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- Title
A hypoarousal model of neurological post-COVID syndrome: the relation between mental fatigue, the level of central nervous activation and cognitive processing speed.
- Authors
Martin, Eva Maria; Rupprecht, Sven; Schrenk, Simon; Kattlun, Fabian; Utech, Isabelle; Radscheidt, Monique; Brodoehl, Stefan; Schwab, Matthias; Reuken, Philipp A.; Stallmach, Andreas; Habekost, Thomas; Finke, Kathrin
- Abstract
Background: Knowledge on the nature of post-COVID neurological sequelae often manifesting as cognitive dysfunction and fatigue is still unsatisfactory. Objectives: We assumed that cognitive dysfunction and fatigue in post-COVID syndrome are critically linked via hypoarousal of the brain. Thus, we assessed whether tonic alertness as a neurocognitive index of arousal is reduced in these patients and how this relates to the level of central nervous activation and subjective mental fatigue as further indices of arousal. Methods: 40 post-COVID patients with subjective cognitive dysfunction and 40 matched healthy controls underwent a whole-report paradigm of briefly presented letter arrays. Based on report performance and computational modelling according to the theory of visual attention, the parameter visual processing speed (VPS) was quantified as a proxy of tonic alertness. Pupillary unrest was assessed as a measure of central nervous activation. The Fatigue Assessment Scale was applied to assess subjective mental fatigue using the corresponding subscale. Results: VPS was reduced in post-COVID patients compared to controls (p = 0.005). In these patients, pupillary unrest (p = 0.029) and mental fatigue (p = 0.001) predicted VPS, explaining 34% of the variance and yielding a large effect with f2 = 0.51. Conclusion: In post-COVID patients with subjective cognitive dysfunction, hypoarousal of the brain is reflected in decreased processing speed which is explained by a reduced level of central nervous activation and a higher level of mental fatigue. In turn, reduced processing speed objectifies mental fatigue as a core subjective clinical complaint in post-COVID patients.
- Subjects
COGNITIVE processing speed; POST-acute COVID-19 syndrome; MENTAL fatigue; POSTPOLIOMYELITIS syndrome; COVID-19 pandemic; COVID-19; TOUGHNESS (Personality trait)
- Publication
Journal of Neurology, 2023, Vol 270, Issue 10, p4647
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-023-11819-7