Even after their bodies have cleared the virus that causes COVID-19, many patients experience long-term effects. One of the most troubling is a deterioration in cognitive function, commonly called brain fog, that is marked by memory problems and a struggle to think clearly. This condition has shown up in a number of reports. For instance, a hospital network in Chicago found that nearly one-third of a group of 509 COVID patients experienced altered mental function. Similar numbers were reported from a study in France, among others.
Although, there are no current treatments for COVID-related brain fog, UAB researchers are starting a clinical trial to test a rehabilitation method that has proven to restore lost function. Known as Constraint-Induced Therapy, it was developed by Edward Taub, PhD, 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.
Taub and his longtime collaborator, Gitendra Uswatte, PhD, professor in the UAB Department of Psychology, have demonstrated the positive effects of CI Therapy on patients with stroke, multiple sclerosis and cerebral palsy. 97 percent of the thousands of stroke patients who have taken part in CI Therapy have seen meaningful improvement, and the average patient uses her affected limb five times more post-therapy than pre-therapy. The improvement in function remains even after years have passed.
MRI scans have shown that CI Therapy rewires the brain, which leads Taub and Uswatte to believe that the therapy 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," Uswatte said.
Because of this, the researchers postulate that CI Therapy can alleviate the brain fog conditions that so many post-COVID patients suffer from. So, with pilot funding from UAB's Integrative Center for Aging Research, Taub and Uswatte will recruit at least 20 adult patients, age 18 or older, who have recovered from COVID-19, but are experiencing memory loss, brain fog or other cognitive issues. Participants will receive CI Therapy training at no cost.
This 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. "At the end of each session, participants are assigned 10 homework tasks that they 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 and will 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. "One of the requirements of the program is that participants have a caregiver or person who lives with them who can prompt them to do this homework. 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."
"The challenge of adapting CI Therapy to a new condition is exciting," Taub said. "We have proved that the therapy works in other conditions. What got us interested here was the fact that current brain-training techniques that aim to help with brain fog work fine in the lab or in the training setting, but they don't transfer robustly to real-life situations. And if it does not transfer to life situations, why bother?"
Individuals 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.