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033 COVID:19 the epicentre of neurological events in the human brain
  1. Nicholas Parsons1,
  2. Fiore D’Aprano2,
  3. Athanasia Outsikas3,
  4. Annie Parish3,
  5. Fidel Toomey4,
  6. Shailesh Advani5 and
  7. Govinda Poudel6
  1. 1Cognitive Neuroscience Unit, Deakin University, Melbourne, VIC, Australia
  2. 2Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
  3. 3School of Psychology, Deakin University, Melbourne, VIC, Australia
  4. 4School of Medicine, Deakin University, Melbourne, VIC, Australia
  5. 5National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
  6. 6Department of Health Sciences, Mary Mackillop Institute for Health Research, Melbourne, VIC, Australia


Objective Neuropathology caused by COVID-19 has been widely reported, and the characterisation of the spatial distribution of these pathology remains critical to assess long and short-term neurological sequelae.

Methods We performed a systematic review of the literature to quantify the locations of small neurological events identified with magnetic resonance imaging (MRI) among COVID-19 patients. Neurological events were localised into the Desikan-Killiany grey and white matter atlases. A mathematical network diffusion model was then used to test whether the spatial distribution of neurological events could be explained via a linear spread through the structural connectome of the brain.

Results The highest proportions (26%) of white matter events were observed within the bilateral corticospinal tracts. The highest proportions (~10%) of grey matter events were observed in areas including the bilateral superior temporal, precentral, and lateral occipital cortices. Sub-cortical events were most frequently identified in the Pallidum. The application of a mathematical network diffusion model suggested that the spatial pattern of the small neurological events in COVID-19 can be modelled with a linear diffusion of spread from epicentres in the bilateral cerebellum and basal ganglia (Pearson’s r=0.41, p<0.001, corrected).

Conclusions To our knowledge, this is the first study to systematically characterise the spatial distribution of small neurological events in COVID-19 patients and test whether the spatial distribution of these events can be explained by a linear diffusion spread model. As such, initial sub-cortical events which manifest as altered consciousness could be expected to be followed by later cortical events manifesting as altered sensorimotor functioning.

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