A collection of cognitive symptoms referred to as “brain fog” occur in up to 10-30% of people who have been infected with the virus that causes COVID-19. But currently there are no treatments for the confusion, fuzzy thinking, and forgetfulness that can last for weeks or months, sometimes interfering with daily life.
Researchers at University of Utah Health are testing whether a non-invasive “brain training” tool that resembles a video game can alleviate these symptoms. They are recruiting up to 200 participants aged 18 and older who feel their cognitive function has worsened after having COVID-19. Clinical trial participants will try a potential treatment in the convenience of their own home for a 10-week study period with a follow-up visit after 90 days. Study coaches will provide support through virtual visits.
The trial, called RECOVER-NEURO, is part of the National Institutes of Health Researching COVID to Enhance Recovery (RECOVER) Initiative.
Study participants will be offered an online intervention called BrainHQ. Although it may look like a game, it is more like a mental workout, according to Sarah Shizuko Morimoto, PsyD, the principal investigator of RECOVER-NEURO and an associate professor of population health sciences at U of U Health. BrainHQ is a suite of computerized games/exercises that train different cognitive functions such as attention, memory, processing speed, and navigation. The games provide rewards for correct answers, and participants can track their learning curves. As the participant practices, the games adapt to their individual abilities. And as they improve, the games get harder, maximizing the brain’s learning potential.
Cognitive computerized remediation technologies like BrainHQ have already shown promise. Preliminary research led by Morimoto, who develops digital interventions for mental health, revealed that similar activities enhance cognitive function and alleviate symptoms in older adults with treatment-resistant depression.
Some study participants will test if adding a second non-invasive method increases effectiveness of BrainHQ. The interventions include:
- BrainHQ: Participants will complete online BrainHQ activities designed to improve memory, attention, and brain processing speed—the time it takes to understand and respond to information.
- BrainHQ and PASC Cognitive Recovery (PASC CoRe): Participants in this intervention group will meet virtually with trained study staff to plan and manage personal goals, learn mindfulness skills to focus attention on goal-oriented tasks, and develop strategies to manage mental tiredness.
- BrainHQ and Transcranial Direct Current Stimulation (tDCS): tDCS is a safe, non-invasive form of brain stimulation that may “boost” cognitive training outcomes and brain health. Participants in this intervention group will wear a headset connected to the tDCS device while they complete the cognitive activities. The tDCS device will be programmed to deliver a mild electrical current to specific parts of the brain to increase activity during BrainHQ activities.
Non-invasive methods such as these are attractive because they avoid risks associated with medication-based symptom management, Morimoto says. “Over the last year, experts across the country have been meeting to evaluate every suggested treatment for long COVID,” she says. The study’s design was developed with input from experts in neurology, immunology, rehabilitation, psychology, and neuroscience, in collaboration with long COVID patient advocates.
“These experts have decided that the best interventions to test are the ones that are both safe and have data to support their use,” Morimoto says. “We are excited to be able to offer this cutting-edge treatment to patients suffering from long COVID at no cost.”
She adds that the clinical trial may reveal a treatment and provide insights into underlying causes of brain fog. Data captured from the clinical trial could pinpoint which cognitive functions become impaired, identify neural circuits responsible for these deficits, and assess the potential to reshape these circuits for improving cognitive capabilities. That knowledge can be used as the basis for further research, ultimately leading to better treatments and preventive measures.
Find additional RECOVER clinical trials for long COVID at trials.recovercovid.org.