The state of brain networks before the COVID-19 pandemic

To what extent did the effect of stress and strategies to cope with COVID-19 depend on the state of each person’s brain networks before the start of the pandemic? The results of a recent study provide the answer to that question.

The COVID-19 pandemic generated a unique scenario to analyze the psychological impact of global and extreme situations on the population. Now, the new study reveals the importance of the configuration of individual brain networks – before the arrival of COVID-19 – in the ability to manage the impact of stress and coping strategies in the face of the pandemic.

According to the results of the study, the functional status of the brain should be taken into account —and not just sociodemographic or psychological aspects— in order to identify the most vulnerable population and thus be able to design preventive mental health strategies in the face of a global stress factor like a pandemic.

The study, which has been carried out within the framework of the “Barcelona Brain Health Initiative” project of the Guttmann Institute – a center attached to the Autonomous University of Barcelona (UAB) – and with the support of the La Caixa Foundation, has been coordinated by the researchers María Cabello-Toscano, David Bartrés-Faz and Lídia Vaqué-Alcázar, from the Faculty of Medicine and Health Sciences and the Institute of Neurosciences of the University of Barcelona (UBNeuro), and members of the August Pi i Sunyer Biomedical Research Institute ( IDIBAPS), with the co-direction of researchers Álvaro Pascual-Leone and Josep M. Tormos, from the Fundación Instituto Guttmann-Neurorehabilitation Hospital.

Teams from the Hospital Clínic de Barcelona, ​​the Barcelona Institute for Global Health (ISGlobal) and the Center for Biomedical Research in Mental Health Network (CIBERSAM) in Spain, among others, have also participated in the work.

In the study, based on a sample of 2,023 people between the ages of 40 and 65, the team analyzed whether sociodemographic, psychological and neurobiological factors before the pandemic could be predictors of changes in mental health experienced by the population during the first year of COVID-19. “As in previous studies, we found that being a woman represents a risk factor, but younger people also suffered more in terms of increased symptoms of anxiety and depression,” says Professor David Bartrés-Faz, member of the Department of Medicine at the University of Barcelona (UB) and associate researcher at the Guttmann Institute.

«This second result -continues the researcher- is consistent with at least most of the works in the scientific literature. Therefore, everything points to the fact that women and younger people have suffered more from the effect of periods of confinement and restriction during the pandemic.

“The second level of predictors that we identified are the psychological ones. Perceiving more stress during the months of the pandemic was associated with an increase in symptoms of anxiety and depression during that period. However, having good strategies for coping with stress —seeking the support of other people, relativizing or putting emotional states into context— attenuated the negative effect of stress”, says Bartrés-Faz.

The application of neuroimaging techniques made it possible to determine useful indicators to identify populations that are more vulnerable to the effect of prolonged stress and with a potential impact on mental health. This is an effective technology for understanding abnormalities in brain morphology or function in different cases (schizophrenia, etc.) or for advancing knowledge of how certain entities, currently identified from clinical diagnoses, can correspond to different neurobiological entities.

The effect of perceived stress and coping strategies also depends on the configuration of the state of brain networks before the start of the pandemic. (Image: UB)

“Using neuroimaging techniques, we were able to verify that the effect of perceived stress and coping strategies also depend on the configuration of the state of brain networks before the start of the pandemic,” explains researcher María Cabello-Toscano, first author of the study.

Thus, people who are characterized by having a more “isolated” functioning of a network —called executive control— from the rest of the brain networks —associated with information about oneself or self-referential— are more sensitive to the effects of stress and Therefore, they need better coping strategies so as not to show symptoms of anxiety or depression.

The identified brain networks that interact with perceived stress and coping strategies—for example, the frontal executive network, the anterior salience network, and the default brain network—overlay those described in the scientific literature as implicated circuits. in stress resilience processes, “but also in resilience processes, understood as the ability to maintain cognitive function in elderly people against brain atrophy or even at the onset of neurodegenerative diseases”, says researcher Lídia Vaqué -Alcazar.

From a methodological perspective, combining the analysis of psychological factors and neuroimaging brain measurements is an innovative strategy in the context of studies conducted during the COVID-19 pandemic. Another methodological turning point was the long-term follow-up —for a whole year— of a relevant population sample, and having a large volume of information on mental health aspects of the study subjects during the two years prior to the start of the study. pandemic.

“This aspect allowed us to adjust the results considering the previous characteristics of each person, which differentiates our work from many other studies based on ad hoc surveys to assess the impact of COVID-19 on mental health with the ongoing pandemic”, exposes Bartés-Faz.

“If previous data is not available -continues the researcher-, it is difficult to interpret whether the results obtained are a true reflection of the impact of COVID-19 or were characteristics already observable in that sample before the start of the pandemic”.

In the field of preventive medicine and global health, “it is not individual factors but the combination of these components in each individual that makes it possible to predict the risk of vulnerability in terms of symptoms of anxiety and depression in the face of a prolonged stress factor” , declares Bartres-Faz.

“These findings point in the direction of applying personalized preventive medicine to promote brain health and reduce the risk of diseases. Thus, interventions should be designed in a more individualized way and take into account the set of sociodemographic, psychological, biological factors, lifestyles and risk factors of people, among others, “concludes the research team.

The study is titled “Functional brain connectivity prior to the COVID-19 outbreak moderates the effects of coping and perceived stress on mental health changes. A first year of COVID-19 pandemic follow-up study”. And it has been published in the academic journal Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. (Source: UB)