Brain Microstructural Alterations in Covid-19: A Systematic Review of Diffusion Weighted Imaging Studies Publisher Pubmed



Jahanshahi A ; Mohammadi S ; Salehi MA ; Dolatshahi M ; Mirakhori S ; Frounchi N ; Zakavi SS ; Harandi H ; Ghasempour H ; Raji CA
Source: Brain Imaging and Behavior Published:2026

Abstract

Introduction: Following its emergence in Wuhan, COVID-19 has been associated with neurological sequalae, pathophysiological basis of which has been under investigation from the early reports. Herein, we aim to provide a comprehensive overview on white matter microstructural findings in COVID-19 patents. Methods: We performed a systematic literature search on PubMed, Scopus, Web of Science, and EMBASE databases on February 9th, 2025, using the combination of keywords related to COVID-19, DTI, and NODDI. Study selection and data extraction was performed to provide a qualitative synthesis of the data. Results: Mean diffusivity (MD) and fractional anisotropy (FA) were the most reported diffusion parameters. Significant alterations in diffusion parameters of longitudinal fasciculi, thalamic radiations, corpus callosum (CC), fronto-occipital fasciculus (FOF), cortico-spinal tract (CST) and uncinate fasciculi (UF) were repeatedly reported among in the studies, of which the results on changes in CR and LF were almost consistent. Conclusion: The observed changes in white matter microstructural integrity are associated with the psychiatric and cognitive symptoms in post-COVID-19 phase. This observation warrants long-term follow-up of COVID-19 patients for the potential neurological sequalae of this disease. © The Author(s) 2026.