Intracortical GABAergic dysfunction in patients with fatigue and dysexecutive syndrome after COVID-19

Autor: Davide Ferrazzoli, Giacomo Koch, Viviana Versace, Leopold Saltuari, Markus Kofler, Valentina Ajello, Roberto Romanello, Luca Sebastianelli, Francesco Porrazzini, Alessia D'Acunto, Paola Ortelli, Antonio Oliviero
Rok vydání: 2021
Předmět:
Male
SAI
short-latency afferent inhibition
medicine.medical_specialty
medicine.medical_treatment
FRS
Fatigue Rating Scale
Audiology
Article
050105 experimental psychology
SICI
short-interval intracortical inhibition
NO
Executive functions
GABA
03 medical and health sciences
0302 clinical medicine
LICI
long-interval intracortical inhibition
Rating scale
Physiology (medical)
Humans
Medicine
Cognitive Dysfunction
0501 psychology and cognitive sciences
GABAergic Neurons
Pathological
Fatigue
Aged
Aged
80 and over
Dysexecutive syndrome
FAB
frontal assessment battery
business.industry
TMS
transcranial magnetic stimulation
05 social sciences
Motor Cortex
COVID-19
Cognition
Middle Aged
Transcranial Magnetic Stimulation
GABA
gamma aminobutyric acid
Sensory Systems
Transcranial magnetic stimulation
Neurology
TMS
COVID-19
TMS
GABA
Fatigue
Executive functions
Female
Neurology (clinical)
Primary motor cortex
business
030217 neurology & neurosurgery
Executive dysfunction
Zdroj: Clinical Neurophysiology
ISSN: 1388-2457
Popis: 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.
Databáze: OpenAIRE
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