I am Professor of Neurology at George Washington University where I have been responsible for the diagnosis and management of patients with memory disorders and Multiple Sclerosis. My principal research has been in applying advanced imaging methods in distinguishing among different cognitive disorders and the source of memory loss and “brain fog” in long term patients who have recovered from COVID-19 infection. I am using voxel-based and atlas-based morphometry (NeuroQuant, Cortechs Laboratories, San Diego) which segments, analyzes and quantifies volumes of different grey matter structures which are compared with a normative database of sex and age matched controls. I have also used these imaging techniques in and those Primary Progressive Multiple Sclerosis patients with cognitive impairment to demonstrate grey matter damage. This finding runs counter to the generally accepted concept that MS is primarily a white matter disease.

The current application regarding COVID long term patients identified a statistically significant loss of cortical grey matter volume (CGM) in patients among 42 consecutive patients with cognitive impairment and “brain fog”. A few of these patients were studied longitudinally for periods of up to 3 years with no meaningful clinical improvement or recovery of their depleted CGM volume. Reduced CGM volume is the likely source of long-term neurologic sequelae and may impair post COVID-19 patients’ quality of life and productivity.  This study contributes to understanding the neuroanatomic basis for prolonged effects of COVID-19 infection on patients’ neurocognitive and other neurological functions, with potential for producing serious personal and economic consequences, and present ongoing challenges to public health systems.