Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
Maccabi Healthcare Services, Tel Aviv-Yafo, Israel.
Neurol Sci. 2024 Jul;45(7):2951-2968. doi: 10.1007/s10072-024-07566-w. Epub 2024 May 2.
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.
患有长新冠的个体可能会出现“脑雾”，其特征是一系列认知障碍，如困惑、短期记忆丧失和注意力集中困难。迄今为止，已经考虑了几种针对脑雾的潜在干预措施。值得注意的是，尚无系统评价全面讨论每种干预类型对脑雾症状的影响。我们纳入了来自 PubMed、MEDLINE、CENTRAL、Scopus 和 Embase 的针对已确诊的长新冠脑雾症状的成年（年龄>18 岁）个体的研究。检索限制为 2020 年 1 月至 2023 年 12 月 31 日期间发表的文章。我们排除了缺乏对脑雾症状进行客观评估的研究和在 COVID-19 感染前影响认知的预先存在的神经疾病的患者。本综述提供了 17 项研究的相关信息。康复研究采用了多种方法，导致干预效果的结果范围广泛。六篇研究描述了非侵入性脑刺激，所有研究都显示出认知能力的改善。三项研究描述了高压氧治疗，所有研究均显示认知评估测试和脑灌注改善。两项研究表明，使用棕榈酸乙醇酰胺和木樨草素（PEA-LUT）可改善认知障碍。非侵入性脑刺激和高压氧治疗显示出治疗长新冠引起的脑雾症状的有前景的结果，改善了灌注和皮质兴奋性。此外，康复策略和 PEA-LUT 给药都与脑雾症状的改善有关。未来的研究应探索干预措施的组合，并包括更长的随访期，以评估这些治疗的长期效果。
