Alteration of white matter microstructure in patients with sleep disorders after COVID-19 infection.

BACKGROUND: The pathophysiology of coronasomnia remains unclear. This study aimed to investigate changes in white matter (WM) microstructure and inflammatory factors in patients with sleep disorders (SD) characterized by poor sleep quantity, quality, or timing following coronavirus disease 2019 (COVID-19) infection in the acute phase (within one month) and whether these changes could be recovered at 3-month follow-up. METHODS: 29 acute COVID-19 patients with SD (COVID_SD) and 27 acute COVID-19 patients without SD (COVID_NonSD) underwent diffusion tensor imaging (DTI), tested peripheral blood inflammatory cytokines level, and measured Pittsburgh Sleep Quality Index (PSQI), and matched 30 uninfected healthy controls. Analyzed WM abnormalities between groups in acute phase and explored its changes in COVID_SD at 3-month follow-up by using tract-based spatial statistics (TBSS). Correlations between DTI and clinical data were examined using Spearman partial correlation analysis. RESULTS: Both COVID_SD and COVID_NonSD exhibited widespread WM microstructure abnormalities. The COVID_SD group showed specific WM microstructure changes in right inferior fronto-occipital fasciculus (IFOF) (lower fractional anisotropy [FA]/axial diffusivity [AD] and higher radial diffusivity [RD]) and left corticospinal tract (CST) (higher FA and lower RD) and higher interleukin-1ß (IL-1ß) compared with COVID_NonSD group. These WM abnormalities and IL-1ß levels were correlated PSQI score. After 3 months, the IFOF integrity and IL-1ß levels tended to return to normal accompanied by symptom improvement in the COVID_SD relative to baseline. CONCLUSION: Abnormalities in right IFOF and left CST and elevated IL-1ß levels were important neurophenotypes correlated with COVID_SD, which might provide new insights into the pathogenesis of neuroinflammation in SD patients induced by COVID-19.

Altered regional homogeneity following moxibustion in mild cognitive impairment.

Moxibustion has a definite clinical effect in improving the cognitive condition in individuals with mild cognitive impairment (MCI), but its underlying neural mechanism remains elusive. This study aimed to investigate the alterations in spontaneous brain activity and cognitive function following moxibustion therapy in MCI patients. This study enrolled a cohort of 33 MCI subjects and 30 matched healthy controls (HCs). MCI subjects underwent a two-month regimen of moxibustion. Employing resting-state functional magnetic resonance imaging, we utilized regional homogeneity (ReHo) analysis to evaluate the changes in brain activity. Cognitive function was evaluated by using the Mini-Mental State Examination and Montreal Cognitive Assessment. There existed aberrant ReHo values in different brain areas mainly involved in the default mode network (DMN) in MCI subjects compared with HCs. After moxibustion treatment, MCI subjects showed an inverse in ReHo values from baseline in the hippocampus/parahippocampus and insula, as well as an increase in ReHo value in the middle frontal gyrus. Notably, the ReHo alterations in the left hippocampus/parahippocampus and middle frontal gyrus were associated with cognitive improvement in MCI patients. Abnormal neural activity occurred in MCI subjects mainly within the DMN. Moxibustion therapy may facilitate cognitive improvement in MCI subjects by modulating brain activity, particularly by reversing the neural activity within the DMN and salience network. These results underscore the therapeutic potential of moxibustion as an early intervention strategy for Alzheimer's disease.