ORIGINAL RESEARCH article
Front. Neuroimaging
Sec. Clinical Neuroimaging
This article is part of the Research TopicUpdating Long COVID: Mechanisms, Risk Factors, and Treatment Volume IIView all 7 articles
Post COVID-19 condition is associated with altered regional cerebral blood volume as revealed by dynamic susceptibility contrast MRI
Provisionally accepted
Bradley J MacIntosh1*
S Shirley Lin2
Finn O'Hara2
Nathan Churchill3Fred Tam4
Alexandra Pavel4
Eugenie Roudaia5Allison Sekuler5Ivy Cheng6
Fuqiang Gao4
Benjamin Lam6Chris Heyn6
Mario Masellis6
Jean Chen5Tom A Schweizer3
Sandra E Black6
Simon James Graham4- 1Sunnybrook Research Institute (SRI), Toronto, Canada
- 2University of Waterloo, Waterloo, Canada
- 3St Michael's Hospital Neuroscience Research Program, Toronto, Canada
- 4Sunnybrook Research Institute, Toronto, Canada
- 5Baycrest Hospital, Toronto, Canada
- 6Sunnybrook Health Sciences Centre, Toronto, Canada
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ABSTRACT Background: Coronavirus disease 2019 (COVID-19) has been associated with central nervous system dysfunction implicating cerebrovascular and neurovascular units, as reflected in lower regional cerebral blood flow among non-hospitalized individuals that experienced post COVID-19 condition (PCC). This study investigates whether PCC is associated altered regional cerebral blood volume assessed using Dynamic Susceptibility Contrast (DSC) Magnetic Resonance Imaging (MRI). The comparison control group are individuals without PCC who previously experienced cold or flu-like symptoms, or COVID-19. Methods: Fifty-seven participants were recruited: 36 with PCC (mean age: 42.7, standard deviation: 10.4, 26 females) and 21 controls (mean age: 41.6, standard deviation: 14.7, 13 females). T2*-weighted DSC MRI was performed at 3 Tesla to image the first passage of the bolus. A total of 22 regions of interest (ROIs) were considered. Group differences in DSC-derived cerebral blood volume (rCBV) and cerebral blood flow (rCBF) were evaluated using Bayesian regression, providing median group differences, highest density interval (HDI), and the probability of direction (PD) estimates. Results: The two groups (PCC and controls) were matched for age, sex, days from symptom onset, and number of previous vaccines, but had different degrees of self-report illness severity. The rCBV analysis showed median group differences (range: -0.05 to -0.13), with PD > 0.90, indicating a high probability of decreased rCBV in the PCC group, consisting of the superior frontal gyrus, thalamus, paracentral lobule, cingulate gyrus, postcentral gyrus, middle frontal gyrus, inferior frontal gyrus, and superior temporal gyrus ROIs. By comparison, group differences in rCBF were muted and did not reach PD>0.90.
Keywords: cerebral blood flow, cerebral blood volume, dynamicsusceptibility contrast, Magnetic Resonance Imaging, Post COVID-19 condition
Received: 19 Aug 2025; Accepted: 17 Dec 2025.
Copyright: © 2025 MacIntosh, Lin, O'Hara, Churchill, Tam, Pavel, Roudaia, Sekuler, Cheng, Gao, Lam, Heyn, Masellis, Chen, Schweizer, Black and Graham. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bradley J MacIntosh
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