The First Step to Clearing Up the Brain Fog

Whether it's COVID-19-related "brain fog" or other cognitive impairments, a new computerized tool may help provide crucial early screening.

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Cognitive impairment is on the rise in North America, and while Alzheimer’s disease, dementia, and brain trauma are leading factors, an emerging source is the “brain fog” phenomenon experienced by some COVID-19 patients.

No matter what the cause, people suffering from cognitive impairment often have trouble with memory, learning, focusing, or making decisions in their everyday lives. The level of impairment ranges in severity. Those with a milder form may start noticing subtle changes in their mental abilities, and those with severe impairment may be so debilitated that they can no longer live independently.

Mild cognitive impairments are seen as a transitional stage towards dementia, and many interventions aren’t as effective unless they are implemented early in the disease course, so early identification and action are important.

Currently, there is no standardized evaluation tool to screen for cognitive impairment similar to what we have for conditions like diabetes. Testing is often completed too late, when the patient’s abilities have already declined significantly, and even then it’s usually conducted through outdated and flawed methods like pen-and-paper exams.

Cognivue have developed the world’s first fully computerized, FDA-approved tool for screening cognitive impairment, significantly improving the ability of healthcare providers to make personalized assessments to get an earlier diagnosis and begin treatment before things get out of hand.

“We are seeing troubling trends related to post-COVID-19 syndrome, including what has been identified and referred to as ‘brain fog’, as well as numerous other clinical scenarios that drive a need for cognitive screening,” said Cognivue CMO Fred Ma in a press release.

“Access to Cognivue’s reliable cognitive assessment tool will have a significant and meaningful impact for Canadian patients and physicians.”

A bias-free, personalized cognitive assessment

Cognivue designed their system to eliminate testing biases and variability while establishing cognitive baselines and a monitoring system for continuous evaluation. The technology behind the device is based on neurophysiology and psychophysical research, and it dynamically tests brain functions like motor, visual, and sensory abilities. Even mild impairments in these areas could indicate the early onset of diseases like dementia, and there is a growing body of evidence supporting this idea.

The Cognivue system uses a proprietary algorithm that uniquely calibrates to each patient’s individual motor and visual abilities and continuously adapts to their performance, providing a personalized screening. The Cognivue test can be completed solo by a patient in under 10 minutes — which is about as long as it takes to do a pen-and-paper version administered by a healthcare professional — but the fact that the digital test is dynamic means it can zero in on even more subtle declines in cognition that happen early on.

The system makes it easy to keep on top of monitoring since the patient can perform the test during routine visits to their doctor without supervision.

Another benefit with Cognivue’s test is that even though it takes a similar amount of time to complete as pen-and-paper tests, it saves on time elsewhere since it can be administrated by the patient or by healthcare professionals other than a neuropsychologist.

The adaptive psychophysical element of Cognivue’s system removes bias from testing by making sure the responses are independent of education, social economics, and demographics. This is opposed to static pen-and-paper screening tools, which are subject to tester bias and aren’t usually administered unless the patient first raises a concern, which contributes to the issue of delayed treatments since the disease has already taken hold.

Screening for brain fog and Health Canada clearance

COVID-19-derived brain fog is not fully understood and it seems to vary from person to person. Some people who have recovered from the virus are reporting things like short-term memory loss, confusion, concentration issues, and just feeling off in general. Just like with regular cases of cognitive impairment, getting on the ball early with screening, diagnosis, and therapy may be essential for safeguarding the health of patients, and Cognivue is being put to work as a screening tool for this condition.

In December 2020, Cognivue received approval from Health Canada to implement its technology in healthcare settings across the country: “Health Canada approval is a meaningful expansion of Cognivue’s presence, which until now has been focused on the United States,” said CEO Tom O’Neill to Audiology Online.

“We are collaborating with pharmaceutical and medical device industries as well as nationally recognized professional institutions, organizations, and advocates on joint clinical research opportunities. These types of partnerships will enable us to generate additional clinical data that further supports the use of Cognivue as a reliable and sensitive alternative to traditional cognitive screening methods.”

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Barry is a journalist, editor, and marketer for several media outlets including HeadStuff, The Media Editor, and Buttonmasher Magazine. He earned his Master of the Arts in Journalism from Dublin City University in 2017 and moved to Toronto to pursue a career in the media. Barry is passionate about communicating and debating culture, science, and politics and their collective global impact.