Neural alterations in viral pneumonia patients comorbid with insomnia in a Chinese population: Insight from surface-based morphometry analysis 2026 Ju

Andy

Senior Member (Voting rights)

Highlights​

  • Pneumonia virus infection induces widespread cortical morphological alterations in young adults.
  • Surface area, cortical thickness, and grey matter volume are all significantly affected.
  • Superior temporal gyrus thinning is a specific biomarker for insomnia comorbidity.
  • Lingual gyrus GMV reduction is a common neural marker regardless of insomnia status.
  • Greater cortical size correlates with better cognitive and neuropsychiatric performance.

Abstract​

Background​

Emerging evidence suggests that viral pneumonia can affect the central nervous system (CNS), potentially leading to neuropsychiatric sequelae. However, the specific impact of viral pneumonia comorbid with insomnia on cortical morphology remains unclear. This study aimed to identify neural markers—specifically cortical grey matter volume (GMV), thickness, and surface area—in patients recovering from Omicron infection with and without insomnia.

Methods​

In this prospective cross-sectional study, a total of 172 age-, sex-, and education-matched participants were finally analyzed (57 HCs, 64 Omicron_non_insomnia, and 51 Omicron_insomnia) during the Omicron pandemic (December 2022–May 2023). Insomnia symptoms were screened by a Pittsburgh Sleep Quality Index (PSQI) score > 5. Cortical morphology was evaluated using surface-based morphometry (SBM) analysis based on T1-weighted MPRAGE images. Morphological metrics were correlated with neuropsychiatric assessment scores.

Results​

Viral pneumonia patients exhibited altered cortical morphology compared to HCs. Significant changes in the temporal, frontal, and cingulate gyrus, as well as the transverse collateral and lingual gyrus, were observed regardless of insomnia comorbidity. Notably, decreased cortical thickness in the left superior temporal gyrus (STG) was identified as a candidate imaging correlate of viral infection comorbid with insomnia. Furthermore, greater cortical size in these regions was significantly correlated with improved neuropsychiatric performance (all P < 0.05).

Conclusions​

Our findings delineate distinct patterns of cortical atrophy following Omicron infection and highlight STG thinning as a potential biomarker for insomnia-related CNS involvement. These neural markers provide insight into the mechanisms of post-viral neuropsychiatric sequelae and may guide clinical management and prognostic evaluation.

Graphical abstract​

It revealed altered cortical morphology in Omicron individuals. Morphological changes in the cingulate, frontal, temporal, lingual gyrus, and transverse collateral were independent from insomnia comorbidity. Decreased cortical thickness in superior temporal gyrus (STG) was a specific feature for Omicron infection comorbid with insomnia. Besides, greater morphological size indicated neuropsychiatric improvement.

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