Jebrini Tarek, Thomas Anabel, Sachenbacher Simone, Heimkes Fides, Karch Susanne, Goerigk Stephan, Ruzicka Michael, Fonseca Gerardo Jesus Ibarra, Wunderlich Nora, Benesch Christopher, Pernpruner Anna, Heindl Bernhard, Stubbe Hans Christian, Uebleis Aline Olivia, Grosse-Wentrup Fabienne, Adorjan Kristina
Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany.
Charlotte Fresenius Hochschule, University of Psychology, Munich, Germany.
Eur Arch Psychiatry Clin Neurosci. 2024 Dec;274(8):1969-1982. doi: 10.1007/s00406-024-01904-x. Epub 2024 Oct 2.
Cognitive complaints are common signs of the Post COVID-19 (PC) condition, but the extent and type of cognitive impairment may be heterogeneous. Little is known about neuropsychological treatment options. Preliminary evidence suggests cognitive symptoms may improve with cognitive training and naturally over time. In this clinical trial, we examined whether participation in a weekly group consisting of cognitive training and group psychotherapy is feasible and would exert beneficial effects on cognitive performance in PC and whether improvements were associated with intervention group participation or represented a temporal improvement effect during syndrome progression. 15 PC patients underwent an 8-week intervention. Cognitive performance was assessed before and after each intervention group participation. A control group of 15 PC patients with subjective neurocognitive or psychiatric complaints underwent two cognitive assessments with comparable time intervals without group participation. To attribute changes to the intervention group participation, interaction effects of group participation and time were checked for significance. This is an exploratory, non-randomized, non-blinded controlled clinical trial. Within the intervention group, significant improvements were found for most cognitive measures. However, significant time x group interactions were only detected in some dimensions of verbal memory and visuo-spatial construction skills. Significant time effects were observed for attention, concentration, memory, executive functions, and processing speed. The intervention setting was feasible and rated as helpful and relevant by the patients. Our results suggest that cognitive symptoms of PC patients may improve over time. Patients affected by both neurocognitive impairments and mental disorders benefit from group psychotherapy and neurocognitive training. The present study provides evidence for a better understanding of the dynamic symptomatology of PC and might help to develop further studies addressing possible therapy designs. The main limitations of this exploratory feasibility trial are the small sample size as well as the non-randomized design due to the clinical setting.
认知主诉是新冠后(PC)状态的常见症状,但认知障碍的程度和类型可能存在异质性。关于神经心理学治疗方案,人们了解甚少。初步证据表明,认知症状可能会通过认知训练并随着时间自然改善。在这项临床试验中,我们研究了参加由认知训练和团体心理治疗组成的每周小组活动是否可行,是否会对PC患者的认知表现产生有益影响,以及改善是否与干预组参与有关,还是代表综合征进展过程中的时间性改善效应。15名PC患者接受了为期8周的干预。在每次参与干预组前后评估认知表现。一个由15名有主观神经认知或精神主诉的PC患者组成的对照组在没有小组参与的情况下,以可比的时间间隔进行了两次认知评估。为了将变化归因于干预组参与,检查了小组参与和时间的交互作用的显著性。这是一项探索性、非随机、非盲法对照临床试验。在干预组中,大多数认知指标都有显著改善。然而,仅在言语记忆和视觉空间构建技能的某些维度中检测到显著的时间×小组交互作用。在注意力、专注力、记忆、执行功能和处理速度方面观察到显著的时间效应。干预设置是可行的,患者将其评为有帮助且相关。我们的结果表明,PC患者的认知症状可能会随着时间改善。同时受到神经认知障碍和精神障碍影响的患者从团体心理治疗和神经认知训练中受益。本研究为更好地理解PC的动态症状学提供了证据,并可能有助于开展进一步研究以探讨可能的治疗设计。这项探索性可行性试验的主要局限性是样本量小以及由于临床环境导致的非随机设计。