November 13, 2025

@michaelokun

What is new for treating 'Long-COVID brain fog?' In this new randomized trial published in JAMA Neurology, David Knopman and colleagues describe results from a large multicenter trial evaluating 3 different remote interventions aimed at improving cognitive symptoms tied to long-COVID. The study tested 1- adaptive computerized cognitive training, 2- a structured cognitive rehabilitation program and 3- transcranial direct current stimulation. Key Points: - All the interventions were delivered remotely over ten weeks. - The active interventions showed no added benefit compared w/ unstructured computer puzzles. - The outcomes were measured on the Everyday Cognition Scale. - All study arms improved modestly over time, suggesting the possibility of natural recovery or placebo-like effects rather than specific treatment-driven gains. - Safety was reassuring w/ no serious intervention-related issues. My take: We urgently need treatments for Long-COVID brain fog and we should not be discouraged by this negative trial. We should keep pushing and testing more interventions. Here are 5 points that resonated w/ me: 1- Long-COVID cognitive symptoms remain challenging and unfortunately the tested interventions did not outperform the 'simple and mentally engaging activities.' 2- Folks still felt somewhat better across all groups tested, highlighting the importance of engagement, structure and support. 3- Home based cognitive programs are feasible and adherence in this trial was really good. 4- Cognitive complaints improved slightly, however no specific strategy rose to the top. 5- We urgently need new approaches, and this study will hopefully set the stage for more effective therapies for the frequently frustrating long-COVID brain fog syndrome. https://jamanetwork.com/journals/jamaneurology/fullarticle/2841155 #fixelinstitute #parkinson #covid_19 #longcovid #longcovidsymptoms #longcovidrecovery