Multimodal Neuropsychological Rehabilitation of Patients with Post-COVID Cognitive Impairment

Background: post-COVID cognitive impairment is an important medical and social problem. Many studies focus on the analysis of the characteristics of cognitive impairment after infection, but neurorehabilitation issues are rarely considered. The aim was to study the effectiveness of combined use of neuropsychological correction and rhythmic magnetic stimulation (rTMS) in the rehabilitation of patients with post-COVID cognitive impairment. Patients and Methods: two groups of 20 people with postCOVID cognitive impairment were compared: group 1 underwent rehabilitation using a multimodal method, group 2 — according to the standard program. The areas of rTMS stimulation were selected based on high-quality neuropsychological diagnostics, which made it possible to identify and form the patient’s neuropsychological profile. The correction program was based on the identified neuropsychological profile and developed individually for each patient. The Montreal Cognitive Assessment, Frontal Area Dysfunction Battery, Clock Drawing Test, Semantic Verbal Fluency Test, 10-Word Learning, Symbolic-Digit Coding Test, Subjective Asthenia Inventory (MFI-20), and Hospital Anxiety and Depression Scale (HADS) were used to assess the state of higher mental functions. Results: after correction, significant differences were found in the MoCA, 10-Word Learning, Symbolic-Digit Coding, and MFI-20 scales, with higher scores in group 1. Comparative analysis showed significant differences in score dynamics between the groups, with group 1 demonstrating better results. Conclusions: multimodal neuropsychological rehabilitation in combination with rTMS demonstrates significantly higher results compared to standard rehabilitation protocols established in the order of the Ministry of Health of the Russian Federation dated July 31, 2020 No. 788n “On approval of the Procedure for organizing medical rehabilitation of adults” [1], as well as with clinical recommendations presented on the website of the Union of Rehabilitation Specialists of Russia [2–4].

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