Grey matter cortical changes in patients with persistent headache after COVID-19

An exploratory case-control study from Spain showed that persistent headache after COVID-19 infection is related to grey matter cortical changes, defined by higher grey matter volume and surface area values, mainly localised in frontal regions [1].

Headache is among the most frequent neurological symptoms of COVID-19 [2]. Half a year after infection, 10% of COVID-19 patients complained of persistent headache [3].

An exploratory case-control study from Spain included 10 patients with persistent headache after COVID-19 (median age: 54.0 years; 9 women) and 10 age- and sex-matched healthy controls (median age: 54.5 years; 9 women) [1]. In patients with persistent headache, mean surface area and grey matter volume values were higher compared with healthy controls in the following regions: bilateral medial orbitofrontal cortex, left rostral middle frontal gyrus, right superior frontal gyrus (all comparisons P=0.009), and pars opercularis (P=0.036). The patients also had significantly higher grey matter volume in the right caudal anterior cingulate gyrus and surface area values in 5 temporal, frontal, and parietal regions (all P<0.05). However, no changes in cortical curvature thickness were found.

Currently, no other neuroimaging studies have directly assessed the relationship between COVID-19 and headache. Nonetheless, in line with the current study, another study demonstrated an increased grey matter volume in COVID-19 patients [4]. “Interestingly, COVID-19 patients showed an opposite trend in grey matter cortical changes to other neurological diseases, including migraine,” Dr Álvaro Planchuelo-Gómez (Universidad de Valladolid, Spain) pointed out [1].

Possible hypotheses to explain these results are the presence of microglial activation or astrogliosis, as reported in previous neuropathological studies, the presence of neuroinflammation, and the compensation of impaired connectivity [4–6].

1. Planchuelo-Gómez Á, et al. Gray matter cortical changes in patients with persistent headache after COVID-19 infection: an exploratory study. AL011, IHC 2021, 8–12 September.
2. Ellul MA, et al. Lancet Neurol. 2020;19:767–83.
3. Logue JK, et al. JAMA Netw Open. 2021;4:e210830.
4. Lu Y, et al. EClinicalMedicine. 2020;25:100484.
5. Thakur KT, et al. Brain. 2021 Apr 15:awab148.
6. Matschke J, et al. Lancet Neurol. 2020;19:919–29.

Copyright ©2021 Medicom Medical Publishers



Posted on 8 November 20218 November 2021