Imaging Generalized and Selective Markers of Presynaptic Density In Persistent Depression With/Without Other Neuropsychiatric Symptoms After COVID-19

After people recover from short term breathing problems, and feelings of sickness with COVID-19, there can be longer term problems affecting the brain like clinical depression. Little is known about how COVID-19 leads to symptoms of depression, including trouble with enjoying things, low motivation, slower movement and reduced concentration; because most brain studies are of those who died in the midst of breathing problems from COVID-19, not later when these symptoms occur. Using brain imaging, we recently discovered inflammation in regions that participate in feeling enjoyment, motivation and movement speed. Inflammation is how the cells in the body respond to infection and trauma, like the redness on the skin after a scrape. Cells that make inflammation in the brain can remove connections between cells, or damage connections between cells so we would like to study whether the connections between cells are reduced in the brain regions where there is more prominent inflammation. To do this we propose two imaging methods, one to measure connections of cells that release a chemical called dopamine, and one that looks at lots of connections between cells. We expect a reduction in connections in those with depression after COVID-19 and that those with the greatest severity of symptoms will have the largest reduction in connections. Presently there are no evidence based treatments for depression after COVID-19. The expected results of this study will be important for cure because if connections between cells are missing in people with depression after COVID-19, there are medication treatments that can be repurposed to increase the density of connections between cells. There are also treatments that can make some types of connections better able to release neurochemicals to compensate for lost connections. If the study shows the expected results both of these approaches could be tested as the next step in clinical trials, justified by the imaging findings.