{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:26:02Z","timestamp":1789392362206,"version":"build-2803163510"},"reference-count":60,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T00:00:00Z","timestamp":1705536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R21 AG079098"],"award-info":[{"award-number":["R21 AG079098"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AG085299"],"award-info":[{"award-number":["R01 AG085299"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AG064792"],"award-info":[{"award-number":["R01 AG064792"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 NS100588"],"award-info":[{"award-number":["U01 NS100588"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RF1 AG071515"],"award-info":[{"award-number":["RF1 AG071515"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 NS106711"],"award-info":[{"award-number":["R01 NS106711"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 NS106702"],"award-info":[{"award-number":["R01 NS106702"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P41 EB031771"],"award-info":[{"award-number":["P41 EB031771"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Post-acute COVID-19 syndrome (PCS) is highly prevalent. Critically ill patients requiring intensive care unit (ICU) admission are at a higher risk of developing PCS. The mechanisms underlying PCS are still under investigation and may involve microvascular damage in the brain. Cerebral misery perfusion, characterized by reduced cerebral blood flow (CBF) and elevated oxygen extraction fraction (OEF) in affected brain areas, has been demonstrated in cerebrovascular diseases such as carotid occlusion and stroke. This pilot study aimed to examine whether COVID-19 ICU survivors exhibited regional misery perfusion, indicating cerebral microvascular damage. In total, 7 COVID-19 ICU survivors (4 female, 20\u201377 years old) and 19 age- and sex-matched healthy controls (12 female, 22\u201377 years old) were studied. The average interval between ICU admission and the MRI scan was 118.6 \u00b1 30.3 days. The regional OEF was measured using a recently developed technique, accelerated T2-relaxation-under-phase-contrast MRI, while the regional CBF was assessed using pseudo-continuous arterial spin labeling. COVID-19 ICU survivors exhibited elevated OEF (\u03b2 = 5.21 \u00b1 2.48%, p = 0.047) and reduced relative CBF (\u03b2 = \u22120.083 \u00b1 0.025, p = 0.003) in the frontal lobe compared to healthy controls. In conclusion, misery perfusion was observed in the frontal lobe of COVID-19 ICU survivors, suggesting microvascular damage in this critical brain area for high-level cognitive functions that are known to manifest deficits in PCS. Physiological biomarkers such as OEF and CBF may provide new tools to improve the understanding and treatment of PCS.<\/jats:p>","DOI":"10.3390\/brainsci14010094","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T11:28:46Z","timestamp":1705577326000},"page":"94","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Brain Frontal-Lobe Misery Perfusion in COVID-19 ICU Survivors: An MRI Pilot Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8533-5893","authenticated-orcid":false,"given":"Jie","family":"Song","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, Johns Hopkins University School of Engineering, Baltimore, MD 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivalika","family":"Khanduja","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Rando","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5312-4889","authenticated-orcid":false,"given":"Wen","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"},{"name":"The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Park 324, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaisha","family":"Hazel","sequence":"additional","affiliation":[{"name":"The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Park 324, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George Paul","family":"Pottanat","sequence":"additional","affiliation":[{"name":"The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Park 324, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebony","family":"Jones","sequence":"additional","affiliation":[{"name":"The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Park 324, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuimei","family":"Xu","sequence":"additional","affiliation":[{"name":"The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Park 324, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyi","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"},{"name":"The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Park 324, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6001-2383","authenticated-orcid":false,"given":"Doris","family":"Lin","sequence":"additional","affiliation":[{"name":"The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Park 324, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevil","family":"Yasar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanzhang","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"},{"name":"The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Park 324, Baltimore, MD 21287, USA"},{"name":"F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5132-0958","authenticated-orcid":false,"given":"Sung-Min","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurosurgery, Surgery, Anesthesiology, and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3843-1020","authenticated-orcid":false,"given":"Dengrong","family":"Jiang","sequence":"additional","affiliation":[{"name":"The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Park 324, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-acute COVID-19 syndrome","volume":"27","author":"Nalbandian","year":"2021","journal-title":"Nat. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S2213-2600(21)00031-X","article-title":"NICE guideline on long COVID","volume":"9","author":"Venkatesan","year":"2021","journal-title":"Lancet Respir. 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