ISSN# 1545-4428 | Published date: 19 April, 2024
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At-A-Glance Session Detail
   
Neuroinflammation
Digital Poster
Neuro
Tuesday, 07 May 2024
Exhibition Hall (Hall 403)
09:15 -  10:15
Session Number: D-121
No CME/CE Credit

Computer #
2497.
17Altered topological properties of morphological and functional brain networks in patients with NMOSD: An individual-based study
Haotian Ma1,2, Yanyan Zhu1, Lin Wu1, Yao Wang1, Xiao Liang1, Xiaoxing Li1, Long Qian3, Gerald L. Cheung4, Jiankun Dai5, and Fuqing Zhou1,6
1Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China, 2Queen Mary School, Nanchang University, Nanchang, China, 3Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, China, 4Spin Imaging Technology Co Ltd, Nanjing, China, 5MR Research, GE Healthcare, Beijing, China, 6Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, China

Keywords: Neuroinflammation, Neuroinflammation

Motivation: Alterations of brain structure and function in patients with neuromyelitis optica spectrum disorder (NMOSD) are not fully understood.

Goal(s): To assess the alteration of individual brain network topological properties and their clinical significance in NMOSD.

Approach: 18 NMOSD patients and 22 healthy controls were enrolled. Individual morphological (MBNs) and functional brain networks (FBNs) were created and compared.

Results: The results revealed compensatory increases in local network properties in NMOSD to maintain overall stability. The MBNs showed more significant changes and stronger correlations with clinical information than FBNs. 

Impact: Our findings provided insights into NMOSD's complex neurological mechanisms from a brain network perspective and revealed the clinical significance of MBN and FBN in patients with NMOSD. 

2498.
18Altered patterns of cerebral perfusion in systemic lupus erythematosus patients with cognitive dysfunction, pain and fatigue.
Tim Salomonsson1, Theodor Rumetshofer2, Kristoffer Zervides3, Andreas Jönsen3, Petra Nilsson4, Malte Knutsson1, Anders Bengtsson3, Ronnie Wirestam5, Jimmy Lätt6, Linda Knutsson7,8, and Pia C. Sundgren1,6,9
1Department of Clinical Sciences/Radiology, Lund University, Lund, Sweden, 2Department of Clinical Sciences/Division of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden, 3Department of Clinical Sciences Lund/Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden, 4Department of Clinical Sciences Lund/Neurology, Lund University, Skåne University Hospital, Lund, Sweden, 5Department of Medical Radiation Physics, Lund University, Lund, Sweden, 6Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden, 7F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States, 8Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, 9Lund University Bioimaging Center, Lund University, Lund, Sweden

Keywords: Neuroinflammation, DSC & DCE Perfusion, Systemic Lupus Erythematosus, Cognitive dysfunction, Fatigue, Pain, Fibromyalgia, Blood-brain barrier

Motivation: Cognitive dysfunction (CD), fatigue and pain are common and debilitating in systemic lupus erythematosus (SLE). Symptom-based neuroimaging could contribute to pathophysiological models and patient-centered care.

Goal(s): Investigating brain perfusion and blood-brain barrier permeability in SLE patients with CD, fatigue and pain.

Approach: 66 SLE patients underwent 3T dynamic susceptibility contrast (DSC) MRI. The leakage parameter K2 and normalized leakage corrected perfusion parameters were estimated in 14 brain regions, compared by symptomatology.

Results: Patients with CD or fibromyalgia displayed increased cerebral blood flow and/or cerebral blood volume in regions associated with pain processing. No differences were found for fatigue, K2 or mean transit time.

Impact: DSC-MRI detects cerebral hyperperfusion in systemic lupus erythematosus patients with cognitive dysfunction or the pain syndrome fibromyalgia, but not fatigue, suggesting different inflammatory or compensatory mechanisms. Investigating each of these debilitating symptoms separately might further characterize and guide patient-centered interventions.

2499.
19Evaluating Obstructive Sleep Apnea Neuropathophysiology with 1H-MRS and Cerebral Small Vessel Disease Imaging
Christopher Bull1,2, Tairon Zhang1,2, Kurt Lancaster3, Peter Burke1,4, Mark Butlin4, Corey Botansky1, Katharina Schregel5, Arunan Srirengan1,2, Ruth Peters2,6, Caroline Rae1,2, Lucette Cysique2,7, Elizabeth Brown1,8, Lynne Bilston1,2, and Lauriane Jugé1,2,9
1Neuroscience Research Australia, Sydney, Australia, 2University of New South Wales, Sydney, Australia, 3St Vincent Applied Medical Research Centre, Sydney, Australia, 4Department of Biomedical Sciences, Macquarie University, Sydney, Australia, 5Heidelberg University Hospital, Heidelberg, Germany, 6The George Institute, Sydney, Australia, 7Kirby Institute, Sydney, Australia, 8Prince of Wales Hospital, Sydney, Australia, 9UNSW Ageing Futures Institute, Sydney, Australia

Keywords: Neuroinflammation, Spectroscopy, Obstructive sleep apnoea, cerebral small vessel disease

Motivation: 1H-MRS may be sensitive enough to detect neuropathological mechanisms of cerebral small vessel disease in obstructive sleep apnoea (OSA).

Goal(s): To investigate the relationships between nocturnal blood pressure surges (caused by sleep disturbances) and hypoxic burden (due to recurring apnoeas) on 1H-MRS metabolite levels and cognitive performance.

Approach: Seven controls and 23 participants with OSA underwent brain MRI, sleep physiological assessment and neuropsychological battery.

Results: A higher hypoxic burden was associated with higher cellular energy (Cr/H2O) and acute inflammation (GPC/H20), while more frequent blood pressure surges were associated with higher chronic neuroinflammation (mI/H20). There were no associations with cognitive performance.

Impact: Estimates of 1H-MRS metabolite levels, along with CSVD standard neuroimaging assessment, provide additional information concerning the neuro-cardiovascular and hypoxic burden associated with OSA that could potentially translate into improved early CSVD diagnosis in high-risk populations due to OSA.  

2500.
20Comparison of postmortem in situ 3T MRI and ex vivo ultra-high-resolution 7T MRI in multiple sclerosis cortical lesions
Kunio Nakamura1, Ken E Sakaie1, Jacqueline T Chen1, Kedar R Mahajan1, Bruce D Trapp1, Mark J Lowe1, Stephen E Jones1, Daniel Ontaneda1, and Emmanuel C Obusez1
1Cleveland Clinic, Cleveland, OH, United States

Keywords: Neuroinflammation, Multiple Sclerosis, Ex vivo; Ultra-high-resolution; Postmortem

Motivation: Cortical lesions in multiple sclerosis are clinically relevant but cannot be detected reliably using conventional MRI. Ex vivo ultra-high-resolution MRI is reliable in cortical lesion detection.

Goal(s): Identify cortical lesions on ex vivo 7T MRI in comparison to postmortem in situ conventional 3T MRI.

Approach: Retrospective visual assessment of cortical lesions on conventional MRI.

Results: 3T T1-weighted MPRAGE showed the highest sensitivity (66%), followed by T2-weighted SPACE (52%), and 3D FLAIR (48%) for detection of cortical lesions. Purely cortical lesions were less visible on in situ MRIs. Some leukocortical lesions appeared juxtacortical white matter lesions on conventional MRI.

Impact: Ultra-high-resolution MRI provides a platform to investigate substrates of cortical pathology in multiple sclerosis by bridging the gap between macroscopic conventional MRI and pathology.

2501.
21MRI T2* Hypointensity at the Glia Limitans in the Olfactory Bulb is due to High Iron in the Olfactory Ensheathing Cells in Young Adult Mouse
Li Liu1, Jung-Hwa Tao-Cheng2, Stephen Dodd1, Nadia Bouraoud1, Hari Rallapalli1, and Alan P Koretsky1
1Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States, 2Electron Microscopy Facility, National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States

Keywords: Neuroinflammation, Neuroinflammation, Brain iron, olfactory ensheathing cells, glia limitans, olfactory sensory neuron, lipofuscin

Motivation: Brain iron overload is a hallmark of neuroinflammatory diseases. Here, T2*-weighted MRI detected an increase of hypointensity at the olfactory nerve layer (ONL) in young mice from 3 to 12 weeks.

Goal(s): Find out the cellular origins of T2*-hypointensity.

Approach: MRI guided immunohistochemistry and electron-microscopy study.

Results: We found that the T2*-hypointensity is due to high iron in olfactory ensheathing cells (OECs). OECs form glia limitans, ensheath bundles of olfactory axons, and are the main phagocytic cells in olfactory system to aid regeneration of olfactory neurons. Near high-iron region, lipofuscin, a neuroinflammation marker was found in activated microglia as early as 6 weeks.

Impact: Guided by MRI, we found that there is an extraordinarily high level of intrinsic iron in the olfactory ensheathing cells in olfactory nerve layer in young mice, which indicates their phagocytic and neuroprotection functions during rapid olfactory sensory neuron turnover.

2502.
22Diffusion Basis Spectrum Imaging in Midlife Obesity: Associations with Abdominal Adipose Tissue
Mahsa Dolatshahi1, Paul Commean1, Farzaneh Rahmani1, Caitlyn Nguyen1, LaKisha Lloyd1, Sara Hosseinzadeh Kassani1, Bettina Mittendorfer2, Weiying Dai3, Claude Sirlin4, Sheng-Kwei Song1, Tammie Benzinger1, Joseph E. Ippolito1, John C. Morris1, and Cyrus A. Raji1
1Washington University in St. Louis, Saint Louis, MO, United States, 2Missouri state university, Columbia, MO, United States, 3Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, United States, 4University of California San Diego, La Jolla, CA, United States

Keywords: Neuroinflammation, Alzheimer's Disease

Motivation: Whether midlife obesity and abdominal adiposity contributes to neuroinflammation, is key to Alzheimer disease (AD) prevention.

Goal(s): We aimed to investigate the association between obesity and abdominal visceral and subcutaneous adipose tissue (VAT and SAT) and neuroinflammation.

Approach: For this aim, we performed brain and abdominal MRI scans to compare inflammation cellularity, edema, and axonal density using diffusion basis spectrum imaging (DBSI), between the obese vs. non-obese, the high- vs. low-VAT and high- vs. low-VAT groups.

Results: A widespread higher inflammation cellularity and a lower axonal density was observed in the obese vs. non-obese, high-SAT vs. low-SAT, and high-VAT vs. low-VAT females.

Impact: Higher neuroinflammation and lower axonal density in females with obesity and higher abdominal fat, highlights the sex-specific role of midlife abdominal obesity in neuroinflammation and neurodegeneration, which prompts future studies to target body fat for modifying neuroinflammation and AD prevention.

2503.
23Microstructure Informed Susceptibility Source Separation (MI-SSS) Improves Correlation with Translocator Protein PET in Multiple Sclerosis
Mert Şişman1,2, Thanh D. Nguyen2, Ilhami Kovanlikaya2, Alexey V. Dimov2, Hannah Schwartz3, Nikolaos A. Karakatsanis2, Pascal Spincemaille2, Susan A. Gauthier3, and Yi Wang2,4
1Electrical and Computer Engineering, Cornell University, Ithaca, NY, United States, 2Department of Radiology, Weill Cornell Medicine, New York, NY, United States, 3Department of Neurology, Weill Cornell Medicine, New York, NY, United States, 4Biomedical Engineering, Cornell University, Ithaca, NY, United States

Keywords: Neuroinflammation, PET/MR, Multiple Sclerosis

Motivation: Noninvasive detection of immune activity of chronic active MS lesions is of great interest. Specific biomarkers of immune activity such as quantitative susceptibility mapping (QSM) was proposed for this purpose. However, QSM suffers from the contamination of diamagnetic myelin.

Goal(s): The aim of this study is to show that paramagnetic susceptibility component derived from susceptibility source separation is more specific to immune activity than QSM.

Approach: The correlation of QSM and paramagnetic susceptibility against TSPO PET in 34 chronic lesions from 7 MS patients are obtained.

Results: Higher correlation of paramagnetic susceptibility shows its higher specificity to immune activity than QSM.

Impact: Chronic active MS lesions with immune activity are of great importance as they demonstrate ongoing demyelination. Susceptibility source separation provides an improved noninvasive biomarker for the in vivo quantification of immune activity. 

2504.
24Linking inter-individual differences in brain structure to post-COVID fatigue
Wenrui Bao1, Xuan Niu2, Zhaoyao Luo2, Huijie Yuan2, Tao Lu2, Weixian Bai3, Junya Mu2, Xiaocheng Wei4, and Ming Zhang2
1School of Future Technology, Xi’an Jiaotong University, Xi'an, China, 2Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China, 3Department of Medical Imaging, The Affiliated Hospital of Northwest University·Xi’an No.3 Hospital, Xi'an, China, 4GE HealthCare MR Research, Beijing, China, Beijing, China

Keywords: Neuroinflammation, COVID-19

Motivation: Identify individuals at risk of developing post-COVID fatigue

Goal(s): Propose a "vulnerability" hypothesis of post-COVID fatigue

Approach: A multi-center, prospective, longitudinal study

Results: The GMV in frontal-limbic regions may serve as potential neural underpinnings that identify individuals at risk of developing post-COVID fatigue

Impact: Our findings emphasized the essential role of frontal-limbic system in the development of post-COVID fatigue, which will improve public health interventions by allowing for the early identification of individuals at risk of persistent post-COVID fatigue and facilitating subsequent neuromodulation treatment.

2505.
25Targeted MRI (tMRI) of Small Changes in the T1 of White Matter of the Brain in Methamphetamine Dependency Before and After Abstinence.
Paul Condron1,2, Gil Newburn1, Eryn Kwon1,2,3, Taylor Emsden1,2, Benjamin Bristow1,2, Maryam Tayebi1,2, Tuta Ngarimu4, Wendy Mohi1, Samantha J Holdsworth1,2, Daniel Cornfeld1,2, Miriam Scadeng1,2, and Graeme M Bydder1,5
1Mātai Medical Research Institute, Gisborne, New Zealand, 2The University of Auckland, Auckland, New Zealand, 3Auckland Bioengineering Institute, Auckland, New Zealand, 4Manaaki Moves, Gisborne, New Zealand, 5University of California San Diego, San Diego, CA, United States

Keywords: Neuroinflammation, Drugs, tMRI, Methamphetamine recovery, WM recovery

Motivation: Targeted MRI (tMRI) of small changes in T1 in lesions in normal appearing white matter using divided Subtracted Inversion Recovery (dSIR) sequences can show high contrast and abnormalities that are not seen with conventional IR sequences.

Goal(s): To depict subtle changes in Tin otherwise normal appearing white matter with dSIR images.

Approach: Applying tMRI in a patient with methamphetamine dependency before and eight months after abstinence.

Results: Widespread abnormalities on dSIR images in areas of normal appearing WM n T2-FLAIR images. There was striking remission of the changes after eight months' abstinence. The changes may be due to neuroinflammation regression with abstinence.

Impact: In a patient with methamphetamine dependency, tMRI using dSIR sequences showed striking abnormalities in white matter that appeared normal with T2-FLAIR sequences of the brain. These changes showed marked regression after eight months' abstinence.

2506.
26Rim Lesion Segmentation on 1MM QSM Positive Source : a Comparison between Deep Learning and Conventional Methods.
Ha Manh Luu1, Susan Gauthier1, Ilhami Kovanlikaya1, Yi Wang1, Pascal Spincemaille1, Mert Sisman1, and Thanh Nguyen1
1Weill Cornell Medicine, New York, NY, United States

Keywords: Neuroinflammation, Segmentation

Motivation: To automate rim lesion segmentation in multiple sclerosis

Goal(s): To compare deep learning and conventional methods for rim lesion segmentation in multiple sclerosis

Approach: We compare Unet with chan-vese and Grabcut segmention of MR rim positive lesions.

Results: Deep learning achieve the highest Dice score among the compared methods.

Impact: Automate rim lesion segmentation in Multiple Sclerosis may allow determine those patient with persistent inflammation.

2507.
27Interpretable and Intuitive Machine Learning Approaches for Predicting Disability Progression in Relapsing-Remitting Multiple Sclerosis
Yongmei Li1 and Zichun Yan1
1Department of Radiology,, the First Affiliated Hospital of Chognqing Medical University, Chongqing, China

Keywords: Multiple Sclerosis, Multiple Sclerosis

Motivation: Improving the interpretability and intuitiveness of the machine learning models can help physicians in clinical decision-making.

Goal(s): To investigate whether clinical and grey matter atrophy indicators can predict disability in relapsing-remitting multiple sclerosis (RRMS) and to enhance the interpretability and intuitiveness of a predictive model.

Approach: Six  machine learning classifiers were trained and tested to predict disability progression. Partial dependence plot (PDP) analysis and a Shiny web application were conducted.

Results: The logistic regression model performed best, with an AUC of 0.950. PDP analysis showed which indicators had increased probabilities of disease progression. Finally, a Shiny web application was developed.

Impact: The PDP analysis and Shiny web application can improve the interpretability and intuitiveness of the machine learning models to help physicians predict disability progression in RRMS.

2508.
28Improved Myelin Content Estimates from Clinical Selective Inversion Recovery Scans via Anisotropic Filtering
Mohammadreza Soltany Sadrabadi1, Ashley M. Stokes1, and Richard Dortch1
1Barrow Neurological Institute, Phoenix, AZ, United States

Keywords: Multiple Sclerosis, Multiple Sclerosis

Motivation:  Traditionally, Selective Inversion Recovery (SIR) images require long scan times for sufficient SNR, while shorter clinical scans yield low SNR images with noisy pool-size-Ratio (PSR) maps, leading to potential inaccuracies. 

Goal(s):  An advanced filtering method has been used to improve the precision and accuracy of PSR maps from lower SNR scans. 

Approach:  An advanced filtering method has been used to improve the precision and accuracy of PSR maps from lower SNR scans. 

Results:  Initial results demonstrate that this method produces PSR maps comparable to longer, higher SNR scans from shorter clinical scans. 

Impact:  The implementation of nonlinear anisotropic filtering methods significantly improves the practicality of SIR imaging in a clinical setting, offering quick, accurate myelin content assessments (without blurring tissue boundaries like linear filters) for applications in MS. 

2509.
29Enlarged choroid plexus in relapsing-remitting multiple sclerosis may lead to brain structural changes through glymphatic impairment
Yan Xie1 and Wenzhen Zhu1
1Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Keywords: Multiple Sclerosis, Multiple Sclerosis

Motivation: The enlarged choroid plexus (CP) in relapsing-remitting multiple sclerosis (RRMS) patients may further cause glymphatic function change and brain tissue damage.

Goal(s): To explore potential links between structural brain changes in RRMS patients and CP volume as well as glymphatic function.

Approach: Brain structural volume was obtained by Freesurfer segmentation. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index was used to assess the function of glymphatic system.

Results: In both cross-sectional and longitudinal studies, RRMS patients had increased CP volume and decreased DTI-ALPS index. Impaired glymphatic clearance partially mediates the effects of CP enlargement on brain structural changes.

Impact: Enlarged CP and impaired glymphatic system in RRMS patient may cause brain tissue damage. Using CP as a target for interventions may be beneficial to improve glymphatic system function and become a promising treatment strategy.

2510.
30Diffusion tensor imaging of multiple sclerosis patients with progression independent of relapse activity show increased white matter damage
Mario Ocampo-Pineda1,2,3, Alessandro Cagol1,2,3,4, Pascal Benkert5, Muhamed Barakovic1,2,3, Po-Jui Lu1,2,3, Jannis Müller1,2,3,6, Sabine Schaedelin1,2,3,7, Matthias Weigel1,2,3, Lester Melie-Garcia1,2,3, Ludwig Kappos1,2,3, Jens Kuhle2,3, and Cristina Granziera1,2,3
1Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland, 2Department of Neurology, University Hospital Basel, Basel, Switzerland, 3Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland, 4Department of Health Sciences, University of Genova, Genova, Italy, 5Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland, 6Clinical Outcomes in Research (CORe), University of Melbourne, Melbourne VIC, Australia, 7Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Basel, Switzerland

Keywords: Multiple Sclerosis, Neurodegeneration, White matter, PIRA

Motivation: Progression independent of relapse activity (PIRA)  is the most frequent manifestation of disability accumulation in multiple sclerosis (MS), but the mechanisms leading to PIRA are currently unknown.

Goal(s): To investigate the link between PIRA and white matter degeneration in people with MS.

Approach: To compare the integrity of normal-appearing white matter (NAWM) between patients with MS who experienced PIRA versus stable patients using diffusion tensor imaging (DTI) measures from a clinical-compatible protocol.

Results: Patients with PIRA exhibited significant differences in DTI-derived measures compared to stable patients: reduced fractional anisotropy and increased mean and radial diffusivity in NAWM.

Impact: This study sheds light on the relationship between progression independent of relapse activity (PIRA) and white matter degeneration in people with multiple sclerosis. The results have important implications for understanding the mechanisms of disability progression in relapsing-remitting multiple sclerosis.

2511.
31Multi-parametric investigation of thalamic iron and neurotransmitter dyshomeostasis in multiple sclerosis patients with high disability
Fahad Salman1, James B. Murdoch1,2, Dejan Jakimovski1, Cheryl McGranor3, Robert Zivadinov1,3, and Ferdinand Schweser1,3
1Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, United States, 2The Murdoch Institute for Advanced Spectronomics, Cleveland, OH, United States, 3Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, NY, United States

Keywords: Multiple Sclerosis, Multiple Sclerosis, Advanced MS, QSM, HERMES, EDSS, Atrophy, Iron content, GABA, Thalamus

Motivation: Several studies found lower susceptibility in the thalamus of MS patients. Few of these studies have focused on an advanced MS disease stage.

Goal(s): To determine if iron and metabolite levels reflect inflammation-induced iron loss in the deep gray matter of patients with advanced MS.

Approach: 14 MS patients (EDSS scores >4.0, aged >40 years) and age- and sex-matched controls. We employed multi-echo GRE, Magnetization Transfer Ratio, and a HERMES sequence for edited GABA and glutathione (GSH) assessment in the thalamus.

Results: Reduced iron metrics and NAA findings were in line with our hypothesis of iron loss in the thalamus concomitant to neurodegeneration.

Impact: Using a combination of edited spectroscopy and MT, R2* and QSM, this study provides support for inflammation-related iron loss in the thalamus of patients with MS.

2512.
32Abnormal brain perfusion detected in elderly Long COVID patients more than one year after initial mild infection
Alexander Cohen1, Kelly Ristow1, Laura Umfleet1, Malgorzata Franczak1, Sara Swanson1, Jessica Pommy2, Milan Patel1, Shawn Obarski1, Lilly Mason1, and Yang Wang1
1Medical College of Wisconsin, Milwaukee, WI, United States, 2The Ohio State University, Columbus, OH, United States

Keywords: Other Neurodegeneration, Arterial spin labelling

Motivation: Long COVID in aging has become a significant public health concern, but the neurological mechanisms of Long COVID symptoms remain elusive.

Goal(s): This study aimed to assess abnormal brain perfusion related to cognitive impairments in Long COVID, who had initial non-hospitalized mild COVID-19.

Approach: : 3D pCASL with Hadamard-encoded multiple PLDs was applied in 30 elderly Long COVID patients in comparison with 28 controls.

Results: Both prolonged arterial transit time (ATT) and reduced ATT-corrected CBF (cerebral blood flow) were detected in Long COVID patients compared with controls, which was linked to cognitive deficits.

Impact: This study demonstrates the usefulness of advanced MR perfusion techniques in evaluating Long COVID patients, where CBF and ATT showed distinctive patterns that correlated with cognitive decline, manifesting more than a year following the initial mild infection.