Attention Deficiency Symptoms Reduction in Post-Viral Syndrome Patients after Auricular Vagal Neuromodulation Therapy

Abstract

Nurosym Auricular Vagal Neuromodulation Therapy (AVNT) was used to measure influence on cognitive function in female Long COVID patients with persistent cognitive deficits. The therapy, involving vagus nerve stimulation via the left tragus, was administered twice daily for ten days. Results demonstrated significant improvements in attention, processing speed, and episodic memory, with notable gains sustained at a one-month follow-up. The findings suggest that neuroinflammation may underlie cognitive deficits in Long COVID and highlight the potential of vagus nerve neuromodulation as an alternative treatment for cognitive impairments, which could be applicable to other conditions such as ADHD.

Background and aims

The study aimed to improve cognitive function in Long COVID patients with persisting symptoms of cognitive deficiency, including attention and memory issues, often referred to as "brain fog." Despite inattention being one of the most common symptoms of Post-COVID-19 Syndrome, there is a gap in the literature regarding its treatment. The previous report presents attentional symptoms that emerged after the SARS-CoV-2 infection. The symptoms were similar to ADHD in adults. This study suggests that insights gained from treating cognitive dysfunctions in Long COVID could be transferable to ADHD management. Understanding how Nurosym AVNT affects these cognitive domains in Long COVID can provide a novel perspective on addressing similar symptoms in ADHD and other cognitive impairment patients.

Methods

The study included female patients with persistent Long COVID symptoms, averaging 20.2 ± 7.1 months since infection. Participants underwent 10 consecutive days of Nurosym therapy at home, twice a day (morning and evening) for 30 minutes per session (60 minutes/day). The electrode was applied to the left tragus of the ear, stimulating the auricular branch of the vagus nerve with micro-pulses of current using a proprietary waveform. The current intensity was personalised based on participants' sensitivity thresholds. Behavioural assessments were conducted at three time points: pre-intervention, post-intervention, and one-month follow-up. The NIH Cognitive Toolbox was used to assess fluid cognition, including attention (Flanker Inhibitory Control and Attention Test), executive function (Dimensional Change Card Sort Test), episodic memory (Picture Sequencing Memory Test), working memory (List Sorting Working Memory), and processing speed (Pattern Comparison Processing Speed).

Results

The study results suggest that neuroinflammation may underlie cognitive deficits in Long COVID. The results indicate that 10 days of Nurosym neuromodulation significantly mitigated neuroinflammation and improved cognitive function in patients with Long COVID, particularly in areas of attention, processing speed, and episodic memory.

Participants were tested at three time points: baseline (Day 0), post-intervention (Day 10), and 1-month follow-up. Significant gains were detected in Flanker Inhibitory Control and Attention from baseline to post-intervention (p = 0.009) and from baseline to follow-up (p < 0.001). Additionally, there were significant increases from baseline to post-intervention and follow-up (p < 0.01) in Pattern Comparison Processing Speed, Pattern Sequencing Memory (PSM), and List Sorting Working Memory (LSWM). Friedman’s test revealed a significant main effect of time (p = 0.001) for all composite cognitive scores.

Conclusion

Effective treatment of cognitive impairment in long-term COVID-19 is crucial to reducing the risk of long-term neurological sequelae. Similarly, early intervention for deficits in ADHD and other cognitive conditions can prevent the progression of related mental health problems and improve overall long-term outcomes. The study revealed that Nurosym can influence various physiological processes, including reducing inflammation and modulating brain activity. While treatments for cognitive impairment typically include behavioural therapies and medications, these can be inappropriate for some patients. Vagus neuromodulation therapy may be beneficial for these patients who exhibit neuroinflammatory markers. Further exploring alternative or complementary treatment approaches, such as vagus nerve neuromodulation, is important to provide more options for managing cognitive impairments across different conditions.