Project: Long-COVID and the Brain White Matter

Draft Status

Ready - team will start page creating immediately

Presenter Location

In-person

Key Investigators

Zora Kikinis (BWH, USA)
Ron Kikinis (BWH, USA)
Poliana Hartung Toppa (MGH, USA)
Kayley Haggerty (MGH, USA)
George Papadimitriou (MGH, USA)
Anastasia Haidar (BWH, USA)
Twishi Puri (BWH, USA)
Bianca Besteher (University Hospital Jena, Germany)
Carina Heller (University in Jena, Germany)
Ed Yeterian (MGH, USA)
Stefano Pallanti (Institute of Neuroscience, Italy)
Yogesh Rathi (BWH, USA)
Marek Kubicki (BWH, USA)
Jarrett Rushmore (MGH, USA)
Nikos Makris (MGH, USA)

Project Description

About 10% of COVID-19 survivors experience long-lasting symptoms known as long-COVID. The debilitating symptoms of PASC impact patient’s health-related quality of life, earnings, caretaking activities for loved ones, and healthcare costs. There is no proven cure for PASC. Amongst the variable sequelae of long-COVID, the neuropsychiatric subtype of long-COVID (neuro-long-COVID) is characterized by fatigue, cognitive impairments, and pro-inflammatory cytokines. Our research project aims to understand how changes in the brain, specifically the white matter, contribute to the symptoms of the neuropsychiatric subtype of long-COVID.

We are particularly interested in the brain white matter fiber system that we term the dorsal vagal complex-corticolimbic fiber system (DVC-CLFS; Kikinis et al., in press). This fiber system interconnects cortical, paralimbic, limbic, and autonomic brain regions. It integrates them with bodily organs via the brainstem and the vagal nerve. The DVC-CLFS underlies brain-immune interactions and involves several centers in the brainstem. The principal fiber tract in the DVC-CFLS is the medial forebrain bundle (MFB).

While we have previously reconstructed the MFB, our new approach allows us to rebuild the streamlines reaching the brainstem. Using the Harvard Oxford Atlas (HOA, Rushmore et al., 2020), we will use whole brain tractography from 10 patients with long-COVID to select the Medial Forebrain Bundle (MFB) at its entire extension.

As part of the project, we will demonstrate the method to reconstruct the MFB. We will offer tutorial of 3DSlicer of segmentation, reconstruction of brain white matter streamlines from whole brain tractography and video demonstration of the application of the Harvard Oxford Atlas.

Objective

Objective A. Describe what you plan to achieve in 1-2 sentences. To test and apply a semi-automated approach to delineate a fiber tracts that reach the brain stem. Tractography in the brain stem is challenging as most fibers run parallel and very close to each other. Additionally, the in nuclei of the brainstem from which tracts originate and are difficult to visualize.
Teach the semi-automated approach using the Harvard Oxford Atlas.

Approach and Plan

Describe specific steps of what you plan to do to achieve the above described objectives. We will use diffusion and structural MRI, specifically whole brain tractography and T1 images, from 10 patients with long-COVID to select the Medial Forebrain Bundle (MFB) at its entire extension to the brainstem.

Progress and Next Steps

Describe specific steps you have actually done.

Illustrations

No response

Background and References

In preparation: video on how to use Harvard Oxford Atlas for semi-automated delineation of fiber tracts whole brain tractography derived from diffusion MRI.

NA-MIC / ProjectWeek