AUTHOR=Jin Ping , Cui Feng , Zhang Luping 

TITLE=Altered metabolites in the periaqueductal gray of COVID-19 patients experiencing headaches: a longitudinal MRS study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1323290

DOI=10.3389/fneur.2023.1323290

ISSN=1664-2295

ABSTRACT=Background: Headache is one of the most common symptoms of acute COVID-19 infection.However, its mechanisms remain poorly understood, and there is a lack of studies investigating changes in the periaqueductal gray (PAG) in COVID-19 patients exhibiting headaches.Purpose: To explore the alterations in metabolites of the PAG pre-and post-COVID-19 infection in individuals who suffered from headaches during the acute phase of the disease using proton magnetic resonance spectroscopy ( 1 H-MRS).Methods: Fifteen participants who experienced headaches during the acute phase of COVID-19 were recruited. All subjects underwent two proton magnetic resonance spectroscopy ( 1 H-MRS) examinations focusing on the PAG before and after they were infected. Metabolite changes were assessed between the pre-and post-infection groups.The combined glutamine and glutamate/total creatine ratio (Glx/tCr) was increased in the PAG following COVID-19 infection. The total choline/total creatine ratio (tCho/tCr) in the preinfection group was negatively correlated with the duration of headache during the COVID-19 acute phase.The present study indicates that PAG plays a pivotal role in COVID-19 headaches, thereby supporting the involvement of trigeminovascular system activation in the pathophysiology of COVID-19 headaches.