Evidence map›Paper›PMID 40738266›Full record

ArticleBrain, behavior, and immunity2025

Blood-Brain barrier disruption in long COVID and cognitive correlates: A cross-sectional MRI study.

Leah H Rubin, Wen Shi, Alba Azola, Aparna Bhattacharyya, Raha M Dastgheyb, Jiani Wu, Christina Della Penna, Hannah Parker, Isabel Santiuste, Ana Ehrenspeck and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Brain, behavior, and immunity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Article
  2. Article
  3. Neurodegenerative and Cognitive Consequences of Long COVID.International journal of molecular sciences · 2026
    Review
  4. Review
  5. Vascular inflammation in neuropsychiatric long COVID.Brain, behavior, & immunity - health · 2026
    Article
  6. Review
  7. Review
  8. Article
  9. Review
  10. Article
  11. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Leah H RubinDepartment of Neurology, Johns Hopkins University, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA; Department of Molecular and Comparative Pathobiology, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA. Electronic address: lrubin@jhu.edu.
Wen ShiDepartment of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
Alba AzolaDepartment of Pediatrics, Johns Hopkins University, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA.
Aparna BhattacharyyaDepartment of Neurology, Johns Hopkins University, Baltimore, MD, USA.
Raha M DastgheybDepartment of Neurology, Johns Hopkins University, Baltimore, MD, USA.
Jiani WuDepartment of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
Christina Della PennaDepartment of Neurology, Johns Hopkins University, Baltimore, MD, USA.
Hannah ParkerDepartment of Neurology, Johns Hopkins University, Baltimore, MD, USA.
Isabel SantiusteDepartment of Neurology, Johns Hopkins University, Baltimore, MD, USA.
Ana EhrenspeckDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.
Jennifer M CoughlinDepartment of Neurology, Johns Hopkins University, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.
Tracy D VannorsdallDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.
Hanzhang LuDepartment of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA. Electronic address: hanzhang.lu@jhu.edu.
Rebecca VeenhuisDepartment of Neurology, Johns Hopkins University, Baltimore, MD, USA; Department of Molecular and Comparative Pathobiology, Johns Hopkins University, Baltimore, MD, USA. Electronic address: rterill1@jhmi.edu.

Funding

TRD 4: Platforms for multi-modal and multi-scale imaging dataP41EB031771 · NIBIB · HUGO W. MOSER RES INST KENNEDY KRIEGER · PI Hanzhang Lu, Peter CM Van Zijl · 2021 to 2026
$9.9M
Blood brain barrier integrity and immune dynamics contributing to neuropsychiatric sequela in COVID long-haulersRF1MH133411 · NIMH · JOHNS HOPKINS UNIVERSITY · PI RUBIN, LEAH HELANE, VEENHUIS, REBECCA TERILLI · 2023 to 2023
$2.9M
Non-contrast MR imaging of blood-brain-barrier permeability in Alzheimer's diseaseR01AG064792 · NIA · JOHNS HOPKINS UNIVERSITY · PI LU, HANZHANG · 2020 to 2023
$2.6M
NIA NIH HHS R01 AG064792NIBIB NIH HHS P41 EB031771NIMH NIH HHS RF1 MH133411
6 · The paper itself

Abstract

Disruption of the blood-brain barrier (BBB) may contribute to neuropsychiatric symptoms observed in Long COVID (LC). Using a non-contrast magnetic resonance imaging (MRI) technique, we investigated BBB permeability in individuals with LC and its relationship to cognitive function. We hypothesized that LC individuals would show greater BBB permeability than recovered individuals, and that higher permeability would correlate with poorer cognition. Ninety-seven participants meeting the 2024 NASEM definition of LC with at least one neuropsychiatric symptom and 31 recovered controls completed an MRI scan and cognitive testing. BBB permeability was assessed using water-extraction-with-phase-contrast-arterial-spin-tagging (WEPCAST) MRI, which estimates the permeability-surface-area product (PS) of arterially labeled water entering the brain. Cognitive performance was summarized into eight factor scores derived from principal components analysis. Compared to controls, the LC group was older (M = 47 vs. 39 years, P = 0.003), less educated (P = 0.02), more likely female (P = 0.04), and had higher hospitalization rates for COVID-19 (P = 0.02). PS was significantly elevated in the LC group after adjusting for age and sex (B = 18.59, SE = 6.11, β = 0.28, P = 0.003). No significant group differences were found in cerebral blood flow, extraction fraction (E), or brain volume. Within the LC group, higher PS was associated with poorer motor function, but not with other cognitive domains. These findings indicate subtle but persistent BBB disruption in LC individuals over two years post-infection, with a potential link to motor dysfunction. This supports prior evidence of BBB changes following severe COVID-19 and suggests that BBB integrity may be a long-term biomarker of neuropsychiatric complications in LC.

Indexed as

Blood-Brain BarrierCognitionCOVID-19AdultAgedBrainCognitive DysfunctionCross-Sectional StudiesFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedSARS-CoV-2Blood brain barrierCognitionCOVID-19Long COVID

Identifiers

PMID40738266
PMCPMC12409700

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.