BIRMINGHAM, Ala. (WBRC) - “Brain fog” is what doctors call a change in cognitive function many COVID-19 patients experience as a long-term effect from the virus. The fog is marked by memory problems and a struggle to think clearly. A new clinical trial at the University of Alabama at Birmingham is testing a rehabilitation method to remedy the problem.
A report on 120 patients in France, published in October 2020, found that more than a third had memory loss and 27 percent had cognitive difficulties months after recovering from COVID-19. In another study, a hospital network in Chicago reported that, among 509 patients, nearly a third experienced altered mental function; of these, 68 percent were unable to handle routine daily activities such as cooking or paying bills.
Therapy used around the world
There are no current treatments for brain fog attributed to COVID-19. But a new clinical trial at UAB is hoping to change that. Known as Constraint-Induced Therapy, it was developed by Edward Taub, Ph.D., director of the Constraint-Induced Movement Therapy Research Group, in collaboration with colleagues at UAB.
CI Therapy is used around the world to help patients regain limb function and language abilities after stroke.
In a host of studies Taub and his longtime collaborator, Gitendra Uswatte, Ph.D., professor in the Department of Psychology, with other members of their research group, have demonstrated the effects of CI Therapy.
Taub said using MRI scans, he and other researchers have shown the therapy rewires the brain following two weeks of intensive training in the clinic and ongoing practice at home. The improvement in function that results remains even after years have passed, says Taub.
Tackling persistent cognitive impairment
Brain scans showing significant rewiring after CI Therapy had long since convinced Taub and Uswatte that the technique could restore cognitive function in the same way it restored a person’s ability to move their arms or legs. “We found in the motor rehabilitation work that the therapy is effective for a number of different types of brain damage,” Dr. Uswatte said.
Clinical trial details
Taub and Uswatte aim to recruit at least 20 adult patients — anyone age 18 or older who has recovered from COVID-19 but is experiencing memory loss, brain fog or other cognitive issues. Participants will receive the training at no cost.
It involves 35 hours of therapy in the clinic, including the computer-based speed-of-processing training and a component called shaping, which involves training simulated cognitive activities in the clinic that are made progressively harder over time.
Transferring gains to everyday life
Typically, the training is spread across two weeks. Participants often have caregivers who must work or have other obligations, so the training can be conducted during a longer period in some cases, Taub says. At the end of each session, participants are assigned ten tasks “that patients use in their everyday lives to focus on transferring the gains they have made in the lab,” Uswatte said. “These are tasks that are important to the person or their quality of life and are going to challenge their cognitive skills.”
The activities might include “cooking a meal with more than three ingredients, starting a conversation, remembering medication, doing the laundry or making out a shopping list,” Taub said. “There are perceived and often real barriers to carrying out cognitive activities. Part of the requirement of the program is that participants have a caregiver or person who lives with them who can prompt them to do this homework when they are at home. We also call them once a week for the first month after the end of training and then once a month for the next 11 months to help participants hold onto their gains.”
People who think they can benefit are welcome to contact the project directly at 205-934-9768 or learn more about the study at uab.edu/citherapy.