Intracortical GABAergic dysfunction in patients with fatigue and dysexecutive syndrome after COVID-19.
Clin Neurophysiol
; 132(5): 1138-1143, 2021 05.
Article
in English
| MEDLINE | ID: covidwho-1128943
ABSTRACT
OBJECTIVE:
A high proportion of patients experience fatigue and impairment of cognitive functions after coronavirus disease 2019 (COVID-19). Here we applied transcranial magnetic stimulation (TMS) to explore the activity of the main inhibitory intracortical circuits within the primary motor cortex (M1) in a sample of patients complaining of fatigue and presenting executive dysfunction after resolution of COVID-19 with neurological manifestations.METHODS:
Twelve patients who recovered from typical COVID-19 pneumonia with neurological complications and complained of profound physical and mental fatigue underwent, 9 to 13 weeks from disease onset, a psychometric evaluation including a self-reported fatigue numeric-rating scale (FRS, Fatigue Rating Scale) and the Frontal Assessment Battery (FAB). Intracortical activity was evaluated by means of well-established TMS protocols including short-interval intracortical inhibition (SICI), reflecting GABAA-mediated inhibition, long-interval intracortical inhibition (LICI), a marker of GABAB receptor activity, and short-latency afferent inhibition (SAI) that indexes central cholinergic transmission. TMS data were compared to those obtained in a control group of ten healthy subjects (HS) matched by age, sex and education level.RESULTS:
Post-COVID-19 patients reported marked fatigue according to FRS score (8.1 ± 1.7) and presented pathological scores at the FAB based on Italian normative data (12.2 ± 0.7). TMS revealed marked reduction of SICI, and disruption of LICI as compared to HS. SAI was also slightly diminished.CONCLUSIONS:
The present study documents for the first time reduced GABAergic inhibition in the M1 in patients who recovered from COVID-19 with neurological complications and manifested fatigue and dysexecutive syndrome.SIGNIFICANCE:
TMS may serve as diagnostic tool in cognitive disturbances and fatigue in post-COVID-19 patients.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Transcranial Magnetic Stimulation
/
Fatigue
/
GABAergic Neurons
/
Cognitive Dysfunction
/
COVID-19
/
Motor Cortex
Type of study:
Experimental Studies
/
Prognostic study
Topics:
Long Covid
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Clin Neurophysiol
Journal subject:
Neurology
/
Psychophysiology
Year:
2021
Document Type:
Article
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