Neuropsychological and neurophysiological correlates of fatigue in post-acute patients with neurological manifestations of COVID-19: Insights into a challenging symptom
| العنوان: | Neuropsychological and neurophysiological correlates of fatigue in post-acute patients with neurological manifestations of COVID-19: Insights into a challenging symptom |
|---|---|
| المؤلفون: | Luca Sebastianelli, Raffaele Nardone, Michael Engl, Giacomo Koch, Ilenia Bonini, Viviana Versace, Leopold Saltuari, Roberto Romanello, Davide Ferrazzoli, Antonio Oliviero, Angelo Quartarone, Markus Kofler, Paola Ortelli |
| المصدر: | Journal of the Neurological Sciences |
| بيانات النشر: | Elsevier B.V., 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, medicine.medical_treatment, RT, reaction time, Action Potentials, FRS, Fatigue Rating Scale, Neuropsychological Tests, Executive Function, 0302 clinical medicine, 80 and over, Medicine, Apathy, 030212 general & internal medicine, Neuropsychological assessment, Evoked potential, TMS, Transcranial magnetic stimulation, Evoked Potentials, Problem Solving, Fatigue, Aged, 80 and over, AES, Apathy Evaluation Scale, CMAP, compound muscle action potential, medicine.diagnostic_test, Peripheral fatigue, Central fatigue, COVID-19, Dysexecutive syndrome, Peripheral fatigue, TMS, Neuropsychology, Motor Cortex, RMT, resting motor threshold, Skeletal, Middle Aged, HC, healthy control, Transcranial Magnetic Stimulation, Compound muscle action potential, CNS, Central Nervous System, Neurology, Motor, CRP, C-reactive protein, Muscle, BDI, Beck Depression Inventory, Female, medicine.symptom, MoCA, Montreal Cognitive Assessment, medicine.medical_specialty, IL-6, interleukine-6, Central fatigue, COVID-19, Dysexecutive syndrome, TMS, Aged, Evoked Potentials, Motor, Humans, Muscle, Skeletal, Clinical Neurology, Neurophysiology, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, Article, NO, 03 medical and health sciences, Physical medicine and rehabilitation, FDI, first dorsal interosseous muscle, SP, silent period, SARS-CoV-2, business.industry, VT, vigilance task, Beck Depression Inventory, FAB, Frontal Assessment Battery, FSS, Fatigue Severity Scale, Transcranial magnetic stimulation, SIT, Stroop Interference Task, MEP, motor evoked potential, CR100, Borg-Category-Ratio scale, Silent period, Neurology (clinical), business, NV, Navon Task, 030217 neurology & neurosurgery |
| الوصف: | More than half of patients who recover from COVID-19 experience fatigue. We studied fatigue using neuropsychological and neurophysiological investigations in post-COVID-19 patients and healthy subjects. Neuropsychological assessment included: Fatigue Severity Scale (FSS), Fatigue Rating Scale, Beck Depression Inventory, Apathy Evaluation Scale, cognitive tests, and computerized tasks. Neurophysiological examination was assessed before (PRE) and 2 min after (POST) a 1-min fatiguing isometric pinching task and included: maximum compound muscle action potential (CMAP) amplitude in first dorsal interosseous muscle (FDI) following ulnar nerve stimulation, resting motor threshold, motor evoked potential (MEP) amplitude and silent period (SP) duration in right FDI following transcranial magnetic stimulation of the left motor cortex. Maximum pinch strength was measured. Perceived exertion was assessed with the Borg-Category-Ratio scale. Patients manifested fatigue, apathy, executive deficits, impaired cognitive control, and reduction in global cognition. Perceived exertion was higher in patients. CMAP and MEP were smaller in patients both PRE and POST. CMAP did not change in either group from PRE to POST, while MEP amplitudes declined in controls POST. SP duration did not differ between groups PRE, increased in controls but decreased in patients POST. Patients' change of SP duration from PRE to POST was negatively correlated to FSS. Abnormal SP shortening and lack of MEP depression concur with a reduction in post-exhaustion corticomotor inhibition, suggesting a possible GABAB-ergic dysfunction. This impairment might be related to the neuropsychological alterations. COVID-19-associated inflammation might lead to GABAergic impairment, possibly representing the basis of fatigue and explaining apathy and executive deficits. Highlights • Neuropsychological and neurophysiological features of fatigue were studied in post-COVID-19 patients. • Apathy, deficits in executive functions and reduction in global cognition were found. • Abnormal shortening of cortical silent period and lack of MEP depression were demonstrated after a fatiguing task. • Disruption of post-exhaustion corticomotor inhibition suggests GABA-ergic dysfunction. • GABA-ergic impairment might subtend fatigue and executive deficits in COVID-19. |
| اللغة: | English |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3261858a298c2c2e79bef1c6c0bf17bdTest http://hdl.handle.net/11570/3195030Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....3261858a298c2c2e79bef1c6c0bf17bd |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |