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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Mood symptoms, cognitive function, and changes of brain hemodynamics in patients with COVID-19: A functional near-infrared spectroscopy study
Wen-Jin Ma, Ruo-Chao Yuan, Zi-Yu Peng, Qian Wu, Manal Al-Matary, Hui-Shu Yang, Peng Cheng, Guang-Ju Zhao, Chao-Chao Lu, Yue-Xin Zhang, Jia-Kun Hong, Wei-Hui Li
Wen-Jin Ma, Qian Wu, Manal Al-Matary, Hui-Shu Yang, Peng Cheng, Guang-Ju Zhao, Chao-Chao Lu, Yue-Xin Zhang, Wei-Hui Li, Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
Ruo-Chao Yuan, Research Center of Educational Neuroscience, School of Educational Science, Huazhong University of Science and Technology, Wuhan 430074, Hubei Province, China
Zi-Yu Peng, Department of Education, Hunan Normal University, Changsha 410081, Hunan Province, China
Jia-Kun Hong, Guigang Medical District of No. 923 Hospital, PLA Joint Logistics Support Force, Guigang 537000, Guangxi Zhuang Autonomous Region, China
Author contributions: Ma WJ contributed to the conceptualization, methodology, and writing of the original draft of this manuscript; Ma WJ, Yuan RC, Peng ZY, and Cheng P were involved in the formal analyses; Ma WJ, Wu Q, Yang HS, Zhao GJ, Lu CC, Zhang YX, and Hong JK contributed to the investigation; Yuan RC, Al-Matary M, Yang HS, and Li WH participated in the writing, review, and editing of this manuscript; Wu Q contributed to the validation of the study; Zhao GJ and Li WH contributed to the data curation; Li WH took part in the resources, supervision, project administration, and funding acquisition.
Supported by Hunan Provincial Scientific Research Plan Project of Traditional Chinese Medicine; National Natural Science Foundation of China, No. 82371521; and Special Tasks for the Construction of Hunan Innovative Province, No. 2023SK4002.
Institutional review board statement: The study was approved by the ethics committee of the Second Xiangya Hospital of Central South University, No. 2023-K031.
Informed consent statement: After providing a complete explanation to the participants, all of them provided written informed consent.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data that support the findings of this study are available on request from the corresponding author, Wei-Hui Li, upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Wei-Hui Li, MD, PhD, Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, Changsha 410011, Hunan Province, China.
weihui_li@csu.edu.cn
Received: August 8, 2024
Revised: November 2, 2024
Accepted: January 10, 2025
Published online: March 19, 2025
Processing time: 201 Days and 21 Hours
BACKGROUND
Many patients with coronavirus disease 2019 (COVID-19) may experience emotional issues and cognitive impairment. However, it remains unclear whether the brain mediates the impact of COVID-19 on the emergence of psychopathological symptoms. It remains unclear whether anxiety and depression are caused by stressors or viral infection.
AIM
To use functional near-infrared spectroscopy (fNIRS) to detect cortical hemodynamic changes in patients with COVID-19 and their relationship with mental symptoms (mainly depression and anxiety), to investigate whether COVID-19 causes these changes by affecting brain function.
METHODS
A total of 58 subjects, comprising 29 patients with first acute COVID-19 infection and 29 healthy controls without COVID-19 infection and without anxiety or depression were recruited. Then cortical activation during the performance of the verbal fluency test (VFT) and brain connectivity during the resting state (rs) were evaluated by 53-channel fNIRS. For the COVID-19-infected group, Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess the emotional state before fNIRS measures.
RESULTS
For the rs, compared to the uninfected group, the infected group exhibited lower rs functional connectivity (FC) in the dorsolateral prefrontal cortex (DLPFC), which was correlated with both the PHQ score and GAD score. During the VFT, the infected group exhibited significantly lower cortical activation than the uninfected group in both Broca-left and Broca-right. Besides, the integral value in the DLPFC-L showed a significant negative correlation with the PHQ-9 score during the VFT in the infected group.
CONCLUSION
There were significant differences in the bilateral Broca area and DLPFC between the COVID-19-infected and uninfected groups, which may be the reason why COVID-19 infection impairs cognitive function and language function and leads to psychiatric symptoms. In addition, the rsFC in patients with COVID-19 was positively correlated with the severity of depression and anxiety, which may be related to the fact that the mental symptoms of patients with COVID-19 are characterized by depression and anxiety, rather than depression or anxiety alone. Our study provides evidence that the psychological and emotional issues caused by COVID-19 are not only due to external social factors but also involve more direct brain neural mechanisms and abnormal neural circuits, which also provide insights into the future treatment and prognosis of individuals with COVID-19.
Core Tip: Our study provides evidence that the psychological and emotional issues caused by coronavirus disease 2019 (COVID-19) are not only due to external social factors but also involve more direct brain neural mechanisms and abnormal neural circuits. Specifically, COVID-19 infection damages the bilateral Broca area and the dorsolateral prefrontal cortex, thus affecting cognitive function and causing mood symptoms. In our study, patients with acute COVID-19 infection were included to rule out the effects of stressors on mood symptoms, and the functional near-infrared spectroscopy data of the resting state and task state confirmed each other.
