以eeg -神经反馈为目标的神经心理康复治疗一位视觉艺术家因SARS-CoV-2感染后的创伤后应激障碍,随后出现严重的神经covid病程和长期药物昏迷的后遗症

IF 1 Q4 PSYCHOLOGY Acta Neuropsychologica Pub Date : 2022-11-13 DOI:10.5604/01.3001.0016.2024
M. Pąchalska
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引用次数: 5

摘要

本研究的目的有两个:1)评估目标导向的神经心理康复的有效性,采用脑电图-神经反馈,为一名视觉艺术家开发,该艺术家因感染SARS-CoV-2而患有创伤后应激障碍,随后出现了严重的神经covid病程和长期药理学昏迷的后遗症,2)评估QEEG/ERP结果,显示在受试者康复过程中迟发性创伤后应激障碍症状(根据DSM-5的定义)的减少。本研究描述了一名67岁的右手视觉艺术家在感染SARS-CoV-2后患有PTSD,导致严重的COVID-19病程并伴有急性呼吸窘迫综合征(ARDS)。她被送到ICU,戴上呼吸机,并在13周的药物诱导昏迷期间给予镇痛镇静治疗。回家后,她接受了康复治疗,以改善运动功能,并被转介到波兰神经心理学会的重返社会和培训中心进行进一步的诊断和治疗。在神经心理学诊断中,她表现出神经认知功能障碍,包括失去绘画能力。在康复过程中,她接受了:方案A包括目标导向的神经心理康复,包括艺术治疗,旨在减少神经认知功能障碍(Pąchalska 2008)。该项目历时9个月(2022年3月初至11月底)。2. 方案B基于最常用的脑电图-神经反馈形式:频率/功率脑电图-神经反馈,使用2个双极表面电极,称为“表面神经反馈”(Kropotov 2016)。她在C3接受了Theta/Beta, SMR训练,包括(1)加强Beta1,抑制Theta +抑制Beta 2,(2)在C4,根据国际10-20系统,加强SMR,抑制Theta +抑制Beta (Thompson & Thompson 2012)。这个项目是在被诊断患有晚发性PTSD症状(根据DSM-5的定义)后进行的,从8月初到11月底,每周两次。神经covid的几乎所有短期和长期副作用(包括创伤后应激障碍)的程度都有所降低。这位艺术家有了明显的进步,又能继续画画了。她在病后创作的艺术品受到艺术品收藏家的追捧,这提高了病人的生活质量。以目标为导向的神经心理康复,对感染SARS-CoV-2后出现严重神经症状和长期药理学昏迷后遗症的PTSD患者进行脑电图-神经反馈治疗,可能有助于减轻短期和长期神经认知功能障碍,包括减轻PTSD症状。
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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
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.
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