Abstract Details

Title Clinical and Imaging Analysis of Headaches in Neurological Post-acute Sequelae of SARS-CoV-2 Infection

Topic Headache

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 2-006

Objective

To determine risk factors associated with headache-predominant post-acute sequelae of COVID syndrome (PASC) versus PASC without headache, as well as differences in brain MRI in these two cohorts.

Background

PASC is an emerging and highly prevalent disease that frequently involves neurologic symptoms such as fatigue, “brain fog”, and headache. Currently, there is a relative paucity of data describing risk factors for development of a headache-predominant PASC phenotype.

Design/Methods This retrospective chart review study identified 56 patients referred to a neuro-immunologist for evaluation of new neurologic symptoms following confirmed COVID-19 infection. Demographic data and past medical history were collected, and white matter hyperintensities were quantified from axial T2 FLAIR images of the brain using the Schelten score.

Results PASC patients complaining of headache were more likely than their counterparts with other neurologic PASC symptoms to be younger (median age 50 vs 57), female (74% vs 63%), and have a higher BMI (median 32.9 vs 28.1) and/or sleep apnea (10/34 [29.4%] vs 2/22 [9.0%]). Interestingly, the PASC headache phenotype was more likely to occur in individuals with a prior headache condition (9/34 [26.4%] vs 2/22 [9.0%]). The non-headache PASC cohort had greater amount of periventricular white matter hyperintensities (mean Schelten score 2.42 vs 1.67).

Conclusions Patients at risk of developing the PASC-associated headache phenotype are generally at risk of developing a primary headache disorder, such as women and those with a higher BMI. The absence of changes on brain MRI suggests that PASC headache is not due to a direct CNS insult as a result of COVID, such as a demyelinating or vascular process. This study is limited by its small sample size and retrospective design; further research is needed to better characterize risk factors and long term outcomes in PASC patients with headache.

Authors/Disclosures
Tyler Kuhns, MD (University of Washington) PRESENTER	Mr. Kuhns has nothing to disclose.
Jaime Imitola, MD, FAAN (UConn Health MS center)	The institution of Dr. Imitola has received research support from Genentech. Dr. Imitola has a non-compensated relationship as a Board Member with National MS Society that is relevant to AAN interests or activities. Dr. Imitola has a non-compensated relationship as a Committee Member with International Society for Stem Cell Research that is relevant to AAN interests or activities.
Shivam Patel, MD	Mr. Patel has nothing to disclose.

��ɫ��

��ɫ��