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Neurochemical Alterations Linked to Persistent Covid-19-Induced Anosmia: Probing Into Orbitofrontal Cortex by Magnetic Resonance Spectroscopy Publisher Pubmed



Haghani Dogahe M1 ; Monsef A2, 3 ; Abbaspour E4 ; Karimzadhagh S5 ; Fallah Arzpeyma S4 ; Teymouri A6 ; Daneshgar N7 ; Nemati S1
Authors
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Authors Affiliations
  1. 1. Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Otorhinolaryngology Research Center, Guilan University of Medical Sciences, Rasht, Iran
  2. 2. Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota Medical School, Minneapolis, MN, United States
  3. 3. Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN, United States
  4. 4. Department of Radiology, Poursina Hospital, Guilan University of Medical Science, Rasht, Iran
  5. 5. Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran

Source: Academic Radiology Published:2025


Abstract

Background: While many COVID-19-induced anosmia patients recover their sense of smell within a few months, a substantial number of them continue to experience olfactory impairment. In our primary study, the metabolic patterns in orbitofrontal cortex (OFC) were observed to exhibit more alterations than other regions. Hence, this study specifically probes into alterations within OFC region in subjects with persistent COVID-19-induced anosmia. Methods: In a new categorization, 54 subjects were studied as two major groups of COVID-19-related anosmia and normal each of which includes 27 subjects. Iran Recognition-Smell Identification Test (IR-SIT) over a three-month follow-up period was utilized for olfactory function assessment and anosmia diagnosis. Proton Magnetic Resonance Spectroscopy (1H-MRS) was employed to examine changes of metabolites in OFC, including N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr), as well as their ratios. Additionally, a linear regression was applied to investigate the potential correlation between MRS data and IR-SIT scores. Results: Patients with COVID-19-induced anosmia exhibited a significant reduction in NAA, Cho, and Cr levels in the OFC region compared to the control group. Moreover, NAA/Cho and NAA/Cr ratios were lower in the anosmia patients, whereas the Cho/Cr ratio elevated. The NAA/Cho ratio had the highest linear correlation with IR-SIT scores in anosmia. Conclusion: This study highlights remarkable neurochemical patterns associated with COVID-19-induced anosmia in brain orbitofrontal cortex detectable by proton MRS, shedding light on the link between OFC function impairment and anosmia. The NAA/Cho ratio derived from MRS data emerged as a potential biomarker that correlates with anosmia severity and recovery examination. © 2025
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