Pharma Focus Asia

SARS-CoV2 Evokes Structural Brain Changes Resulting in Declined Executive Function

Daniel Deuter, Katharina Hense, Kevin Kunkel, Johanna Vollmayr, Sebastian Schachinger, Christina Wendl, Andreas Schicho, Claudia Fellner, Bernd Salzberger, Florian Hitzenbichler, Judith Zeller, Veronika Vielsmeier, Frank Dodoo-Schittko, Nils Ole Schmidt, Katharina Rosengarth.


Several research has underlined the multi-system character of COVID-19. Though effects on the Central Nervous System are mainly discussed as disease-specific affections due to the virus’ neurotropism, no comprehensive disease model of COVID-19 exists on a neurofunctional base by now. We aimed to investigate neuroplastic grey- and white matter changes related to COVID-19 and to link these changes to neurocognitive testings leading towards a multi-dimensional disease model.


Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first identified in Wuhan, China, rapidly spreading around the world causing a global pandemic in the following. Though SARS-CoV-2 is mainly attributed to infect the respiratory system causing severe pneumonia, a multitude of studies is rather underlining a multi-system character of COVID-19 including involvement of the digestive system, the cardiovascular system and the central nervous system (CNS).


This study was approved by the local ethics committee of the University of Regensburg (protocol code 20-1831-101) and was performed in accordance with the Declaration of Helsinki. Written informed consent was obtained from each subject.


In the presented study, we evaluated the impact of a COVID-19 infection on structural alterations as well as neurocognitive functions. Acutely ill patients were examined using neuropsychological tests and MRI and compared to patients recovered from COVID-19 and a group of healthy controls.

Citation: Deuter D, Hense K, Kunkel K, Vollmayr J, Schachinger S, Wendl C, et al. (2024) SARS-CoV2 evokes structural brain changes resulting in declined executive function. PLoS ONE 19(3): e0298837.

Editor: Yangming Ou, Harvard Medical School, UNITED STATES

Received: December 30, 2022; Accepted: January 30, 2024; Published: March 12, 2024.

Copyright: © 2024 Deuter et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: The authors received funding from the Bavarian Ministry for Science and Arts (Bayerisches Staatsministerium für Wissenschaft und Kunst) for the promotion of Corona research projects (“Förderung von Corona-Forschungsprojekten”). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Abbreviations: AC, Anterior Commissure; ACE2, Angiotensin-converting enzyme; AF, Arcuate Fasciculus; AR, Acoustic Radiation; ATR, Anterior Thalamic Radiation; CBD, dorsal Cingulum subsection; CBP, peri-genual Cingulum subsection; CBT, temporal Cingulum subsection; CNS, central nervous system; COVID-19, Coronavirus disease 2019; CSF, cortico spinal fluid; CST, Corticospinal Tract; DTI, Diffusion Tensor Imaging; FA, Fractional Anistropy; FAs, Frontal Aslant; FLAIR, FLuid Attenuated Inversion Recovery; FMA, Forceps Major; FMI, Forceps Minor; FoV, Field-of-view; FX, Fornix; ILF, Inferior Longitudinal Fasciculus; IFO, Inferior Fronto-Occipital Fasciculus; MCP, Middle Cerebellar Peduncle; MD, Mean Diffusivity; MdLF, Middle Longitudinal Fasciculus; MNI, Montreal Neurological Institute; MP-RAGE, Magnetization Prepared Rapid Acquisition with Gradient Echo; OR, Optic Radiation; ROI, Region Of Interest; RWAT, Regensburg Word Fluency Test; SARS-CoV2, severe acute respiratory syndrome coronavirus 2; SLF1/ 2/ 3, Superior Longitudinal Fasciculus 1/ 2/ 3; S-protein = spike-like protein; STR, Superior Thalamic Radiation; SWI, Susceptibility Weighted Image; TBSS, Tract-Based Spatial Statistics; TE, echo time; TFCE, Threshold-Free Cluster Enhancement; TIV, total intracranial volume; TR, repetition time; UF, Uncinate Fasciculus; VBM, voxel-based morphometry; VOF, Vertical Occipital Fasciculus; WAIS, Wechsler Adult Intelligence Scale; 3D, three-dimensional.

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