对长期COVID认知症状的干预措施的评估:一项随机临床试验
David S Knopman1, Deborah Koltai2, Daniel T Laskowitz2
1Department of Neurology, Mayo Clinic, Rochester, Minnesota.
JAMA neurology
|November 10, 2025
概括
这项研究发现,认知训练,认知行为疗法和大脑刺激并没有改善长期COVID患者的认知症状. 对于有效的长期COVID认知功能障碍治疗,需要进一步的研究.
科学领域:
- 神经学 神经学
- 康复医学 康复医学 康复医学
- 传染性疾病 传染性疾病
背景情况:
- 认知功能障碍,包括疲劳和困惑,对于经历长期COVID (PASC) 后急性后续症状的人来说是一个持续的挑战.
- 长期COVID认知障碍的有效治疗仍然是一个重要的未满足的医疗需求,影响了许多幸存者的生活质量.
研究的目的:
- 评估基于证据的康复策略在改善与长期COVID相关的认知症状方面的有效性.
- 为了比较计算机化认知训练,认知行为康复和跨直流刺激 (tDCS) 与主动和假比较器的有效性.
主要方法:
- 进行了一项多中心,五臂随机临床试验,涉及认知长期COVID的328名参与者.
- 干预措施包括自适应式计算机认知训练 (BrainHQ),认知行为康复 (PASC-CoRE) 与BrainHQ,和tDCS与BrainHQ,远程交付超过10周.
- 主要结果是自我报告的修改后的日常认知量表2 (ECog2),该量表在干预期结束时进行评估.
主要成果:
- 在这三种主动干预措施 (BrainHQ,PASC-CoRE + BrainHQ,tDCS + BrainHQ) 中,与主动比较剂相比,没有一个在首要结局 (ECog2) 上显示出统计学上显著的好处.
- 二次结果和神经心理测试也没有透露跨治疗臂的差异性益处.
- 所有参与者,无论干预措施如何,随着时间的推移都显示出一些改善,并且没有严重的不良事件归因于干预措施.
结论:
- 这一第二阶段随机临床试验没有证明测试的干预措施对认知长期COVID的差异性益处.
- 这些发现表明,目前的远程康复策略,包括认知训练,认知行为疗法和tDCS,可能不足以解决长期COVID的认知功能障碍.
- 需要进一步的研究来开发和验证更有效的治疗方法,以治疗COVID-19感染后的认知障碍.
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