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Gorenshtein A, Liba T, Leibovitch L, Stern S, Stern Y. Intervention modalities for brain fog caused by long-COVID: systematic review of the literature. Neurol Sci 2024; 45:2951-2968. [PMID: 38695969 PMCID: PMC11176231 DOI: 10.1007/s10072-024-07566-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 04/27/2024] [Indexed: 06/15/2024]
Abstract
Individuals suffering from long-COVID can present with "brain fog", which is characterized by a range of cognitive impairments, such as confusion, short-term memory loss, and difficulty concentrating. To date, several potential interventions for brain fog have been considered. Notably, no systematic review has comprehensively discussed the impact of each intervention type on brain fog symptoms. We included studies on adult (aged > 18 years) individuals with proven long- COVID brain-fog symptoms from PubMed, MEDLINE, Central, Scopus, and Embase. A search limit was set for articles published between 01/2020 and 31/12/2023. We excluded studies lacking an objective assessment of brain fog symptoms and patients with preexisting neurological diseases that affected cognition before COVID-19 infection. This review provided relevant information from 17 studies. The rehabilitation studies utilized diverse approaches, leading to a range of outcomes in terms of the effectiveness of the interventions. Six studies described noninvasive brain stimulation, and all showed improvement in cognitive ability. Three studies described hyperbaric oxygen therapy, all of which showed improvements in cognitive assessment tests and brain perfusion. Two studies showed that the use of Palmitoylethanolamide and Luteolin (PEA-LUT) improved cognitive impairment. Noninvasive brain stimulation and hyperbaric oxygen therapy showed promising results in the treatment of brain fog symptoms caused by long-COVID, with improved perfusion and cortical excitability. Furthermore, both rehabilitation strategies and PEA-LUT administration have been associated with improvements in symptoms of brain fog. Future studies should explore combinations of interventions and include longer follow-up periods to assess the long-term effects of these treatments.
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Affiliation(s)
- Alon Gorenshtein
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
| | - Tom Liba
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | | | - Shai Stern
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Yael Stern
- Maccabi Healthcare Services, Tel Aviv-Yafo, Israel
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Turkowitch D, Donkers SJ, Costa SL, Vaduvathiriyan P, Williams J, Siengsukon C. Behavioral Interventions to Improve Sleep Outcomes in Individuals With Multiple Sclerosis: A Systematic Review. Int J MS Care 2024; 26:22-29. [PMID: 38213676 PMCID: PMC10779715 DOI: 10.7224/1537-2073.2022-110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND Sleep disturbances are common in individuals with multiple sclerosis. The objective of this systematic review was to determine effective behavioral interventions to improve their sleep. METHODS Literature searches were performed in December 2021 in Ovid MEDLINE, Elsevier Embase, and Web of Science, along with hand searching for grey literature and cited references. Four reviewers independently reviewed titles and abstracts (2 reviewers for each article; n = 830) and the full-text articles (n = 81). Consensus for inclusion was achieved by a fifth reviewer. Thirty-seven articles were eligible for inclusion. Four reviewers extracted relevant data from each study (2 reviewers for each article) using a standard data extraction table. Consensus was achieved for completeness and accuracy of the data extraction table by a fifth reviewer. The same 4 reviewers conducted a quality appraisal of each article to assess the risk of bias and quality of the articles, and consensus was achieved by a fifth reviewer as needed. Descriptive data were used for types of interventions, sleep outcomes, results, and key components across interventions. RESULTS Overall, the cognitive behavioral therapy for insomnia, cognitive behavioral therapy/psychotherapy, and education/self-management support interventions reported positive improvements in sleep outcomes. Quality appraisal scores ranged from low to high, indicating potential for bias. CONCLUSIONS Variability in the intervention type, intervention dose, outcomes used, training/expertise of interventionist, specific sample, and study quality made it difficult to compare and synthesize results. Further research is necessary to demonstrate the efficacy of most of the interventions.
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Affiliation(s)
- David Turkowitch
- From the Department of Physical Therapy, Rehabilitation Science, and Athletic Training (DT, CS) and AR Dykes Library (PV), University of Kansas Medical Center, Kansas City, KS, USA
| | - Sarah J. Donkers
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, SK, Canada (SJD)
| | - Silvana L. Costa
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, East Hanover, NJ, USA (SLC)
- Department of Physical Medicine and Rehabilitation, Rutgers–New Jersey Medical School, Newark, NJ, USA (SLC)
| | - Prasanna Vaduvathiriyan
- From the Department of Physical Therapy, Rehabilitation Science, and Athletic Training (DT, CS) and AR Dykes Library (PV), University of Kansas Medical Center, Kansas City, KS, USA
| | - Joy Williams
- Rehabilitation Services, Kaiser Permanente Sacramento, Sacramento, CA, USA (JW)
| | - Catherine Siengsukon
- From the Department of Physical Therapy, Rehabilitation Science, and Athletic Training (DT, CS) and AR Dykes Library (PV), University of Kansas Medical Center, Kansas City, KS, USA
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Trombini M, Ferraro F, Iaconi G, Vestito L, Bandini F, Mori L, Trompetto C, Dellepiane S. A Study Protocol for Occupational Rehabilitation in Multiple Sclerosis. SENSORS 2021; 21:s21248436. [PMID: 34960529 PMCID: PMC8707782 DOI: 10.3390/s21248436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/22/2021] [Accepted: 12/13/2021] [Indexed: 11/26/2022]
Abstract
Digital medical solutions can be very helpful in restorative neurology, as they allow the patients to practice their rehabilitation activities remotely. This work discloses ReMoVES, an IoMT system providing telemedicine services, in the context of Multiple Sclerosis rehabilitation, within the frame of the project STORMS. A rehabilitative protocol of exercises can be provided as ReMoVES services and integrated into the Individual Rehabilitation Project as designed by a remote multidimensional medical team. In the present manuscript, the first phase of the study is described, including the definition of the needs to be addressed, the employed technology, the design and the development of the exergames, and the possible practical/professional and academic consequences. The STORMS project has been implemented with the aim to act as a starting point for the development of digital telerehabilitation solutions that support Multiple Sclerosis patients, improving their living conditions. This paper introduces a study protocol and it addresses pre-clinical research needs, where system issues can be studied and better understood how they might be addressed. It also includes tools to favor remote patient monitoring and to support the clinical staff.
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Affiliation(s)
- Marco Trombini
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture (DITEN), Università degli Studi di Genova, Via all’Opera Pia 11a, I-16145 Genoa, Italy; (M.T.); (F.F.); (G.I.)
| | - Federica Ferraro
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture (DITEN), Università degli Studi di Genova, Via all’Opera Pia 11a, I-16145 Genoa, Italy; (M.T.); (F.F.); (G.I.)
| | - Giulia Iaconi
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture (DITEN), Università degli Studi di Genova, Via all’Opera Pia 11a, I-16145 Genoa, Italy; (M.T.); (F.F.); (G.I.)
| | - Lucilla Vestito
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Children’s Sciences (DINOGMI), Università degli Studi di Genova, Largo Paolo Daneo 3, I-16132 Genoa, Italy; (L.V.); (L.M.); (C.T.)
- Ospedale Policlinico San Martino IRCCS, Largo Rosanna Benzi 10, I-16132 Genoa, Italy
| | - Fabio Bandini
- Struttura Complessa di Neurologia-Ospedale Villa Scassi ASL 3, Corso Onofrio Scassi 1, I-16149 Genoa, Italy;
| | - Laura Mori
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Children’s Sciences (DINOGMI), Università degli Studi di Genova, Largo Paolo Daneo 3, I-16132 Genoa, Italy; (L.V.); (L.M.); (C.T.)
- Ospedale Policlinico San Martino IRCCS, Largo Rosanna Benzi 10, I-16132 Genoa, Italy
| | - Carlo Trompetto
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Children’s Sciences (DINOGMI), Università degli Studi di Genova, Largo Paolo Daneo 3, I-16132 Genoa, Italy; (L.V.); (L.M.); (C.T.)
- Ospedale Policlinico San Martino IRCCS, Largo Rosanna Benzi 10, I-16132 Genoa, Italy
| | - Silvana Dellepiane
- Department of Electrical, Electronics and Telecommunication Engineering and Naval Architecture (DITEN), Università degli Studi di Genova, Via all’Opera Pia 11a, I-16145 Genoa, Italy; (M.T.); (F.F.); (G.I.)
- Correspondence: ; Tel.: +39-(0)1-0335-2754
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