iron deposition. Blood proteomic analysis showed significantly altered proteins involved in oxidative stress responses and synaptic function in Cog-PASC patients, linked to neurodegenerative pathways.

Conclusions These findings suggest unique neurodegenerative processes in Cog-PASC, not prominent in other PASC patients, even after mild COVID-19.

Authors/Disclosures
Dayoung Seo, RN PRESENTER	Miss Seo has nothing to disclose.
Yangsean Choi, MD, PhD	Dr. Choi has nothing to disclose.
EUNSEON JEONG	Miss JEONG has nothing to disclose.
sanghui bang, RN	Mr. bang has nothing to disclose.
In-Hye Jang (University of Ulsan)	In-Hye Jang has nothing to disclose.
lynkyung choi, PhD	Dr. choi has nothing to disclose.
JIN HEE KIM, PhD	Dr. KIM has nothing to disclose.
Wangyong Shin, PhD	Dr. Shin has nothing to disclose.
Bo-Ra Seo (Asan Medical Center)	Bo-Ra Seo has nothing to disclose.
Shina Kim, MD	Mrs. Kim has nothing to disclose.
Hee Jae Jung, MD (Asan Medical Center)	Dr. Jung has nothing to disclose.
Ji-Yon Kim (Asan Medical Center)	No disclosure on file
Hyunjin Kim, MD (Asan Medical Center, Dept of Neurology)	Dr. Kim has nothing to disclose.
Young-Min Lim, MD	Dr. Lim has nothing to disclose.
Eun-Jae Lee, MD, PhD (Asan Medical Center)	Prof. Lee has nothing to disclose.
Sung Han Kim, MD, PhD	Prof. Kim has nothing to disclose.

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