{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:31:24Z","timestamp":1792161084128,"version":"4.4.0"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Persisting neurological symptoms after COVID\u201019 affect up to 10% of patients and can manifest in fatigue and cognitive complaints. Based on recent evidence, we evaluated whether cerebral hemodynamic changes contribute to post\u2010COVID syndrome (PCS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using resting\u2010state functional magnetic resonance imaging, we investigated brain perfusion and oxygen level estimates in 47 patients (44.4\u2009\u00b1\u200911.6\u2009years; F:M\u2009=\u200938:9) and 47 individually matched healthy control participants. Group differences were calculated using two\u2010sample\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests. Multivariable linear regression was used for associations of each regional perfusion and oxygen level measure with cognition and sleepiness measures. Exploratory hazard ratios were calculated for each brain metric with clinical measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients presented with high levels of fatigue (79%) and daytime sleepiness (45%). We found widespread decreased brain oxygen levels, most evident in the white matter (false discovery rate adjusted\u2010\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010\n                      <jats:sub>FDR<\/jats:sub>\n                      )\u2009=\u20090.038) and cortical grey matter (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010\n                      <jats:sub>FDR<\/jats:sub>\n                      \u2009=\u20090.015). Brain perfusion did not differ between patients and healthy participants. However, delayed patient caudate nucleus perfusion was associated with better executive function (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010\n                      <jats:sub>FDR<\/jats:sub>\n                      \u2009=\u20090.008). Delayed perfusion in the cortical grey matter and hippocampus were associated with a reduced risk of daytime sleepiness (hazard ratio (\n                      <jats:italic>HR<\/jats:italic>\n                      )\u2009=\u20090.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037 and\n                      <jats:italic>HR<\/jats:italic>\n                      \u2009=\u20090.06,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). Decreased putamen oxygen levels were associated with a reduced risk of poor cognitive outcome (\n                      <jats:italic>HR<\/jats:italic>\n                      \u2009=\u20090.22,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). Meanwhile, lower thalamic oxygen levels were associated with a higher risk of cognitive fatigue (\n                      <jats:italic>HR<\/jats:italic>\n                      \u2009=\u20096.29,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Our findings of lower regional brain blood oxygen levels suggest increased cerebral metabolism in PCS, which potentially holds a compensatory function. These hemodynamic changes were related to symptom severity, possibly representing metabolic adaptations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.52121","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T08:56:14Z","timestamp":1718355374000},"page":"2016-2029","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Altered brain perfusion and oxygen levels relate to sleepiness and attention in post\u2010\n                    <scp>COVID<\/scp>\n                    syndrome"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8280-9513","authenticated-orcid":false,"given":"Claudia","family":"Chien","sequence":"first","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin Experimental and Clinical Research Center  Berlin Germany"},{"name":"Neuroscience Clinical Research Center Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"Department of Psychiatry and Neurosciences Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"Max Delbr\u00fcck Center for Molecular Medicine in the Helmholtz Association (MDC)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5226-6650","authenticated-orcid":false,"given":"Josephine","family":"Heine","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin Experimental and Clinical Research Center  Berlin Germany"},{"name":"Department of Psychiatry and Neurosciences Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"Max Delbr\u00fcck Center for Molecular Medicine in the Helmholtz Association (MDC)  Berlin Germany"},{"name":"Department of Neurology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1752-4305","authenticated-orcid":false,"given":"Ahmed","family":"Khalil","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Schlenker","sequence":"additional","affiliation":[{"name":"Department of Neurology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin, Berlin Institut f\u00fcr Med. 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