tetano
Editor, Senior Moderator
J Transl Med
. 2024 Aug 5;22(1):720.
doi: 10.1186/s12967-024-05319-z. PFC/M1 activation and excitability: a longitudinal cohort study on fatigue symptoms in healthcare workers post-COVID-19
Tao Han[SUP] #[/SUP][SUP] 1 [/SUP], Chunqiu Dai[SUP] #[/SUP][SUP] 1 2 [/SUP], Ying Liang[SUP] 3 [/SUP], Xiaodong Lin[SUP] 1 [/SUP], Ming Gao[SUP] 1 [/SUP], Xinyu Liu[SUP] 1 [/SUP], Xiangbo Wu[SUP] 1 [/SUP], Yuheng Lu[SUP] 1 [/SUP], Xiao Xi[SUP] 1 [/SUP], Fei Tian[SUP] 1 [/SUP], Chenguang Zhao[SUP] 1 [/SUP], Xiaolong Sun[SUP] 4 [/SUP], Hua Yuan[SUP] 5 [/SUP]
Affiliations
Background: Fatigue is one of the most common neurological symptoms reported post coronavirus disease 2019 (COVID-19) infection. In order to establish effective early intervention strategies, more emphasis should be placed on the correlation between fatigue and cortical neurophysiological changes, especially in healthcare workers, who are at a heightened risk of COVID-19 infection.
Methods: A prospective cohort study was conducted involving 29 COVID-19 medical workers and 24 healthy controls. The assessment included fatigue, sleep and health quality, psychological status, and physical capacity. Functional near-infrared spectroscopy (fNIRS) was employed to detect activation of brain regions. Bilateral primary motor cortex (M1) excitabilities were measured using single- and paired-pulse transcranial magnetic stimulation. Outcomes were assessed at 1, 3, and 6 months into the disease course.
Results: At 1-month post-COVID-19 infection, 37.9% of patients experienced severe fatigue symptoms, dropping to 10.3% at 3 months. Interestingly, the remarkable decreased activation/excitability of bilateral prefrontal lobe (PFC) and M1 were closely linked to fatigue symptoms after COVID-19. Notably, greater increase in M1 region excitability correlated with more significant fatigue improvement. Re-infected patients exhibited lower levels of brain activation and excitability compared to single-infection patients.
Conclusions: Both single infection and reinfection of COVID-19 lead to decreased activation and excitability of the PFC and M1. The degree of excitability improvement in the M1 region correlates with a greater recovery in fatigue. Based on these findings, targeted interventions to enhance and regulate the excitability of M1 may represent a novel strategy for COVID-19 early rehabilitation.
Trial registration: The Ethics Review Committee of Xijing Hospital, No. KY20232051-F-1; www.chictr.org.cn , ChiCTR2300068444.
Keywords: COVID-19; Fatigue; Functional near-infrared spectroscopy; Healthcare Workers; Long COVID; Transcranial magnetic stimulation.
. 2024 Aug 5;22(1):720.
doi: 10.1186/s12967-024-05319-z. PFC/M1 activation and excitability: a longitudinal cohort study on fatigue symptoms in healthcare workers post-COVID-19
Tao Han[SUP] #[/SUP][SUP] 1 [/SUP], Chunqiu Dai[SUP] #[/SUP][SUP] 1 2 [/SUP], Ying Liang[SUP] 3 [/SUP], Xiaodong Lin[SUP] 1 [/SUP], Ming Gao[SUP] 1 [/SUP], Xinyu Liu[SUP] 1 [/SUP], Xiangbo Wu[SUP] 1 [/SUP], Yuheng Lu[SUP] 1 [/SUP], Xiao Xi[SUP] 1 [/SUP], Fei Tian[SUP] 1 [/SUP], Chenguang Zhao[SUP] 1 [/SUP], Xiaolong Sun[SUP] 4 [/SUP], Hua Yuan[SUP] 5 [/SUP]
Affiliations
- PMID: 39103842
- DOI: 10.1186/s12967-024-05319-z
Background: Fatigue is one of the most common neurological symptoms reported post coronavirus disease 2019 (COVID-19) infection. In order to establish effective early intervention strategies, more emphasis should be placed on the correlation between fatigue and cortical neurophysiological changes, especially in healthcare workers, who are at a heightened risk of COVID-19 infection.
Methods: A prospective cohort study was conducted involving 29 COVID-19 medical workers and 24 healthy controls. The assessment included fatigue, sleep and health quality, psychological status, and physical capacity. Functional near-infrared spectroscopy (fNIRS) was employed to detect activation of brain regions. Bilateral primary motor cortex (M1) excitabilities were measured using single- and paired-pulse transcranial magnetic stimulation. Outcomes were assessed at 1, 3, and 6 months into the disease course.
Results: At 1-month post-COVID-19 infection, 37.9% of patients experienced severe fatigue symptoms, dropping to 10.3% at 3 months. Interestingly, the remarkable decreased activation/excitability of bilateral prefrontal lobe (PFC) and M1 were closely linked to fatigue symptoms after COVID-19. Notably, greater increase in M1 region excitability correlated with more significant fatigue improvement. Re-infected patients exhibited lower levels of brain activation and excitability compared to single-infection patients.
Conclusions: Both single infection and reinfection of COVID-19 lead to decreased activation and excitability of the PFC and M1. The degree of excitability improvement in the M1 region correlates with a greater recovery in fatigue. Based on these findings, targeted interventions to enhance and regulate the excitability of M1 may represent a novel strategy for COVID-19 early rehabilitation.
Trial registration: The Ethics Review Committee of Xijing Hospital, No. KY20232051-F-1; www.chictr.org.cn , ChiCTR2300068444.
Keywords: COVID-19; Fatigue; Functional near-infrared spectroscopy; Healthcare Workers; Long COVID; Transcranial magnetic stimulation.