{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:02:13Z","timestamp":1791928933466,"version":"4.3.4"},"reference-count":62,"publisher":"Oxford University Press (OUP)","issue":"1172","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Chronic Post COVID-19 Infection Neuroimaging and Cerebrovascular Imaging"},{"name":"Bayer Healthcare LLC"},{"name":"Long terms effects of COVID-19"},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>COVID-19, caused by SARS-CoV-2, has led to the condition known as Long COVID or post-acute sequelae of COVID-19 (PASC), where individuals experience persistent debilitating symptoms long after the initial infection. We provide here a comprehensive review of findings in the central nervous system associated with PASC. Neuroimaging has been instrumental in identifying brain changes associated with PASC. Structural MRI studies consistently reveal grey matter volume reductions in the frontal and temporal lobes and white matter hyperintensities, particularly in the periventricular regions. Studies especially found these changes to correlate strongly with cognitive deficits. Diffusion tensor imaging has shown increased tissue damage and oedema in the brain\u2019s white matter tracts, particularly in the sagittal stratum and thalamic radiation. Resting-state functional MRI studies indicate altered brain connectivity in PASC patients, especially in those with post-traumatic stress symptoms. Reduced connectivity within and between critical networks, such as the default mode network and the executive control network, has been observed. These changes correlate with cognitive impairments, such as attention and memory deficits. Dynamic functional connectivity analyses further reveal that PASC patients spend less time in states with rich inter-regional connectivity, and transitions between connectivity states were linked to post-traumatic stress disorder symptoms. Positron emission tomography scans have shown hypometabolism in the frontal and temporal lobes, particularly in regions associated with memory and executive functions. Hypometabolism in the hippocampus and thalamus is linked to symptoms like anosmia and fatigue. Despite the heterogeneity in clinical presentations and diagnostic criteria, these neuroimaging findings underscore the significant impact of COVID-19 on brain structure and function. Continued research using advanced imaging techniques is essential for a deeper understanding of PASC\u2019s neurological effects. This will aid in developing targeted interventions and improving outcomes for those affected by Long COVID and inform studies investigating downstream effects of viral infections on the brain.<\/jats:p>","DOI":"10.1093\/bjr\/tqaf090","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T15:29:39Z","timestamp":1745940579000},"page":"1165-1175","source":"Crossref","is-referenced-by-count":8,"title":["Neuroimaging biomarkers of post-acute sequelae of Coronavirus Disease 2019"],"prefix":"10.1093","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8863-3168","authenticated-orcid":false,"given":"Swati","family":"Rane Levendovszky","sequence":"first","affiliation":[{"name":"Department of Radiology, University of Washington School of Medicine , Seattle, WA 98195,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payal","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Washington School of Medicine , Seattle, WA 98195,","place":["United States"]},{"name":"Department of Neurology, Seattle Children\u2019s Hospital, Seattle, WA 98105, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengcheng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Washington School of Medicine , Seattle, WA 98195,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M","family":"Rutman","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Washington School of Medicine , Seattle, WA 98195,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmud Mossa","family":"Basha","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Washington School of Medicine , Seattle, WA 98195,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"2026071503070472900_tqaf090-B1","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1038\/s41569-020-0413-9","article-title":"COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives","volume":"17","author":"Nishiga","year":"2020","journal-title":"Nat Rev Cardiol"},{"key":"2026071503070472900_tqaf090-B2","doi-asserted-by":"publisher","first-page":"698169","DOI":"10.3389\/fmicb.2021.698169","article-title":"Long COVID or post-acute sequelae of COVID-19 (PASC): an overview of biological factors that may contribute to persistent symptoms","volume":"12","author":"Proal","year":"2021","journal-title":"Front Microbiol"},{"key":"2026071503070472900_tqaf090-B3","doi-asserted-by":"publisher","first-page":"21501327211030826","DOI":"10.1177\/21501327211030826","article-title":"Central sensitization phenotypes in post acute sequelae of SARS-CoV-2 infection (PASC): defining the post COVID syndrome","volume":"12","author":"Bierle","year":"2021","journal-title":"J Prim Care Commun Health"},{"key":"2026071503070472900_tqaf090-B4","doi-asserted-by":"publisher","first-page":"2055","DOI":"10.1093\/cid\/ciab408","article-title":"Population-based estimates of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) prevalence and characteristics","volume":"73","author":"Hirschtick","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2026071503070472900_tqaf090-B5","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1080\/10408363.2020.1860895","article-title":"COVID-19: from an acute to chronic disease? 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