{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:56:32Z","timestamp":1790207792788,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007210","name":"RWTH Aachen University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007210","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Clin Neurosci"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Up to 10% of SARS\u2010CoV\u20102 infected individuals suffer from post\u2010COVID\u201019 condition, marked by fatigue and cognitive dysfunction as major symptoms. Longitudinal studies on neuropsychological and clinical trajectories and related brain changes are scarce. Here, we aimed to examine their evolution up to 2\u2009years post\u2010infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a multi\u2010center, longitudinal study of 79 post\u2010COVID patients (mean age 46, 48 female) with persistent symptoms and 21 age\u2010 and sex\u2010matched never\u2010infected, healthy controls (mean age 42, eight female), we analyzed neuropsychological performance, self\u2010reported outcomes and associated neuroimaging alterations of resting\u2010state functional and structural magnetic resonance imaging data 23\u2009months post\u2010infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In post\u2010COVID patients 23\u2009months after SARS\u2010CoV\u20102 infection we observed (1) that fatigue severity had reduced but still remained present in most patients, (2) widespread brain changes involving the brainstem, the pre\u2010 and postcentral gyrus and the limbic olfactory network, (3) a weakening of self\u2010reported fatigue and its cerebral associations. Notably, findings of brain aberrations were more pronounced in hospitalized patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings indicate that complex brain adaptations take place up to 2\u2009years following SARS\u2010CoV\u20102 infection. Some regions manifest enduring abnormalities while others undergo restitution. The attenuation of radio\u2010clinical associations suggests a compensatory function for these regions, pointing to non\u2010brain intrinsic factors to sustain persistent fatigue.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pcn.13789","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T08:45:06Z","timestamp":1738658706000},"page":"176-186","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Two\u2010year impact of <scp>COVID<\/scp>\u201019: Longitudinal <scp>MRI<\/scp> brain changes and neuropsychiatric trajectories"],"prefix":"10.1111","volume":"79","author":[{"given":"Ravi","family":"Dadsena","sequence":"first","affiliation":[{"name":"Department of Neurology RWTH Aachen University  Aachen Germany"},{"name":"JARA Brain Institute Molecular Neuroscience and Neuroimaging (INM\u201011) Research Centre J\u00fclich and RWTH Aachen University  Aachen 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