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      Brain functional connectivity alterations associated with neuropsychological performance 6–9 months following SARS‐CoV‐2 infection

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          Abstract

          Neuropsychological deficits and brain damage following SARS‐CoV‐2 infection are not well understood. Then, 116 patients, with either severe, moderate, or mild disease in the acute phase underwent neuropsychological and olfactory tests, as well as completed psychiatric and respiratory questionnaires at 223 ± 42 days postinfection. Additionally, a subgroup of 50 patients underwent functional magnetic resonance imaging. Patients in the severe group displayed poorer verbal episodic memory performances, and moderate patients had reduced mental flexibility. Neuroimaging revealed patterns of hypofunctional and hyperfunctional connectivities in severe patients, while only hyperconnectivity patterns were observed for moderate. The default mode, somatosensory, dorsal attention, subcortical, and cerebellar networks were implicated. Partial least squares correlations analysis confirmed specific association between memory, executive functions performances and brain functional connectivity. The severity of the infection in the acute phase is a predictor of neuropsychological performance 6–9 months following SARS‐CoV‐2 infection. SARS‐CoV‐2 infection causes long‐term memory and executive dysfunctions, related to large‐scale functional brain connectivity alterations.

          Abstract

          One hundred and ten patients, with either severe, moderate, or mild disease in the acute phase underwent neuropsychological and olfactory tests, as well as completed psychiatric and respiratory questionnaires at 223 ± 42 days postinfection. Additionally, a subgroup of 50 patients underwent functional magnetic resonance imaging. The severity of the infection in the acute phase is a predictor of neuropsychological performance 6–9 months following SARS‐CoV‐2 infection. SARS‐CoV‐2 infection causes long‐term memory and executive dysfunctions, related to large‐scale functional brain connectivity alterations.

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          Post-acute COVID-19 syndrome

          Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae. Finally, we discuss relevant considerations for the multidisciplinary care of COVID-19 survivors and propose a framework for the identification of those at high risk for post-acute COVID-19 and their coordinated management through dedicated COVID-19 clinics.
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            The organization of the human cerebral cortex estimated by intrinsic functional connectivity.

            Information processing in the cerebral cortex involves interactions among distributed areas. Anatomical connectivity suggests that certain areas form local hierarchical relations such as within the visual system. Other connectivity patterns, particularly among association areas, suggest the presence of large-scale circuits without clear hierarchical relations. In this study the organization of networks in the human cerebrum was explored using resting-state functional connectivity MRI. Data from 1,000 subjects were registered using surface-based alignment. A clustering approach was employed to identify and replicate networks of functionally coupled regions across the cerebral cortex. The results revealed local networks confined to sensory and motor cortices as well as distributed networks of association regions. Within the sensory and motor cortices, functional connectivity followed topographic representations across adjacent areas. In association cortex, the connectivity patterns often showed abrupt transitions between network boundaries. Focused analyses were performed to better understand properties of network connectivity. A canonical sensory-motor pathway involving primary visual area, putative middle temporal area complex (MT+), lateral intraparietal area, and frontal eye field was analyzed to explore how interactions might arise within and between networks. Results showed that adjacent regions of the MT+ complex demonstrate differential connectivity consistent with a hierarchical pathway that spans networks. The functional connectivity of parietal and prefrontal association cortices was next explored. Distinct connectivity profiles of neighboring regions suggest they participate in distributed networks that, while showing evidence for interactions, are embedded within largely parallel, interdigitated circuits. We conclude by discussing the organization of these large-scale cerebral networks in relation to monkey anatomy and their potential evolutionary expansion in humans to support cognition.
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              A new method for measuring daytime sleepiness: the Epworth sleepiness scale.

              The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness. One hundred and eighty adults answered the ESS, including 30 normal men and women as controls and 150 patients with a range of sleep disorders. They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. Total ESS scores significantly distinguished normal subjects from patients in various diagnostic groups including obstructive sleep apnea syndrome, narcolepsy and idiopathic hypersomnia. ESS scores were significantly correlated with sleep latency measured during the multiple sleep latency test and during overnight polysomnography. In patients with obstructive sleep apnea syndrome ESS scores were significantly correlated with the respiratory disturbance index and the minimum SaO2 recorded overnight. ESS scores of patients who simply snored did not differ from controls.
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                Author and article information

                Contributors
                julie.peron@unige.ch
                Journal
                Hum Brain Mapp
                Hum Brain Mapp
                10.1002/(ISSN)1097-0193
                HBM
                Human Brain Mapping
                John Wiley & Sons, Inc. (Hoboken, USA )
                1065-9471
                1097-0193
                02 December 2022
                02 December 2022
                : 10.1002/hbm.26163
                Affiliations
                [ 1 ] Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology University of Geneva Geneva Switzerland
                [ 2 ] Department of Clinical Neurosciences, Neurology Department Geneva University Hospitals Geneva Switzerland
                [ 3 ] Faculty of Medicine University of Geneva Geneva Switzerland
                [ 4 ] Leenaards Memory Center Lausanne University Hospital and University of Lausanne Lausanne Switzerland
                [ 5 ] Psychiatry Department Geneva University Hospitals Geneva Switzerland
                [ 6 ] Diagnostic and Interventional Neuroradiology Department Geneva University Hospitals Geneva Switzerland
                [ 7 ] Division and Department of Primary Care Medicine Geneva University Hospitals Geneva Switzerland
                [ 8 ] Division of General Internal Medicine, Department of Medicine Geneva University Hospitals and Geneva University Geneva Switzerland
                [ 9 ] Intensive Care Department Geneva University Hospitals Geneva Switzerland
                [ 10 ] Neurorehabilitation Department Geneva University Hospitals Geneva Switzerland
                [ 11 ] Rhinology‐Olfactology Unit, Otorhinolaryngology Department Geneva University Hospitals Geneva Switzerland
                [ 12 ] Division of Pulmonary Diseases Geneva University Hospitals Geneva Switzerland
                [ 13 ] Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL) Lausanne Switzerland
                Author notes
                [*] [* ] Correspondence

                Julie A. Péron, Faculté de Psychologie et des Sciences de l'Education, 40 bd du Pont d'Arve, 1205 Geneva, Switzerland.

                Email: julie.peron@ 123456unige.ch

                Author information
                https://orcid.org/0000-0001-6796-8807
                https://orcid.org/0000-0002-1910-9650
                https://orcid.org/0000-0003-1923-1653
                Article
                HBM26163
                10.1002/hbm.26163
                9878070
                36458984
                ab487790-2f04-4bee-b462-fb2d8bd8412f
                © 2022 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 October 2022
                : 11 November 2022
                Page count
                Figures: 7, Tables: 1, Pages: 18, Words: 14392
                Funding
                Funded by: Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung , doi 10.13039/501100001711;
                Award ID: 407840_198438
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.4 mode:remove_FC converted:26.01.2023

                Neurology
                cognition,covid‐19,functional connectivity,mri,neuropsychological deficits
                Neurology
                cognition, covid‐19, functional connectivity, mri, neuropsychological deficits

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