Impact of Zika Virus on adult human brain structure and functional organization

Richard Bido-Medina, Jonathan Wirsich, Minelly Rodríguez, Jairo Oviedo, Isidro Miches, Pamela Bido, Luis Tusen, Peter Stoeter, Sepideh Sadaghiani
2018 Annals of Clinical and Translational Neurology  
Objective: To determine the impact of Zika virus (ZIKV) infection on brain structure and functional organization of severely affected adult patients with neurological complications that extend beyond Guillain-Barr e Syndrome (GBS)-like manifestations and include symptoms of the central nervous system (CNS). Methods: In this first case-control neuroimaging study, we obtained structural and functional magnetic resonance images in nine rare adult patients in the subacute phase, and healthy age-and
more » ... sex-matched controls. ZIKV patients showed atypical descending and rapidly progressing peripheral nervous system (PNS) manifestations, and importantly, additional CNS presentations such as perceptual deficits. Voxel-based morphometry was utilized to evaluate gray matter volume, and resting state functional connectivity and Network Based Statistics were applied to assess the functional organization of the brain. Results: Gray matter volume was decreased bilaterally in motor areas (supplementary motor cortex, specifically Frontal Eye Fields) and beyond (left inferior frontal sulcus). Additionally, gray matter volume increased in right middle frontal gyrus. Functional connectivity increased in a widespread network within and across temporal lobes. Interpretation: We provide preliminary evidence for a link between ZIKV neurological complications and changes in adult human brain structure and functional organization, comprising both motor-related regions potentially secondary to prolonged PNS weakness, and nonsomatomotor regions indicative of PNS-independent alternations. The latter included the temporal lobes, particularly vulnerable in a range of neurological conditions. While future studies into the ZIKV-related neuroinflammatory mechanisms in adults are urgently needed, this study indicates that ZIKV infection can lead to an impact on the brain. and its potential to cause neural damage. 3 Surprisingly, the causal association of the virus with clinically relevant neurological manifestations is recent. In consonance with the increased rate of microcephaly associated with ZIKV in pregnant women, 4 the majority of efforts have been devoted to understanding such unfortunate developmental disruptions. ZIKV-related neurological complications in adults have been overlooked, and the understanding of such a nosological entity remains significantly limited. 752
doi:10.1002/acn3.575 pmid:29928658 pmcid:PMC5989769 fatcat:asgp6kt25ngste7lgv4id3asrq