In:
Journal of Neurology, Springer Science and Business Media LLC, Vol. 270, No. 10 ( 2023-10), p. 4647-4660
Abstract:
Knowledge on the nature of post-COVID neurological sequelae often manifesting as cognitive dysfunction and fatigue is still unsatisfactory. Objectives We assumed that cognitive dysfunction and fatigue in post-COVID syndrome are critically linked via hypoarousal of the brain. Thus, we assessed whether tonic alertness as a neurocognitive index of arousal is reduced in these patients and how this relates to the level of central nervous activation and subjective mental fatigue as further indices of arousal. Methods 40 post-COVID patients with subjective cognitive dysfunction and 40 matched healthy controls underwent a whole-report paradigm of briefly presented letter arrays. Based on report performance and computational modelling according to the theory of visual attention, the parameter visual processing speed (VPS) was quantified as a proxy of tonic alertness. Pupillary unrest was assessed as a measure of central nervous activation. The Fatigue Assessment Scale was applied to assess subjective mental fatigue using the corresponding subscale . Results VPS was reduced in post-COVID patients compared to controls ( p = 0.005). In these patients, pupillary unrest ( p = 0.029) and mental fatigue ( p = 0.001) predicted VPS, explaining 34% of the variance and yielding a large effect with f 2 = 0.51. Conclusion In post-COVID patients with subjective cognitive dysfunction, hypoarousal of the brain is reflected in decreased processing speed which is explained by a reduced level of central nervous activation and a higher level of mental fatigue. In turn, reduced processing speed objectifies mental fatigue as a core subjective clinical complaint in post-COVID patients.
Type of Medium:
Online Resource
ISSN:
0340-5354
,
1432-1459
DOI:
10.1007/s00415-023-11819-7
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2023
detail.hit.zdb_id:
1421299-7
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