Neurological post-COVID syndrome is associated with substantial impairment of verbal short-term and working memory, 2025, Charles James+

[SNT Gatchaman]

Neurological post-COVID syndrome is associated with substantial impairment of verbal short-term and working memory
Charles James, Jeyanthan; Schulze, Hannah; Siems, Nadine; Prehn, Christian; Quast, Daniel R.; Trampe, Nadine; Gold, Ralf; Faissner, Simon

A substantial proportion of patients suffer from Post-COVID Syndrome (PCS) with fatigue and impairment of memory and concentration being the most important symptoms. We here set out to perform in-depth neuropsychological assessment of PCS patients referred to the Neurologic PCS clinic compared to patients without sequelae after COVID-19 (non-PCS) and healthy controls (HC) to decipher the most prevalent cognitive deficits.

We included n = 60 PCS patients with neurologic symptoms, n = 15 non-PCS patients and n = 15 healthy controls. Basic socioeconomic data and subjective complaints were recorded. This was followed by a detailed neuropsychological test battery, including assessments of general orientation, motor and cognitive fatigue, screening of depressive and anxiety symptoms, information processing speed, concentration, visuomotor processing speed, attention, verbal short-term and working memory, cognitive flexibility, semantic and phonematic word fluency, as well as verbal and visual memory functions.

Neurologic PCS patients had more complaints with significantly higher fatigue scores as well as higher levels of depressive and anxiety symptoms compared to Non-PCS and HC. Deep neuropsychological assessment showed that neurologic PCS patients performed worse in a general screening of cognitive deficits compared to HC. Neurologic PCS patients showed impaired mental flexibility as an executive subfunction, verbal short-term memory, working memory and general reactivity (prolonged reaction time). Multiple regression showed fatigue affected processing speed; depression did not. Self-reported cognitive deficits of patients with neurologic PCS including fatigue, concentration, and memory deficits, are well mirrored in impaired performance of cognitive domains of concentration and working memory.

The present results should be considered to optimize treatment algorithms for therapy and rehabilitation programs of PCS patients with neurologic symptoms.

Link | PDF (Nature Scientific Reports) [Open Access]

 

[EndME]

I think there might be an interesting aspect here related to "cognitive fatiguability" and I wonder whether this has been sufficiently examined, here and in studies of ME/CFS.

Since patients often complain about concentration and attention deficits, we set out to assess general alertness (tonic alertness) and specific responsiveness (phasic alertness) using the subtest Alertness of the Test for Attentional Performance (TAP) at two different time points. Examining tonic alertness during the first trial, HC achieved a SD of -0.7 (median − 0.8, range − 2.0 to 0.3), non-PCS patients a SD of -0.7 (median − 0.7, range − 2.0 to 0.2) and PCS-patients a SD of -1.0 (median − 1.0, range − 2.0 to 2.0) (ns; Fig. 4a). The second trial was conducted at the end of the test battery to potentially objectify fatiguability over time. HC achieved a SD of -0.3 (median − 0.2, range − 1.0 to 0.7), non-PCS patients achieved a SD of -0.6 (median − 0.6, range − 2.0 to 0.5) and PCS on average a SD of -1.0 (median − 2.0, range − 2.0 to 0.4), which was significantly slower comparing PCS vs. Non-PCS (q = 0.0017) (Fig. 4b).

Examining the phasic alertness during the first trial HC scored on average a SD of -0.8 (median − 1, range − 2.0 to 0.9), non-PCS a SD of -0.5 (median − 0.5, range − 2.0 to 0.5), PCS − 0.03 (median − 0.3, range − 2.0 to 2.0). The difference between PCS and HC was significant with q = 0.0207 (Fig. 4c). This effect was unchanged during the second trial (HC mean SD -0.4 (median − 0.4, range − 1.0 to 0.5), non-PCS SD of -0.5 (median − 0.4, range − 1.0 to 0.6), PCS 0.2 (median 0, range − 1.0 to 0.4) (Fig. 4d). The multiple regression analysis did not reveal any significantly influencing factors (not shown).

What I don't quite understand is how one might think cognitive fatiguability could influence results but then one has patients do a lot of different tests, presumably after each other and at the same time only does re-testing for one for the tests?