Reduced TMS-evoked EEG oscillatory activity in cortical motor regions in patients with post-COVID fatigue

IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY
Elias P. Casula , Romina Esposito , Sabrina Dezi , Paola Ortelli , Luca Sebastianelli , Davide Ferrazzoli , Leopold Saltuari , Valentina Pezzopane , Ilaria Borghi , Lorenzo Rocchi , Valentina Ajello , Eugen Trinka , Antonio Oliviero , Giacomo Koch , Viviana Versace
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Abstract

Objective

Persistent fatigue is a major symptom of the so-called ’long-COVID syndrome’, but the pathophysiological processes that cause it remain unclear.

We hypothesized that fatigue after COVID-19 would be associated with altered cortical activity in premotor and motor regions.

Methods

We used transcranial magnetic stimulation combined with EEG (TMS-EEG) to explore the neural oscillatory activity of the left primary motor area (l-M1) and supplementary motor area (SMA) in a group of sixteen post-COVID patients complaining of lingering fatigue as compared to a sample of age-matched healthy controls. Perceived fatigue was assessed with the Fatigue Severity Scale (FSS) and Fatigue Rating Scale (FRS).

Results

Post-COVID patients showed a remarkable reduction of beta frequency in both areas. Correlation analysis exploring linear relation between neurophysiological and clinical measures revealed a significant inverse correlation between the individual level of beta oscillations evoked by TMS of SMA with the individual scores in the FRS (r(15) = -0.596; p = 0.012).

Conclusions

Post-COVID fatigue is associated with a reduction of TMS-evoked beta oscillatory activity in SMA.

Significance

TMS-EEG could be used to identify early alterations of cortical oscillatory activity that could be related to the COVID impact in central fatigue.

COVID 后疲劳患者皮层运动区的 TMS 诱发脑电图振荡活动减少。
目的:持续疲劳是所谓 "长COVID综合征 "的一个主要症状,但导致疲劳的病理生理过程仍不清楚。我们假设 COVID-19 后的疲劳与前运动区和运动区皮质活动的改变有关:方法:我们采用经颅磁刺激结合脑电图(TMS-EEG)的方法,对 16 名主诉持续疲劳的 COVID 后患者的左侧初级运动区(l-M1)和辅助运动区(SMA)的神经振荡活动进行了研究,并与年龄匹配的健康对照组样本进行了比较。通过疲劳严重程度量表(FSS)和疲劳评定量表(FRS)对患者的疲劳感进行评估:结果:COVID 后患者在这两个方面的贝塔频率都明显下降。探索神经生理学和临床测量之间线性关系的相关性分析表明,SMA 的 TMS 所诱发的个人 beta 振荡水平与 FRS 的个人评分之间存在显著的反相关性(r(15) = -0.596; p = 0.012):结论:COVID 后的疲劳与 TMS 诱发的 SMA β 振荡活动减少有关:TMS-EEG可用于识别皮层振荡活动的早期改变,这些改变可能与COVID对中枢疲劳的影响有关。
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来源期刊
Clinical Neurophysiology
Clinical Neurophysiology 医学-临床神经学
CiteScore
8.70
自引率
6.40%
发文量
932
审稿时长
59 days
期刊介绍: As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.
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