AAN 2025 | The link between post-COVID headache/brain fog and cerebral vascular changes

In this year’s presentation, I will give a presentation and my research question is that what is the link behind the post-COVID brain fog and headache to some cerebral vascular changes. And in our research findings we recruited about 108 patients who suffered from COVID-19 and we divided our patients into four groups: those with a headache for three months and brain fog for three months and the combined symptoms for three months and a control group without any symptoms after the resolution of COVID-19. And we found that regarding the severity in anterior circulation, we found that patients with more symptom categories associated with a higher anterior cerebral arteriopathy. And in posterior circulation, we also found that patients with any symptom categories have a higher posterior cerebral arteriopathy than the asymptomatic control group. Regarding the locations of the arteriopathy, we found that patients with brain fog tend to have a more predominant anterior circulation arteriopathy. However, in post-COVID headache, we found that a more balanced distribution between the anterior and posterior cerebral arteriopathy. And this difference in the distribution might have some implications in their underlying mechanisms. For example, the brain fog might link to the decreased perfusion for certain regions that are supplied by the anterior circulation, such as frontal, temporal, or parietal regions. But in headache, although the cerebral arteriopathy is common, but we think other mechanisms such as elevation of CGRP or the activation of trigeminal vascular pathway might play some important roles in the development of post-COVID headaches. That’s our research findings.

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