What EEGs say about COVID-19 and the mind

During the pandemic, healthcare workers saw more than just the lungs affected by COVID-19. Doctors have reported neurological complications such as stroke, headache, and seizures, but the information is limited to a number of individual reports that do not reflect a larger population.

Researchers from Baylor College of Medicine and the University of Pittsburgh have collected more than 80 studies that reviewed the data and identified similarities that help paint a broader picture of how COVID-19 affects the brain.

The findings, published in Seizure: European Journal of Epilepsy, focused on electroencephalogram (EEG) abnormalities of the brain. The EEG is a test that assesses electrical activity in the brain. The researchers found that about a third of patients who were given an EEG had abnormal imaging in the frontal lobe of the brain.

We found more than 600 patients affected in this way. Before, when we saw this in small groups we weren’t sure if this was just a coincidence, but now we can confidently say there is a connection.

Dr. Zulfi Haneef, Assistant Professor for Neurology / Neurophysiology in Baylor.

The main reason a patient would receive an EEG is if altered mentation is detected, which means that a patient may respond more slowly to stimuli, followed by seizure-like events, language problems, confusion, or inability to wake up after sedation. The most common findings from the EEG were slowing or abnormal electrical discharge, mainly in the frontal lobe.

Some of the EEG changes seen in COVID-19 patients may indicate brain damage that may not be repairable after recovering from the disease.

As we know, the brain is an organ that cannot regenerate. So if you do have damage, it is most likely permanent or you will not fully recover.

Dr. Zulfi Hanee

Haneef found the location of the abnormal activity interesting.

We know that the most likely entry point for the virus is the nose, so there appears to be a connection between the part of the brain that is right next to this entry point. Another interesting observation was that the average age of those affected was 61 years, one-third were female and two-thirds were male. This suggests that brain involvement in COVID-19 may be more common in older men. More research is needed, but these results show that we need to focus on these areas as we move forward.

Dr. Zulfi Hanee

It can’t always be the virus that acts directly on the brain and causes the abnormal EEG levels, Haneef said. This could be oxygen uptake, heart problems related to COVID-19, or some other type of side effect, which is why he says comprehensive patient care should include increased brain imaging or EEG testing if necessary.

These results show that we need to try the EEG on a larger number of patients, as well as other types of brain imaging such as MRI or CT scans, to get a closer look at the frontal lobe. Many people believe that they will get the disease, get healthy, and everything will go back to normal, but these results tell us that there could be long-term problems that we suspected and now we are finding more evidence of that.

Dr. Zulfi Hanee

Haneef worked closely with Dr. Arun Antony at the University of Pittsburgh. Haneef is also at the Michael E. DeBakey VA Medical Center.

Details on the study can be found here.

Read press release

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