Update on our national conference
Due to COVID-19, we have rescheduled our conference in Ottawa for June 2-4, 2021. Registration is open, and conference details will be updated regularly as they become available.
Addressing the neurological consequences of COVID-19
Provided by corporate sponsor VoxNeuro
The world has been overwhelmed by the onslaught of the COVID-19 virus. What we’re all just beginning to understand is how this virus affects the different parts of our body – including the brain. The medical community has repeatedly reported that the virus crosses the “blood-brain barrier” – a very effective border keeping harmful substances from entering the brain – and thus has an effect on the brain and nervous system that can continue beyond the duration of the illness [1-3]. Long-lasting cognitive issues are a common outcome of a brain and nervous system affected by an illness like the COVID-19 virus. While communities are having varying levels of success in getting ahead of this dangerous virus (as of early April, 2020), there is an equally damaging consequence looming: Front line medical personnel (e.g., medical specialists and neurologists) are reporting brain injury symptoms in up to 45% of COVID-19 patients (1). This aspect of COVID-19 does not surprise researchers due to evidence that viruses of this kind have been shown to affect the brain, causing negative behavioral and cognitive changes (learning, memory) in people of all ages (7,8,15,16). In fact, it has been suggested that the respiratory symptoms in these disorders, and in particular COVID-19, may not cause the observed brain injury symptoms, but rather the reverse – that is, the respiratory problems may be the result of the brain changes from the virus crossing the blood-brain barrier. There is now undeniable evidence that even “lesser” viruses such as the highly contagious flu virus (influenza virus type A) can result in a compromised brain and nervous system.
Research has demonstrated a specific link between the human coronavirus and neurological disease by showing the virus is capable of crossing into the human brain. The same research team hypothesizes that the human coronavirus may cause neurological diseases such as multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, and encephalitis (8).
A recent report in the New York Times (April 1, 2020 RC Rabin: Some Coronavirus Patients Show Signs of Brain Ailments) describes an older patient diagnosed as suffering from COVID19 with CT and MRI brain scans indicating swelling, inflammation and brain cell death. The report states, “The pattern of involvement, and the way that it rapidly progressed over days, is consistent with viral inflammation of the brain. This may indicate the virus can invade the brain directly in rare circumstances.”
These U.S. reports make similar observations to those already seen in Italy where the severity of the brain and nervous system effects have led to COVID-19 being described as a microorganism that can cause nervous system disease. Many countries have already begun opening centres designed specifically for the assessment and treatment of the neurological effects of COVID-19. For example, the University of Brescia (Italy) is not alone in opening a NeuroCovid unit due to the dramatic increase in issues with the body’s blood system, like stroke and thrombosis. In China, almost half of the patients with severe respiratory symptoms from COVID-19 also had brain injury symptoms, including stroke and abnormalities associated with consciousness. Overall, between ⅓ to ½ of COVID-19 patients are reported as displaying neurological symptoms.
The ability of an objective, cognitive assessment to identify what aspects of cognitive function show a deficit and track cognitive function over time makes it possible to verify if and when an individual is back to healthy cognitive performance. This subsequently assists with streamlining treatment and ultimately reduces healthcare resources – enabling the healthcare system to continue their focus on the active symptoms of COVID-19. It is also imperative to note that even with the eventual discovery of an established vaccine, and the world returning to its “normal” routine, there will still be thousands of individuals recovering from the virus who will be seeking cognitive rehabilitation. A cognitive assessment based on neuro-markers will be able to inform rehabilitation specialists with the objective data required to accelerate recoveries so individuals can return to the workforce quicker and contribute to the economy sooner in a time of (likely) economic instability.
Finally, a truly objective cognitive assessment will be a particularly valuable service to assess patients and assist healthcare professionals in the post-COVID period. For the duration of COVID-19’s demands on our healthcare system, many patients who have sustained mild-to moderate brain injuries will not have been seen as efficiently as usual within our healthcare system. This situation is unavoidable given the impact of COVID-19 on healthcare facilities as well as the justified restrictions on our movements in cities and towns across the country. For this reason there is anticipated to be a surge of patients and clients in need of healthcare providers. Rapid and objective cognitive assessments help to streamline the patient pathway, facilitate the assessment of large numbers of patients and quickly provide valuable information to health professionals as they make their treatment and care decisions.
Information provided by Dr. John F. Connolly, Chief Science Officer of VoxNeuro, Director of ARiEAL Research Centre, and Professor at McMaster University.
Learn more about Cognitive Health Assessments™ at voxneuro.com
- Mao, Wang, Chen, … Hu (February 24, 2020). Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: A Retrospective Case Series Study. Available at SSRN:https://ssrn.com/abstract=354840
- Poyiadji et al., (online: March 31, 2020). COVID-19–associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI:https://doi.org/10.1148/radiol.2020201187
- Nath, (2020). Neurologic complications of coronavirus infections. Neurology, DOI: 10.1212/WNL.0000000000009455
- Espinoza, Bohmwald, Cespedes, … Kalergis. (2013). Impaired learning resulting from respiratory syncytial virus infection. Proceedings National Academy Sciences USA 110(22):9112–9117. DOI:10.1073/pnas.1217508110
- Beraki, Aronsson, Karlsson, Ogren, & Kristensson. (2005). Influenza A virus infection causes alterations in expression of synaptic regulatory genes combined with changes in cognitive and emotional behaviors in mice. Molecular Psychiatry. 10(3):299–308. DOI: 10.1038/sj.mp.4001545
- Jurgens, Amancherla, & Johnson. (2012). Influenza infection induces neuroinflammation, alters hippocampal neuron morphology, and impairs cognition in adult mice. Journal Neuroscience. 32(12):3958–3968. DOI: 10.1523/JNEUROSCI.6389-11.2012
- Desforges, Le Coupanec, Brison, Meessen-Pinard & Talbot. (2014). Neuroinvasive and Neurotropic Human Respiratory Coronaviruses: Potential Neurovirulent Agents in Humans. In, R. Adhikari and S. Thapa (eds.), Infectious Diseases and Nanomedicine I, 75 Advances in Experimental Medicine and Biology 807, DOI: 10.1007/978-81-322-1777-0_6, Springer India.
- Morfopoulou, Brown, Davies, … Talbot & Breuer. (2016). Human Coronavirus OC43 Associated with Fatal Encephalitis. New England Journal of Medicine, 375 (5): 497 DOI: 10.1056/NEJMc1509458
- Jang, Boltz, Webster, & Smeyne. (2009). Viral parkinsonism. Biochimica Biophysica Acta 1792(7):714–721. DOI:10.1016/j.bbadis.2008.08.001
- Zeng, Wang, & Kang-Sheng. (2013) Influenza virus and CNS infections. In: Singh & Ruzek (eds) Neuroviral Infections. RNA viruses and retroviruses. CRC Press/Taylor and Francis, Boca Raton, pp 325–339. DOI: 10.1007/978-81-322-1777-0
- Wang, Li, Li. (2010) Acute encephalopathy and encephalitis caused by influenza virus infection. Current Opinion Neurology. 23(3):305–311. DOI: 10.1097/wco.0b013e328338f6c9
- Millichap & Millichap. (2006). Role of viral infections in the etiology of febrile seizures. Pediatric Neurology. 35(3):165–172. doi:10.1016/j.pediatrneurol.2006.06.004
- Toovey. (2008). Influenza-associated central nervous system dysfunction: a literature review. Travel Medicine Infectious Disease 6(3):114–124. doi:10.1016/j.tmaid.2008.03.003
- Ozkale, Erol, Ozkale, Demir, & Alehan. (2012). Acute disseminated encephalomyelitis associated with influenza A H1N1 infection. Pediatric Neurology, 47(1):62–64. DOI: 10.1016/j.pediatrneurol.2012.03.019
- Kawashima H, Ioi H, Ushio M, Yamanaka G, Matsumoto S, Nakayama T (2009) Cerebrospinal fluid analysis in children with seizures from respiratory syncytial virus infection. Scand J Infect Dis 41(3):228–231. DOI:10.1080/00365540802669543
- Millichap JJ, Wainwright MS (2009) Neurological complications of respiratory syncytial virus infection: case series and review of literature. J Child Neurol 24(12):1499–1503. DOI:10.1177/0883073808331362
For more information on COVID-19 and neurology:
- The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings: https://academic.oup.com/brain/article/doi/10.1093/brain/awaa240/5868408#supplementary-data
- Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study: https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(20)30287-X.pdf
Meet Jonathan McMurray
My name is Jonathan McMurray and I have been living with a traumatic brain injury since 1995. This story begins in August 1995 in Riviere Du Loup, Quebec. My life changed forever that day, late at night in the dark along the Trans-Canada highway near the New Brunswick border.
Brain Injury Across Canada
June was Brain Injury Awareness Month. Our goal this year was to bring more awareness to the prevalence of brain injury in Canada and the fact that it can happen to anyone, anywhere, anytime. We shared stories, video interviews, and information about brain injury using the hashtag #BrainInjuryAcrossCanada.