Description (from grant): 

Significance: Many patients who have recovered from SARS-CoV-2, the virus that causes COVID-19, continue to experience a constellation of symptoms long after the initial illness. Known as “long-COVID”, or Post-Acute Sequelae of SARS-Cov-2 infection (PASC), the most frequently reported symptoms are fatigue, post exertional malaise and cognitive dysfunction, which are also the primary symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Many of the PASC patients fulfill diagnostic criteria for ME/CFS, but differ from these non-PASC ME/CFS patients in that they share a common infectious trigger and have a shorter duration of illness, reducing heterogeneity. Understanding whether PASC ME/CFS shares overlapping mechanisms with non-PASC ME/CFS is critical, as this could provide insights into the mechanisms and inform treatment strategies of ME/CFS in general. To address this question, we propose a comparison study of PASC ME/CFS patients with sudden onset illness to non-PASC ME/CFS patients who reported a sudden flu-like illness onset. Limited studies have shown reductions in CBF and increased cerebroventricular lactate in ME/CFS patients suggesting alterations in perfusion and metabolic properties. Our recent preliminary results show that OEF was elevated in PASC ME/CFS patients, which may be attributed to reduced CBF and mitochondrial dysfunction. Here, we aim to conduct brain MRI to compare the similarities and differences in cerebral oxygen and glucose metabolism between the two patient groups and healthy controls. We will measure and compare the OEF, CBF, CMRO2, and glucose uptake and metabolic rate in the patient groups and healthy controls. The MRI derived parameters will then be correlated to the disease symptom burden. Additional, since many PASC patients recover over one year, we aim to perform a follow-up study on the PASC and non-PASC ME/CFS groups. Through analysis of this longitudinal data, we will be able to determine whether the changes in metabolic properties are associated with changes of patient reported outcome measures. Completion of this study will provide comparison of PASC and non-PASC ME/CSF in terms of changes in glucose and oxygen metabolic properties, as well as how these imaging parameters are related to the disease burden.

Pei H, Lyu X, Lambrecht S, Lin D, Feng L, Liu F, Nyquist P, van Zijl P, Knutsson L, Xu X. Deep learning based generation of DSC MRI parameter maps using DCE MRI data. 2025 Apr 7:ajnr.A8768.