Decoding Post-Viral Fatigue: The Basal Ganglia’s Complex Role in Long-COVID
Abstract
:1. Introduction
2. Basal Ganglia Dysfunction in Long-COVID Fatigue: Evidence from Neuroimaging
2.1. Evidence of Metabolic Dysfunction
2.2. Functional Connectivity Disruptions
2.3. Mismatch in Structural Architecture
3. Theories on Causative Mechanisms
3.1. Inflammation-Induced Dopamine Signaling Dysfunction
3.2. Disruption of Cortical-Striatal Motivational Pathways
3.3. Loss of Excitatory Basal Ganglia Input to Arousal Centers
4. Fatigue-Related Symptoms and Basal Ganglia Dysfunction
5. Therapeutic Opportunities
6. The Challenges of Long-COVID Fatigue Research
7. Conclusions and Future Directions
Funding
Conflicts of Interest
References
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Reference | Subjects | Disease Duration | Comorbidities | Hospitalization | Observed Brain Changes |
---|---|---|---|---|---|
Douaud et al., [10] | 600+ SARS-CoV-2 infected | Not specified | Cognitive impairment | Not specified | Connectivity weakening between basal ganglia, thalami, and sensory regions |
Lu et al., [12] | Long-COVID patients vs. controls | 10 months | Hypertension, memory loss, headache, tremor, impaired mobility, myalgia | Hospitalized | Striatal neuroinflammation compromised neuronal integrity in caudate and putamen |
Kandemirli et al., [14] | ICU COVID-19 patients | Not specified | Hypertension, diabetes mellitus, cerebrovascular accident, chronic kidney disease, coronary artery disease | In ICU | 56% had basal ganglia hyperintensities, reduced NAA/Cr and NAA/Cho ratios |
Helms et al., [13] | 58 Severe COVID-19 patients | Not specified | Confusion, cognitive dysfunction | Hospitalized | Basal ganglia hyperintensities (MRI) |
Hampshire et al., [18] | Recovered COVID-19 patients | Not specified | Anxiety, depression, lung conditions, psychiatric conditions | Hospitalized | Cognitive deficits linked to disrupted basal ganglia communication |
Meinhardt et al., [19] | 33 deceased COVID-19 patients | Not specified | Not specified | Not specified | Olfactory SARS-CoV-2 invasion as path to central nervous system |
Zhou et al., [20] | Recovered COVID-19 patients | Nearly 1 year | Diabetes, hypertension, hyperlipidemia | Hospitalized 17.5–41.5 days | Reduced white matter integrity in nigrostriatal pathways |
Hafiz et al., [21] | 46 COVID-19 vs. 30 controls | 2 weeks post-discharge | Fatigue | Hospitalized | Higher gray matter volume in limbic regions and basal ganglia; correlation with fatigue |
Heine et al., [22] | 50 long-COVID vs. 47 controls | Median 7.5 months | Anxiety, depression, sleep problems in long-COVID | 13% Hospitalized | Thalamus and basal ganglia volume loss, surface deformations, altered diffusion; correlated with fatigue |
Deters et al., [23] | 33 mild COVID-19 patients | <6 months (n = 18) vs. >6 months (n = 15) | Persistent fatigue in some >6 month patients | Not hospitalized | Smaller putamen, pallidum, thalamus volumes in >6 month group, especially fatigued; frontal hypometabolism |
Luo et al., [17] | 32 post-COVID-19 patients (16 fatigued, 16 non-fatigued) | 6.9 ± 4.8 months (FT), 8.5 ± 5.7 months (NF) | Not specified | Not hospitalized | Decreased globus pallidus activity in both fatigued and non-fatigued groups compared to healthy controls; non-fatigued group showed greater hypometabolism; right hemisphere more affected in both groups |
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Rudroff, T. Decoding Post-Viral Fatigue: The Basal Ganglia’s Complex Role in Long-COVID. Neurol. Int. 2024, 16, 380-393. https://doi.org/10.3390/neurolint16020028
Rudroff T. Decoding Post-Viral Fatigue: The Basal Ganglia’s Complex Role in Long-COVID. Neurology International. 2024; 16(2):380-393. https://doi.org/10.3390/neurolint16020028
Chicago/Turabian StyleRudroff, Thorsten. 2024. "Decoding Post-Viral Fatigue: The Basal Ganglia’s Complex Role in Long-COVID" Neurology International 16, no. 2: 380-393. https://doi.org/10.3390/neurolint16020028