7T Neurosurgical Mapping Protocol for Endoscopic Resection of Skull Base Tumors

Project Summary: Although neurological symptoms are being observed in a high number of COVID-19 patients, a prospective studyaimed at scanning recovered COVID-19 patients with advanced multi-modal neuroimaging methods has yet tobe performed. There is much to be learned about the persisting effects of the SARS-CoV-2 virus on the centralnervous system, and high-resolution magnetic resonance imaging (MRI) is the ideal non-invasive tool to revealthese effects as well as mechanisms of infection. In this work, we will leverage the high resolution and enhancedcontrasts offered by multi-modal 7 Tesla (7T) imaging to study the structural, vascular, functional, andconnectomic changes in the brain related to the pathophysiology of COVID-19. In particular, we will reveal,in unprecedented detail, brain abnormalities resulting from the SARS-CoV-2 infection as well as shine a brighterlight on possible links to loss of respiratory drive due to viral infection through the brain stem. Imaging findingswill be correlated to clinical neurological symptoms and neuropsychological measures. Three patient subgroupswill be recruited for our prospective study: non-cancer patients with neurological symptoms who did not requirea ventilator, cancer patients with neurological symptoms who did not require a ventilator, and patients who hadsevere respiratory distress and required ventilation. A retrospective study will also be performed on clinical brainMRI scans for a group of COVID-19 patients with neurological symptoms, seen at Mount Sinai Health System,and outcomes of this analysis will aid in patient selection for the 7T study and additional analysis of persistingversus transient neurological effects. Our study falls within the scope of our R01 application on "7TNeurosurgical Mapping Protocol for Endoscopic Resection of Skull Base Tumors" as we are applying similarmultimodal 7T imaging techniques to reveal detailed anatomy in the brain and to characterize effects of diseasein both studies. We will simply extend the cohort to include COVID-19 recovered patients and further optimizeimaging in the brain stem which will be applicable to both studies. Our study aligns with the goals of the Noticeof Special Interest announced by the NCI for administrative supplements on COVID-19 as it addressespotential for differential responses among diverse cancer patient populations to SARS-CoV-2 infection orCOVID-19 disease in central nervous system.