Evidence map›Paper›PMID 40800841›Full record

ArticleImaging neuroscience (Cambridge, Mass.)2025

Long COVID-related blood-brain barrier breakdown and microstructure in older adults are modified by sex and Alzheimer's disease genetic risk.

Emilie T Reas, Austin Alderson-Myers, Seraphina K Solders, Qian Shen, Charlotte S Rivera, Xin Wang, Jordan Stiver, Sarah J Banks, Jennifer S Graves

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Imaging neuroscience (Cambridge, Mass.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Sleep duration promotes resistance and resilience to tau in older women at risk for Alzheimer's disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Article
  6. Article
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

9 authors.

Emilie T ReasDepartment of Neurosciences, University of California, San Diego, La Jolla, CA, United States.ORCID https://orcid.org/0000-0002-4110-5154
Austin Alderson-MyersDepartment of Neurosciences, University of California, San Diego, La Jolla, CA, United States.
Seraphina K SoldersDepartment of Neurosciences, University of California, San Diego, La Jolla, CA, United States.
Qian ShenDepartment of Neurosciences, University of California, San Diego, La Jolla, CA, United States.
Charlotte S RiveraDepartment of Neurosciences, University of California, San Diego, La Jolla, CA, United States.
Xin WangDepartment of Neurosciences, University of California, San Diego, La Jolla, CA, United States.
Jordan StiverDepartment of Neurosciences, University of California, San Diego, La Jolla, CA, United States.
Sarah J BanksDepartment of Neurosciences, University of California, San Diego, La Jolla, CA, United States.
Jennifer S GravesDepartment of Neurosciences, University of California, San Diego, La Jolla, CA, United States.

Funding

UCSD Leading the Advancement of Underrepresented Neuroscientists for Change (LAUNCH) Faculty Development ProgramR25NS117367 · NINDS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Victoria B Risbrough, Joann Trejo · 2020 to 2026
$1.6M
NINDS NIH HHS R25 NS117367
6 · The paper itself

Abstract

Long COVID is characterized by lingering symptoms following SARS-CoV-2 infection, which may include neurological and cognitive complaints. Hypothesized mechanisms, including blood-brain barrier (BBB) dysfunction and neuroinflammation, are shared with Alzheimer's disease (AD) and related dementias. To address concern that long COVID may accelerate cognitive decline and neurodegeneration, this study examined neuroimaging-based markers of BBB breakdown and brain microstructure among older adults with long COVID, and modification by AD risk factors. Individuals with persistent cognitive complaints following SARS-CoV-2 infection (neurological long COVID, NLCV) and cognitively normal controls (50-90 years, 61% women) underwent neuropsychological evaluation, genotyping, dynamic contrast-enhanced MRI to measure BBB permeability, and multi-compartment diffusion MRI to measure brain microstructure. Cognitive and brain measures were compared between NLCV and controls using analysis of covariance, and associations among measures were assessed using linear regression. Interaction models probed modification by sex and AD genetic risk, quantified with a polygenic hazard score. Compared to controls, NLCV exhibited cognitive impairment, BBB breakdown, and subcortical microstructural abnormalities. NLCV-related BBB leakage was widespread across the brain and more pronounced among men, whereas white matter and subcortical microstructural differences were stronger among women. AD polygenic hazard score modified associations of BBB permeability with memory and microstructure, such that higher caudate BBB permeability correlated with worse immediate recall, and higher white matter permeability correlated with higher free water only for those with elevated genetic risk. BBB dysfunction and microstructural compromise may contribute to cognitive symptoms of long COVID in older adults. Sex-specific patterns, and more deleterious associations between brain and memory abnormalities among individuals with elevated AD genetic risk, highlight the need for precision medicine diagnostic and therapeutic approaches for long COVID.

Indexed as

Alzheimer’s diseaseblood-brain barrierCOVID-19diffusion MRIsex differences

Identifiers

PMID40800841
PMCPMC12319845

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.