Coronavirus disease 2019 (COVID-19) is likely to have long-term mental health effects on individuals who have recovered from COVID-19. According to Centers for Disease Control and Prevention (CDC), individuals diagnosed with COVID-19 can see a range of long-term side effects. The aim of the study was to evaluate the effectiveness of neurotherapy (EEG neurofeedback and goal-oriented cognitive training) in the treatment of neurocognitive dysfunctions in a patient after the infection of SARS-CoV-2 and the long long-term side effects after the contraction of COVID-19. The 48-year-old woman ZR, an accountant by profession, an employee of the administration of the Municipal Board of Municipal Resources, fell ill on October 13, 2020. The disease began with very severe burning headache, eyeballs pain, muscle aches. Ten days later more symptoms joined: loss of smell (anosmia) and loss of taste (ageusia), hearing disorders, shortness of breath and chest pains. The symptoms were associated with SARS-CoV-2 coron- avirus infection confirmed by an rt-PCR genetic test. Brain MRI with intravenous paramagnetic contrast medium injection did not show either lesions of acute microischemic significance or areas of pathological enhancement after paramagnetic contrast medium ad- ministration. The patient was treated at home. In mid-November 2020, about a month after the infection of SARS-CoV-2 and con- tracting NeuroCOVID-19, neurocognitive impairment developed and after half a year she was deteriorating and not able to live in- dependently in society because of her condition. She called her problem "brain fog", and was referred for further diagnosis and therapy to the Reintegration and Training Center of the Polish Neuropsychological Society. We diagnosed a range of long-term side effects and introduced neurotherapy (EEG neurofeedback and goal-oriented cognitive training) in the treatment of neurocognitive dysfunctions. It was found that almost all the long-term side effects were reduced in magnitude. The patient improved and she was able to return to work. EEG neurofeedback and goal-oriented cognitive training might be helpful in the reduction of neurocognitive dysfunctions in patients following the infection of SARS-CoV-2 and long-term side effects after the contraction of COVID-19.
This paper is devoted to illustrating how process neuropsychology and neurolinguistics, based on microgenetic theory androoted in process thought, can help to explain the often baffling symptomatology of brain damage. Our purpose is to present an overview of this difficult and complex subject matter for readers, with particular emphasis on its creative potential. The essence of microgenetic theory in neuropsychology is an account of the phases in brain process through which successive mind/brain states arise and perish over the duration of the psychological present, measured in milliseconds. According to the theory, mental states are rhythmically generated out of a “core” in the anatomically deepest and phylogenetically oldest parts of the central nervous system, over phases to the outermost and youngest regions of the brain, the neocortex. The clinical applications are only one aspect of the creative potential of microgenetic theory. Indeed, the elegance of the theory consists in the way in which it can be extended into a number of different fields of endeavor, providing a kind of “unified field theory” for the explanation of often rather diverse phenomena. This provides an opportunity for neuropsychology and neurolinguistics to resume the interdisciplinary discourse they were founded to conduct.
Stroke is a sudden-onset neurological deficit resulting from focal vascular lesions. This is either due to a clot-induced obstruction of a vessel (ischemic stroke) or a rupture of a vessel causing haemorrhage (hemorrhagic stroke). The appropriate diagnosis of brain stroke aphasic patients is a major public health problem one so important for effective rehabilitation. Here an important role is played by the diagnosis of impaired cognitive processes. The aim of the research was to find the index of impaired cognitive control with the use of ERPs in a patient following an ischemic stroke with aphasia. A male patient, aged 69, after an ischemic brain stroke experienced 4 months previously with resulting naming problem, was admitted to the Reintegrative and Teaching Center of the Polish Neuropsychological Society. In the neuropsychological evaluation three neuropsychological tests were employed: (a) the Boston Naming Test-Polish version, to evaluate the naming and word finding problem; (b) the nonverbal Bell test to ascertain a selective, visuospatial and strategic attentional evaluation; (c) the Digit Memory test to evaluate working memory capabilities; (d) ERPs as a neurophys- iological index of impaired cognitive control. Significant changes were observed in testing. All cognitive functions including naming, non- verbal, visuospatial and strategic attention, along with the digit memory deviate substantially from the norm. The patient obtained a lo wer score, compared to the norm (p <0.05). Boston Naming Test (patient = 21< Mean-Norm = 57.29; SD= 0.52). Bell test (patient = 23 < Mean-Norm = 31.29; SD= 2.52). Digit Memory Test scores: Forward digit span (patient = 3 < Mean-Norm = 7.65, SD = 0.49). Backward digit span (patient = 2 <Mean-Norm = 6.51, SD = 0.7). Significant changes were observed also in neurophysiological testing: behavioral parameters (except RT) deviate substantially from the reference. EEG spectra show clear abnormalities on the left side within the left Rolandic fis- sure. The deviations include excessive mu-rhythm and beta activity, which means that this area is inhibited. The ERPs show no difference between GO and NOGO conditions in the patient in comparison to the norm from HBI database indicating poor cognitive control. ERPs could be treated as an index of impaired cognitive control in the ischemic stroke aphasic patient.
Nowadays, amphetamines constitute the prescription drugs most commonly abused by adolescents and young adults (Berman, O’Neill, Fears et al. 2008). The prevalence of problematic (mainly illegal) use of amphetamines as a stimulant by college students, and here especially before serious examinations, has also been rising. This fact represents a serious public health concern. The patient, aged 19, was awakened from from a long-term coma that had lasted 21 days following an amphetamine overdose and manifested tetraparesis, cortical blindness and deficits in cognitive and emotional processes. After a year of rehabilitation the majority of symptoms had disappeared, but cortical blindness andworking memory deficits remained. In addition, frontal lobe syndrome symptoms appeared. After two years of therapy as a result of immense tiredness caused by all an night wedding reception she started to manifest Charles-Bonnet syndrome. She experienced strange visual sensations such as visual hallucinations and saw various non-existing shapes (coloured blots, patterns and fireworks of vivid colours). She also saw objects (often terrifying) as well as animals (mainly African) and people with deformed faces and long teeth, and persons in African dress with feathers and coral beads in their hair. Her real identity was not remembered by the patient for longer than 2 hours and even then she insisted on being referred to as Shakira. She was given a qEEG examination (in open and closed eyes conditions) and ERPs with the use of auditory stimuli at the period when the hallucinations (to a small degree) still occurred. Studies conducted into the functional neuroimaging of the brain work in milliseconds in the examined patient can explain her symptoms. A comparison of the subject’s ERPs with the grand average of ERPs in healthy controls shows that the N170 and N 250 components are impaired in the subject: the occipital-temporal area of the subject brain shows a strong positivity instead of negativities. This positivity might reflect an enhanced reactivity of neurons in the corresponding area induced by the removal of lateral inhibition from the neurons as a result of local damage. ------------------------------------------------------------------------------------------------------------------------------------
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