Evidence map›Paper›PMID 42287361›Full record

ArticleEuropean archives of psychiatry and clinical neuroscience2026

Cerebral arteriopathy and its role in persistent post-COVID headache and brain fog: a quantitative study.

Jr-Wei Wu, Shu-Ting Chen, Feng-Chi Chang, Yung-Lin Chen, Juosi Leung, Mei-Chun Chen, Jiing-Feng Lirng, Yuan-Hwa Chou

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Article in European archives of psychiatry and clinical neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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8 authors.

Jr-Wei WuDepartment of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.ORCID http://orcid.org/0000-0003-0952-9608
Shu-Ting ChenCollege of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Feng-Chi ChangCollege of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Yung-Lin ChenInstitute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Juosi LeungDepartment of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Mei-Chun ChenDepartment of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Jiing-Feng LirngCollege of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Yuan-Hwa ChouDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan. c520608@ms64.hinet.net.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHeadache and brain fog are common after COVID-19 infection, and inflammation and vasculopathy might be the potential underlying mechanisms. This study aimed to delineate the extent and impact of cerebrovascular involvement in patients with persistent long-COVID syndrome in a large Asian cohort.

methodsWe prospectively collected data from patients with persistent (≥ 3 months) post-COVID headache or brain fog, and controls were free from neurological symptoms within 3 months after COVID-19 resolution. The anterior and posterior Focal Cerebral Arteriopathy Severity Score (FCASS) was used to assess the severity of arteriopathy and was modified to account for bilateral involvement (total score: anterior: 0-40; posterior: 0-52). Symptom severity was assessed using monthly headache days, Migraine Disability Assessment (MIDAS), and brain fog severity scale (0-10).

resultsA total of 108 patients (M: F = 27:81) were divided into four groups based on symptoms categories. The presence of more symptom categories was associated with higher anterior-FCASS (combined 6.6 [2.1] vs. headache 3.6 [1.6] vs. brain-fog 4.7 [1.7] vs. control 0.8 [0.6], p < 0.001 by one-way ANOVA) and a posterior-FCASS (combined 5.5 [2.2] vs. headache 4.2 [1.6] vs. brain-fog 4.4 [2.3] vs. control 0.8 [0.8], p < 0.001 by one-way ANOVA). Pure brain- fog was more likely have predominance of anterior circulation involvement than pure headache (80.8% vs. 48.0%, p = 0.020), but the severity of brain fog was correlated with only the posterior-FCASS (Pearson's r = 0.338, p = 0.009) rather than the anterior-FCASS (Pearson's r = 0.173, p = 0.195).

conclusionsAnterior circulation arteriopathy and hypoperfusion may underlie persistent post-COVID brain fog. However, post-COVID headaches may not depend solely on changes in intracranial vessels.

Indexed as

Cerebral Arterial DiseasesCOVID-19HeadacheAdultFemaleHumansMaleMiddle AgedPost-Acute COVID-19 SyndromeProspective StudiesSeverity of Illness IndexBrain fogCerebral arteriopathyCOVID-19Headache

Identifiers

PMID42287361
PMCPMC13481567

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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.