Goal-oriented neuropsychological rehabilitation with EEG-Neurofeedback for a visual artist with PTSD resulting from SARS-CoV-2 infection, followed by severe course of neuroCovid and the sequelae of long term pharmacological coma

Abstract

The purpose of the study was twofold: 1) to evaluate the effectiveness of goal-oriented neuropsychological rehabilitation, with EEG-Neurofeedback, developed for a visual artist with PTSD resulting from infection with SARS-CoV-2, followed by severe course of neuroCovid and the sequelae of long term pharmacological coma, 2) to evaluate QEEG/ERP results showing a reduction of late-onset PTSD symptoms (as defined by DSM-5) over the course of the subject’s rehabilitation. The present study describes a 67-year-old right-handed visual artist with PTSD after infection with SARS-CoV-2, resulting in severe course of COVID-19 complicated by acute respiratory distress syndrome (ARDS). She was send at ICU, put on a respirator and treated with analgesic sedation during 13 weeks of pharmacologically induced coma. After returning home she received rehabilitation to improve motor functioning, and was referred for further diagnosis and therapy to the Reintegration and Training Center of the Polish Neuropsychological Society. In neuropsychological diagnosis she presented with neurocognitive dysfunctions, including lost ability to paint. In the course of rehabilitation she received: 1. Program A consisted in goal-oriented neuropsychological rehabilitation, including art therapy, aimed at the reduction of the neurocognitive dysfunctions (Pąchalska 2008). This program lasted for 9 months (from the beginning of March till the end of November 2022). 2. Program B based on the most commonly used form of EEG-Neurofeedback: frequency/ ower EEG-Neurofeedback, using 2 bipolar surface electrodes, called “surface neurofeedback” (Kropotov 2016). She received Theta/Beta, SMR training on C3, including (1) strengthening Beta1 and inhibiting Theta + inhibiting Beta 2,and (2) at C4, strengthening SMR and inhibiting Theta + inhibiting Beta, based on the international 10-20 system (Thompson & Thompson 2012). This program was given after a diagnosis of PTSD with late onset symptoms (as defined by DSM-5), from the beginning of August till the end of November, twice a week. Almost all the short and the long-term side effects of neuroCOVID (including the PTSD) were reduced in magnitude. The artist showed marked improvement and was able to return to painting. The artwork she made after her illness is in high demand with art collectors, which has improved the patient's quality of life. Goal-oriented neuropsychological rehabilitation, with EEG-Neurofeedback administered for patient with PTSD resulting from infection with SARS-CoV-2, followed by severe course of neuroCovid symptoms and the sequelae of long term pharmacological coma, might be helpful in the reduction of short and long term neurocognitive dysfunctions, including the reduction of PTSD symptoms.