Purpose
This study aimed to investigate functional abnormalities in the brain of patients with neurological adverse effects following COVID-19 (coronavirus disease 2019) vaccination using
18
F-FDG PET/MRI and
15
O-water PET.
Methods
Eight patients (1 man and 7 women, aged 26–47 years [median age, 36.5 years]) who experienced neurological symptoms after the first COVID-19 vaccination underwent CT, MRI,
18
F-FDG PET/MRI, and
15
O-water PET of the brain. After 7 days, each patient underwent a follow-up
18
F-FDG PET/MRI and
15
O-water PET of the brain. Imaging data were analyzed using visual and semiquantitative analyses, which included a cluster subtraction workflow (
P
= 0.05).
Results
There was no evidence of vascular abnormalities, acute infarction, or hemorrhage on the CT or MRI scans. On the
15
O-water PET images, 1 patient had mildly significant decreases in perfusion in the bilateral thalamus and bilateral cerebellum, and another patient showed a diffuse increase in perfusion in the cerebral white matter. The visual and semiquantitative analyses showed hypometabolism in the bilateral parietal lobes in all 8 patients on both the first and follow-up
18
F-FDG PET/MRI scans. Metabolic changes in the bilateral cuneus were also observed during the first visit; all patients exhibited neurological symptoms. Moreover, 6 patients showed hypometabolism, and 2 patients showed hypermetabolism.
Conclusion
All regions of metabolic abnormality were part of the fear network model that has been implicated in anxiety. Our study findings support the concepts of and provide evidence for the immunization stress-related response and the biopsychosocial model.