By D.W.G. Kalani Tharanga, JadeTimes News
Unraveling the Mysteries of Long Covid and Long Concussion, Striking Parallels and New Horizons in Treatment
The similarities between Long Covid and post concussion syndrome have intrigued scientists, who hope that these parallels could unlock new understandings and treatments for both conditions. Midway through 2023, neurologist Ioannis Mavroudis, working at Leeds Teaching Hospitals NHS Trust, noticed that many Long Covid patients exhibited neurological symptoms strikingly similar to those seen in post concussion syndrome. This revelation could have significant implications for future research and treatment approaches.
Mavroudis observed that Long Covid patients often suffer from fatigue, sleep disturbances, light and noise sensitivity, exercise intolerance, and cognitive issues. These symptoms mirror those of post concussion syndrome, which can affect anyone who has experienced head trauma, from mild knocks to severe impacts. Post concussion syndrome is commonly seen in professional athletes, military veterans, and victims of physical abuse. Mavroudis believes that the condition results from the brain’s neurons demanding more energy than the brain can supply, leading to a cycle of fatigue.
In a scientific review of post concussion syndrome published in May 2023, Mavroudis highlighted these similarities. He was not alone in his observations. Researchers at the University of Denver had also noted parallels between the two conditions. Their studies applied standard concussion tests to Long Covid patients, revealing similar issues with eye tracking movements, balance, and spatial reasoning, suggesting these patients might have experienced a form of traumatic brain injury.
The Role of the Brainstem and Neuronal Connectivity
Herbert Renz Polster, a researcher at the University of Heidelberg, found these connections unsurprising. His work on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) revealed that many patients have hypermobility between the skull and upper spine, which can lead to brainstem constriction. This constriction disrupts the connectivity and flow of information in the brain, causing difficulties in adapting to various stresses.
Recent research has shown that the brainstem is particularly vulnerable to neurotropic viruses like SARS CoV 2. The ACE2 receptor, used by the virus to enter cells, is abundant in the brainstem, making it susceptible to infection and damage from immune activation. Renz Polster theorizes that initial trauma whether from a viral infection or physical impact can impair brainstem activity and disrupt the blood brain barrier. This disruption allows inflammatory molecules to damage the small blood vessels feeding the brain, affecting mitochondria, the energy factories of cells. This mitochondrial dysfunction can lead to the fatigue and cognitive issues seen in Long Covid, ME/CFS, and post concussion syndrome.
Exploring New Treatment Paradigms
While these explanations remain theoretical, they open up new avenues for research and treatment. Advanced scanning technologies, such as ultrahigh field MRI, could provide more detailed examinations of the brainstem. Psychedelic drugs like ibogaine, psilocybin, and ketamine, which modulate the default mode network in the brain, show potential for treating these conditions. A small study found that ibogaine and magnesium improved brain functioning in veterans with traumatic brain injury, and anecdotal reports suggest benefits for Long Covid patients from MDMA and psilocybin therapy. Additionally, the reactivation of latent viruses, such as herpes and varicella zoster, may contribute to ongoing symptoms. Strategies like administering the BCG vaccine for tuberculosis have shown some success in preventing viral reactivation, offering another potential treatment path.