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EVENT-RELATED POTENTIALS STUDIES OF PTSD AFTER INFECTION OF SARS-COV-2 AND NEUROCOVID-19

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Pąchalska M., Nowaczyk N.

Acta Neuropsychologica

2021

vol. 19(3)

347-360

Coronavirus disease 19 (COVID-19) hospitalisation is a potentially traumatic experience, especially in severe cases. Furthermore, the unprecedented context of the SARS-CoV-2 pandemic, with the daily media bombardment about COVID-19 mortality, may have amplified its life-threatening perception also in patients with moderate infection. The purpose of our study was twofold: 1) to evaluate QEEG/ERPs shows of PTSD associated with severe infection SARS-CoV-2, and neuroCOVID-19, 2) to construct a neurofeedback protocol based on these indices to support the psychotherapy of the case study described herein. Patient N.C. 49, a frontline healthcare worker in the emergency services (an ambulance driver), became ill with Covid-19 on November 14, 2020. Initially, he lost his sense of smell (anosmia), of taste (ageusia), and had latent blinks (heterophila), headaches, and dizziness. After 10 days of illness, the patient had additionally a dry cough and a shortness of breath and he was hospitalized, sedated and mechanically ventilated for 24 days. After a few months he was diagnosed with PTSD (according to the DSM- 5 criteria) and referred to the Reintegration and Training Center of the Polish Neuropsychological Society for further diagnosis and treatment. It was found that the P3 GO and P3 NOGO waves were indeed less in his case (p < 0.01) when compared to the ERPs results of a health group of individuals of a similar age (n = 100), derived from the normative data bases of the Human Brain Index (HBI) in Switzerland. The ERPs wave pattern in our patient reflects the pattern appearing in patients with PTSD. The patient took part in 20 sessions of individually tailored anodal transcranial direct current stimulation (tDCS), with the excitatory stimulation of the left prefrontal cortex and inhibitory stimulation of the right prefrontal cortex which can reduce anxiety, as was proposed in the subject literature. Also, the neuromarker of PTSD obtained with the use of QEEG/ERPs was helpful in choosing the appropriate tDCS protocol. Neurostimulation with the use of tDCS was administered systematically, every day, 15-20 and 30-40 minutes for each session, for 20 days. He also received individual sessions of psychotherapy every day, 30-40 minutes for each session, for 20 day. After the treatment the patient improved and returned to his previous job as a frontline healthcare worker in the emergency services (an ambulance driver) in the fight against COVID-19. Detection of the PTSD neuromarker enabled the development of a proper tDCS protocol and the conduct of effective brain neurostimulation of a patient with PTSD. The proposed protocol of treatment, in combination with goal-oriented individual psychotherapy, offered to the patient, was effective in the reduction of PTSD. ERPs can be useful in the diagnosis of PTSD as well as in selecting an appropriate therapy protocol for these patients.

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1 Acta Neuropsychologica

1 2021

1 Nowaczyk N.

1 Pąchalska M.

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EVENT-RELATED POTENTIALS STUDIES OF PTSD AFTER INFECTION OF SARS-COV-2 AND NEUROCOVID-19