Video Game Therapy: A “Game Changer” for Post-COVID Brain Fog

You’ve just recovered from a mild case of Covid-19 and experienced the usual symptoms: stuffy nose, loss of taste and smell, sore throat…but something else isn’t right. You think little of it and go about your day as usual when suddenly it’s impossible to focus on reading the daily news, and it’s a little more difficult than normal to remember what you ate for dinner last night. There seems to be a layer of haze hovering over your brain, making it difficult to think clearly. This frustrating feeling is a long-term symptom of COVID called “brain fog,” and researchers around the country are experimenting with a novel form of therapy to combat it.

What Causes Brain Fog?

There are many layers to peel back when understanding what occurs inside the brain during a viral illness like COVID. Naturally, when a virus enters the human body, our immune system sends out inflammatory cells to fight the infection. Our immune system also produces antibodies – proteins made from plasma cells that identify and counteract a virus – that also cause inflammation.¹ Ultimately, brain fog is caused by inflammation due to the body’s natural response to fight off an infection.² Brain fog is categorized as a long COVID symptom due to prolonged inflammation in the brain, causing cognitive impairments.

Scientists propose that microglia cells are also responsible for causing this extended inflammation, but these cells are not meant to cause harm. The primary function of microglia cells is to clean up the brain: taking in and breaking down dead cells and materials.³ Their job changes when a virus or bacteria disrupts the body. When a virus is present, microglia cells emit signals to cause inflammation within brain tissue. When triggered, microglia cells also alter their shape and multiply within the brain.⁴ This can cause neurological harm like cell death and inhibit the production of new neurons within the hippocampus.⁵

The hippocampus, the part of the brain responsible for learning and memory, is greatly affected by the increased inflammation caused by microglia cells.⁶ Scientists Karen Ritchie, Dennis Chan, and Tam Watermeyer explain the extent to which the hippocampus is damaged in their scientific article, “The cognitive consequences of the COVID-19 epidemic: collateral damage.” When the hippocampus is affected by COVID, short-term deterioration may occur. Injury to the hippocampus explains why individuals experience forgetfulness and trouble paying attention post-COVID infection.

What is Video Game Therapy?

Researchers around the world are scrambling to find therapeutic methods that will alleviate the cognitive deterioration caused by brain fog. Akili Interactive, a biotech company that produced “digital therapeutic AKL-T01” created a prescription video game, called EndeavorRx for individuals with ADHD. They are currently the only company to have created an FDA-approved video game that requires authorization from a healthcare provider. Now, Akili is in the process of creating a specialized game for individuals suffering from brain fog. Their goal is to create “a new class of digital medicines for people living with cognitive impairment, delivered through captivating video game experiences.”⁷

Trial Process Breakdown

Clinical trials for a brain fog video game therapy are already underway with Akili Interactive and renowned research partners including Weill Cornell Medicine, New York-Presbyterian Hospital, and Vanderbilt University Medical Center. The research consists of a four-week study to evaluate the effectiveness of their AKL-T01 technology with 100 randomly assigned 18 to 89-year-olds. Fifty individuals will be treated with video game therapy, and the other half will serve as the control group. Akili states that the process of measuring the effectiveness of their technology will be determined using, “meaningful change in cognitive function, as measured by composite score of cognitive function, especially attention and processing speed.”⁸

Long-Term Effects

Dr. James Jackson, the leading psychologist for The Critical Illness, Brain Dysfunction and Survivorship Center at Vanderbilt University, is one of the contributors to Akili’s research. Dr. Jackson claims that most recovered patients are concerned about making careless mistakes in their workplace or having extreme difficulties focusing.⁹
In an interview with Akili Interactive, he expresses that this research is extremely meaningful to him as nearly 100 million people have contracted COVID in the U.S., and a good number of them are experiencing mental discrepancies. In fact, a University of Oxford study claims that 1 in 3 COVID patients developed a cognitive illness. As a result, 1 in 8 individuals with brain fog symptoms is experiencing anxiety for the first time.¹⁰

Obscure, yet Creative

The uncertainties of this pandemic have allowed for obscure, yet creative forms of therapies to emerge in an effort to treat long COVID. Researchers around the country are experimenting and creating video games designed for individuals that experience cognitive impairment, including brain fog. As nearly 100 million cases of COVID have been recorded in the U.S. and nearly 600 million cases reported worldwide, a crucial goal of this innovative therapy is to make it accessible to as many individuals as possible.¹¹

References

1. “NCI Dictionary of Cancer Terms.” National Cancer Institute, https://www.cancer.gov/publications/dictionaries/cancer-terms/def/antibody
2. “Inflammation: What Is It, Causes, Symptoms & Treatment.” Cleveland Clinic, https://my.clevelandclinic.org/health/symptoms/21660-inflammation
3. Haseltine, William A. “Even Mild Covid-19 May Cause Lasting Brain Fog (Part 1).” Forbes, Forbes Magazine, 2 Aug. 2022, https://www.forbes.com/sites/williamhaseltine/2022/08/01/even-mild-covid-19-may-cause-lasting-brain-fog-part-1/?sh=7af5a171fd6b
4. “What Are Microglia?” YouTube, 11 Sept. 2016, https://www.youtube.com/watch?v=L2t7eTYWnl0
5. Fernández-Castañeda, Anthony, et al. “Mild Respiratory Covid Can Cause Multi-Lineage Neural Cell and Myelin Dysregulation.” Cell, Elsevier, 12 June 2022, https://www.cell.com/cell/fulltext/S0092-8674(22)00713-9
6. Ritchie, Karen, et al. “Cognitive Consequences of the Covid-19 Epidemic: Collateral Damage?” OUP Academic, Oxford University Press, 28 May 2020, https://academic.oup.com/braincomms/article/2/2/fcaa069/5848404
7. Akili Interactive, https://www.akiliinteractive.com/
8. Akili technology: “Akili Collaborates with Weill Cornell Medicine, NewYork-Presbyterian Hospital and Vanderbilt University Medical Center to Study Digital Therapeutic Akl-T01 as Treatment for Covid Brain Fog.” Akili Interactive, Akili Interactive, 7 Apr. 2021
9. Ryll, Megan. “Ask the Experts: The Impact of Covid Brain Fog on Covid-19 Survivors.” Akili Interactive, Akili Interactive, 17 Dec. 2021, https://www.akiliinteractive.com/console-blog/ask-the-experts-the-impact-of-covid-brain-fog-on-covid-19-survivors
10. Elizabeth Cooney April, et al. “1 In 3 Covid-19 Patients Are Diagnosed with a Neuropsychiatric Condition in the Next Six Months, Large Study Finds.” STAT, 6 Apr. 2021
11. “Coronavirus Cases:” Worldometer, https://www.worldometers.info/coronavirus/?utm_campaign=homeAdvegas1%3F%22