A systematic review of quantitative EEG findings in Long COVID, Fibromyalgia and Chronic Fatigue Syndrome (preprint)

Long COVID (LC) is a multisymptom clinical syndrome with similarities to Fibromyalgia Syndrome (FMS) and Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). All these conditions are believed to be associated with centrally driven mechanisms such as central sensitisation. There is a lack of consensus on quantitative EEG (qEEG) changes observed in these conditions. This review aims to synthesise and appraise the literature on resting-state qEEG in LC, FMS and CFS/ME, to help uncover possible mechanisms of central sensitisation in these similar clinical syndromes. A systematic search of MEDLINE, Embase, CINHAL, PsycINFO and Web of Science databases for articles published between December 1994 and September 2023 was performed. Following screening for predetermined selection criteria and out of the initial 2510 studies identified, 17 articles were retrieved that met all the inclusion criteria, particularly of assessing qEEG changes in one of the three conditions compared to healthy controls. All studies scored moderate to high quality on the Newcastle-Ottawa scale. There was a general trend for decreased low-frequency EEG band activity (delta, theta, and alpha) and increased high-frequency EEG beta activity in FMS, whereas an opposite trend was found in CFS/ME. The limited LC studies included in this review focused mainly on cognitive impairments and showed mixed findings not consistent with patterns seen in FMS and CFS/ME. Further research is required to explore whether there are phenotypes within LC that have EEG signatures similar to FMS or CFS/ME. This could inform identification of reliable diagnostic markers and possible targets for neuromodulation therapies.

Changes in Gross Anatomy Laboratory Assessment During Covid-19

INTRODUCTION P<0.001) while computer-based platforms increased (before: 9%, during: 61%;P<0.001). The use of medical imaging and other anatomical images were maintained (before: 11%, during: 51%;P=0.37), but there were decreases in the use of cadavers (before: 63%, during: 14%;P<0.001) as well as bones, plastic models, and plastinates (before: 12%, during: 0%;P<0.001). There were no significant changes in assessment structure, with the majority of participants maintaining a practical examination (i.e. ?bell ringer?) format during Covid-19 (before: 66%, during: 62%;P=0.39). CONCLUSION: Anatomy educators continued the use of ?bell ringer? style lab assessments during the early part of the Covid-19 pandemic. The setting shifted towards computer-based examinations due to Covid-19 restrictions;thus, the use of digital images was maintained while cadaver use decreased. SIGNIFICANCE/IMPLICATION: The early adaptations made by anatomy educators to their lab assessments during Covid-19 provide insight into how assessment may be offered in dire circumstances when the physical lab is unavailable, when accommodating students with extenuating circumstances preventing them from attending in-person lab assessments, and for remediation assessments.

Adverse effects of COVID-19 related lockdown on pain, physical activity and psychological wellbeing in people with chronic pain (preprint)

Countries across the world imposed lockdown restrictions during the COVID-19 pandemic. It has been proposed that lockdown conditions disproportionately impact those living with chronic pain, requiring adaptation to treatment and care strategies. We investigated how lockdown restrictions in the United Kingdom impacted individuals with chronic pain (N=431) relative to a healthy control group (N=88) using an online survey. In accordance with the fear-avoidance model, we hypothesised increases in perceived pain and psychological distress that would be mediated by pain catastrophizing. Survey questions answered during the lockdown period, probing patients self-perceived changes retrospectively, revealed that people with chronic pain perceived increases in their pain severity compared to before lockdown. They were also more adversely affected by lockdown compared to pain-free individuals, demonstrating greater increases in anxiety and depressed mood, increased loneliness and reduced levels of physical exercise. Pain catastrophizing was found to be an important factor in predicting the extent of self-perceived increases in pain, and accounted for the relationship between decreased mood and pain. Perceived decreases in levels of physical exercise also independently predicted perceptions of increased pain. Interestingly, actual changes in pain symptoms (measured at two time points at pre- and post-lockdown in a subgroup, N = 85) did not change significantly on average, but those reporting increases also demonstrated greater baseline levels of pain catastrophizing. Overall, the findings suggest that remote pain management provision to target reduction of catastrophizing and increases to physical activity could be beneficial for chronic pain patients in overcoming the adverse effects of lockdown.