Can brain-training computerized games help evaporate brain fog from long COVID?

Neuropsychologist Dr. Cutter Lindbergh of UConn Health has been seeing an uptick in older adult patients experiencing brain fog including forgetfulness, slow-downed thinking, trouble with attention and concentration, low mood, and feeling like they are just not as mentally sharp as they used to be after COVID-19 infection.

"Most people who have had COVID-19 show resolution of their symptoms within a few weeks. But about 10 to 30% of older adults are noticing that cognitively they are not returning to their baseline post-COVID," says Lindbergh, assistant professor of psychiatry at UConn School of Medicine.

The culprit is Long COVID, a diverse range of persistent symptoms after the viral infection. Post-COVID Neurocognitive Dysfunction (PCND) is a common and debilitating characteristic of Long COVID, especially among older adults says Lindbergh.

"People are noticing something is really different about their thinking and they are saying they are not the same and feeling like 'not me.' Unfortunately, there is a lack evidence-based treatments available for Long COVID brain fog symptoms which can really impact people's day to day life.

"If patients notice they are having brain fog symptoms after COVID, they should talk to their doctor," says Lindbergh.

While post-COVID brain fog symptoms can happen to anyone during the lifespan, mounting research evidence shows that older adults may be at heightened risk for Long COVID impairments in their brain's frontal-lobe mediated executive functions. Executive brain function controls our cognitive thinking skills such as attention, problem-solving, organization, planning and completing tasks.

This is alarming to psychiatry experts like Lindbergh as executive functioning deficits are a major cause of functional disability and loss of independence in older adults. Early scientific evidence is also showing that COVID may even cause accelerated brain aging, neurodegeneration, and even dementia in older adults already at elevated risk due to their age, weakened immune systems, and pre-existing age-related cognitive changes.

To respond to this public health threat and find a potential treatment, UConn Health is launching a new clinical trial testing the feasibility, adherence and outcomes of older adults 55 and over using a computerized cognitive remediation "brain training" program.

"We believe a brain training intervention holds potential to treat executive functioning impairments in older adults with Long COVID and ultimately improve everyday functioning," says Lindbergh.

The brain-training games are offered to clinical trial participants on a computerized tablet for six weeks in the convenience of their homes. Participants are asked to game seven days a week for about one hour a day performing gamified tasks on the computer tablet to cognitively target and stimulate their brain's executive functioning and decision-making. In addition, they meet with a "study coach" once a week to help guide them through the treatment.

UConn Health's clinical trial is leveraging the tablet gaming intervention tool developed by Dr. Sarah Shizuko Morimoto and her colleagues at the University of Utah. The brain training gaming tool works by repeatedly, targeting and stimulating a patient's executive cognitive brain function. It has already been successful in the treatment of older adults with treatment resistant depression. University of Utah researchers have shown it improves cognitive function and depression symptoms in older patients with treatment resistant depression.

"These brain-training exercises are like taking your brain to the gym. If you can repeatedly exercise your brain over and over, the hope is that you can induce neuroplasticity and ultimately improve your cognitive performance and day-to-day functioning," says Lindbergh who hopes to improve the outcomes of his patient's struggling post-COVID infection with brain fog symptoms causing disruptions in their executive functions and quality of life.

"The COVID pandemic has had such a profound impact, changing the world as we know it," says Lindbergh. "My hope is that those in our clinical trial using these at-home brain-training games will indeed improve their long-COVID brain fog symptoms. If the results of this initial study are promising, we will have the opportunity to disseminate the brain-training exercises more widely and hopefully help more people around the world suffering from post-COVID cognitive symptoms."

Provided by University of Connecticut