By Padmini Konidena. This text was initially revealed within the 6/13/24 version of our Concussion Replace publication; please think about subscribing.
A BBC article explains how sufferers with persisting post-concussion symptoms (PPCS) and Long Covid exhibit related signs, together with fatigue, train intolerance, sleep disturbances, reminiscence and focus issues, gentle and sound sensitivity, and visible dysfunction, corresponding to impairments in eye monitoring. BBC journalist David Cox describes researchers within the U.Okay. and U.S. who’ve developed totally different theories of the potential overlaps in pathophysiology behind PPCS and Lengthy Covid and the way evaluation and therapy choices for the 2 situations might be related. One other researcher in Germany sees an overlap between PPCS, Lengthy Covid, and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and has therapy concepts–together with the usage of the psychedelic medication ibogaine, psilocybin, and ketamine.
Because the onset of the COVID-19 pandemic, U.Okay. researcher, concussion specialist, and neurologist Ioannis Mavroudis discovered that he was more and more treating sufferers with Lengthy Covid and located that sufferers with each Lengthy Covid and PPCS have related symptom expression. Mavroudis theorizes that PPCS is “associated to the vitality demand on the mind’s neurons on account of the pinnacle trauma.” The concussed mind can’t meet this demand, inflicting fatigue and locking the mind right into a “vicious cycle,” much like what might happen within the brains of these with Lengthy Covid. (See Moavroudis’s associated paper on the connection between PPCs and functional neurological disorders.)
Equally, researchers from the College of Denver performed steadiness and spatial reasoning research on sufferers with Lengthy Covid, concluding that “the sufferers had successfully skilled a traumatic damage to the mind.” The College of Denver researchers counsel that concussion diagnostics might be used to evaluate the progress of Lengthy Covid sufferers. As well as, they hypothesize that focusing on the vestibular system (which incorporates the brainstem) might assist deal with sufferers with Lengthy Covid––a therapy technique already employed with sufferers with PPCS. For additional info, see the staff’s preprint article on medRxiv, our Concussion Replace Publication synopsis about the team’s research, and our interview with Allison Grossberg, one of many staff’s researchers. Moreover, see our useful resource on Vestibular Therapy.
Herbert Renz-Polster, an ME/CFS researcher in Germany, believes that the ME/CFS, Lengthy Covid, and PPCS signs could also be on account of impairment within the brainstem inflicting mitochondrial dysfunction, present in all three situations. Constriction within the brainstem may happen from a concussive impression or as a result of “A really good portion of ME/CFS sufferers have abnormalities in how the pinnacle is supported.” “The brainstem coordinates connectivity within the mind,” states Renz-Polster. “So, when it will get squished, that leads to a whole disruption of the connectivity and movement of data between the varied facilities that underlie our mind capabilities.”
Renz-Polster’s brainstem constriction principle is supported by new analysis exhibiting that the brainstem is especially inclined to viral an infection. So, TBI or a virus may injury the liner across the mind and brainstem, leading to an inflow of inflammatory molecules that hurt the blood vessels feeding the mitochondria. With out ample blood movement, the mitochondria can’t produce sufficient vitality for the mind and physique to operate correctly, which can be the reason for the cognitive and neurological signs seen in sufferers with ME/CFS, PPCS, and Lengthy Covid. Happily, Renz-Polster says that his principle might be examined utilizing an advanced MRI technique to check the brainstem; the outcomes of such analysis could be one thing to stay up for. If his brainstem constriction principle is right, it has the potential to revolutionize therapy choices and supply new insights into the mechanisms leading to signs for sufferers with ME/CFS, PPCS, and Lengthy Covid.
Renz-Polster additionally notes that the brainstem is a part of the default mode community and that psychedelics have the potential to modulate this community with therapeutic advantages. He references a current examine the place therapy with the psychedelic ibogaine improved the functioning of veterans with a historical past of TBI; see our weblog put up about this groundbreaking ibogaine study. Moreover, the BBC article references a case examine of Lengthy Covid signs bettering after MDMA and psilocybin therapy.
