Exploring effects of COVID-19 pandemic on neurodevelopment and mental health in adolescents

By Tarun Sai LomteReviewed by Aimee MolineuxDec 5 2022

In a recent study published in Biological Psychiatry: Global Open Science (BPGOS), researchers examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on adolescents' neurodevelopment and mental health.

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been a significant adversity worldwide. A meta-analysis observed that the prevalence of internalizing problems doubled in youth since the pandemic began; still, the potential ramifications of the pandemic for the neurodevelopment of children remain unknown.

Evidence from before the pandemic suggests an association between exposure to adversities in early life and poor mental health and maladaptive neurodevelopment, indicative of accelerated brain maturation. Lately, researchers have been able to predict age from neuroanatomical features using machine learning (ML) algorithms.

About the study

In the present study, researchers analyzed the effects of the COVID-19 pandemic on adolescents' mental health and neurodevelopment. They included 163 adolescents from the San Francisco Bay Area who were participants in a longitudinal analysis investigating the effects of stress in early life on psychobiology.

Subjects were invited for follow-up assessments every two years, but the COVID-19 shutdown interrupted in-person assessments. Two matched sub-samples were created from this cohort, using data from before the COVID-19 pandemic (pre-COVID-19) and after the end of the COVID-19 shutdown in the Bay Area (peri-COVID-19). Specifically, subjects were matched based on age and sex to the closest possible.

The 10-item children’s depression inventory captured information on depressive symptoms. Anxiety symptoms were assessed using the aggregate score of two subscales (physical symptoms and social anxiety) of the multidimensional anxiety scale for children (MASC). Externalizing and internalizing problems were assessed using the youth self-report (YSR) subscales of the child behavior checklist (CBCL). 

A subset of participants underwent magnetic resonance imaging (MRI). Based on the cortical and sub-cortical features, the brain age gap estimate (BrainAGE) was computed using sex-specific ML models created by the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA)-Brain Age working group. BrainAGE was calculated as the difference between the chronological and predicted age of the brain.

The researchers performed tests between the two groups on measures of externalizing and internalizing problems, cortical thickness, and sub-cortical volume to examine if peri-COVID-19 adolescents differed from pre-COVID-19 peers. A one-way multivariate analysis of variance (MANOVA) test examined the overall differences in mental health scores. Independent sample t-tests were performed to determine if the two groups showed differences in mental health aspects.

Findings

The authors did not find significant group differences in demographic and clinical characteristics between the two groups for brain samples or mental health. The MANOVA test identified significant differences in mental health between pre- and peri-COVID-19 groups. The t-tests suggested that peri-COVID-19 adolescents had more severe anxiety, depression, and internalizing symptoms.

There were no differences in externalizing symptoms between the two groups. The MANOVA test on brain metrics showed significant differences between pre- and peri-COVID-19 adolescents. Peri-COVID-19 adolescents had decreased cortical thickness and larger bilateral hippocampal and amygdala volumes. Moreover, peri-COVID-19 adolescents had an older BrainAGE than pre-COVID-19 peers.

Finally, the authors analyzed clinical functioning and brain measures as a function of time since the COVID-19 shutdown began on March 17, 2020. They did not find significant associations between the interval from the COVID-19 shutdown to the time when participants completed psychopathologic measures and mental health/brain metrics.

Conclusions

The research team found that adolescents in the peri-COVID-19 group had neuroanatomical features, typically observed in older individuals or those who experienced adversity in childhood. The peri-COVID-19 group showed advanced cortical thinning and larger amygdala and hippocampal volumes, indicating accelerated brain maturation. Further, the authors also noted large BrainAGE values in peri-COVID-19 adolescents, reflecting older-appearing brains.

Therefore, the COVID-19 pandemic impacts mental health and hastens the brain maturation of adolescents. These results have potential implications for researchers analyzing longitudinal data from normative developmental studies interrupted by COVID-19. Future research should determine if these neuro-alterations are temporary or stable changes characterizing the current generation.