Functional connectivity underlying cognitive and psychiatric symptoms in post-COVID-19 syndrome: is anosognosia a key determinant?

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_6C5BA928C61D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Functional connectivity underlying cognitive and psychiatric symptoms in post-COVID-19 syndrome: is anosognosia a key determinant?
Journal
Brain communications
Author(s)
Voruz P., Cionca A., Jacot de Alcântara I., Nuber-Champier A., Allali G., Benzakour L., Thomasson M., Lalive P.H., Lövblad K.O., Braillard O., Nehme M., Coen M., Serratrice J., Pugin J., Guessous I., Landis B.N., Adler D., Griffa A., Van De Ville D., Assal F., Péron J.A.
ISSN
2632-1297 (Electronic)
ISSN-L
2632-1297
Publication state
Published
Issued date
2022
Peer-reviewed
Oui
Volume
4
Number
2
Pages
fcac057
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Lack of awareness of cognitive impairment (i.e. anosognosia) could be a key factor for distinguishing between neuropsychological post-COVID-19 condition phenotypes. In this context, the 2-fold aim of the present study was to (i) establish the prevalence of anosognosia for memory impairment, according to the severity of the infection in the acute phase and (ii) determine whether anosognosic patients with post-COVID syndrome have a different cognitive and psychiatric profile from nosognosic patients, with associated differences in brain functional connectivity. A battery of neuropsychological, psychiatric, olfactory, dyspnoea, fatigue and quality-of-life tests was administered 227.07 ± 42.69 days post-SARS-CoV-2 infection to 102 patients (mean age: 56.35 years, 65 men, no history of neurological, psychiatric, neuro-oncological or neurodevelopmental disorder prior to infection) who had experienced either a mild (not hospitalized; n = 45), moderate (conventional hospitalization; n = 34) or severe (hospitalization with intensive care unit stay and mechanical ventilation; n = 23) presentation in the acute phase. Patients were first divided into two groups according to the presence or absence of anosognosia for memory deficits (26 anosognosic patients and 76 nosognosic patients). Of these, 49 patients underwent an MRI. Structural images were visually analysed, and statistical intergroup analyses were then performed on behavioural and functional connectivity measures. Only 15.6% of patients who presented mild disease displayed anosognosia for memory dysfunction, compared with 32.4% of patients with moderate presentation and 34.8% of patients with severe disease. Compared with nosognosic patients, those with anosognosia for memory dysfunction performed significantly more poorly on objective cognitive and olfactory measures. By contrast, they gave significantly more positive subjective assessments of their quality of life, psychiatric status and fatigue. Interestingly, the proportion of patients exhibiting a lack of consciousness of olfactory deficits was significantly higher in the anosognosic group. Functional connectivity analyses revealed a significant decrease in connectivity, in the anosognosic group as compared with the nosognosic group, within and between the following networks: the left default mode, the bilateral somatosensory motor, the right executive control, the right salient ventral attention and the bilateral dorsal attention networks, as well as the right Lobules IV and V of the cerebellum. Lack of awareness of cognitive disorders and, to a broader extent, impairment of the self-monitoring brain system, may be a key factor for distinguishing between the clinical phenotypes of post-COVID syndrome with neuropsychological deficits.
Keywords
MRI, anosognosia, functional connectivity, neuropsychological deficits, post-COVID syndrome
Pubmed
Web of science
Open Access
Yes
Funding(s)
Swiss National Science Foundation / Programmes / 407840_198438
Create date
08/04/2022 16:36
Last modification date
09/01/2024 8:14
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