Complex psychological evaluation and correction methods of disorders in the emotional and personal sphere in children with post-COVID syndrome, considering structural and functional features of the brain by Inga A Plotnikova* in Journal of Clinical & Medical Case Reports, Images (JCMCRI)
Abstract Introduction: A number of systematic reviews on the PubMed and Scopus databases confirmed that post-COVID syndrome in children is a topical issue and is considered mainly in terms of the influence of social factors. The COVID-19 pandemic by itself and lockdown have created fear and anxiety around the world, leading to short- and long-term consequences for the psychosocial and mental health of children and adolescents. The reviews analyzed studies to understand the major effects of COVID-19 in children with the goal of developing effective treatment strategies. However, such strategies must be designed with consideration of the pathogenetic echanisms that explain the deleterious effects of COVID-19 on the central nervous system. In the meantime, the evidence for long-term effects on neurodevelopment after COVID-19 should be further investigated. The timing of the resolving of neurological damage or the ppearance of nervous dysfunction is still largely unclear, due to the fact that this disease has only recently become known to the world. The present study in this area aims to help in the rehabilitation of children after COVID-19. Purpose of the study. Development of rehabilitation programs for children with postCOVID syndrome, which is based on a comprehensive psychological assessment of the cognitive and emotional sphere, taking into account the structural and functional characteristics of the brain.
Materials and methods. 25 children (9 girls and 16 boys) aged from 12 to 17 years were admitted to the hospital, among them 9 children were in a state of moderate severity of acute respiratory infections and indication of family contact with COVID-19 patients. 16 children had mild form of COVID-19 during the 12 months preceding the examination, including 8 children (50%) in the previous 4 months and 8 (50%) in the previous 6-12 months. The control group consisted of 25 students in Moscow (14 girls and 11 boys) aged from 12 to 16 years, who were examined before the pandemic. Examination methods consisted of 2 blocks. In the first block we investigated: kinesthetic, spatial, dynamic, graphic praxis; auditory-motor coordination; visual, object-constructive gnosis; auditory-verbal, visual memory; voluntary attention; and thinking. The second block of methods were “Eysenck Questionnaire” for studying three individual qualities: introversion - extroversion, neuroticism and deceit, “Lüscher Color Test. Diagnosis of a neuropsychic state,” adapted by V.I. Timofeeva, Yu.I. Filimonenko, which is an assessment of psycho-functional state (determination of the level of unproductive neuropsychic tension or total deviation from the autogenic norm; autonomic coefficient).
Results: Significant differences were found with the neuropsychological tests in the control group, suggesting impairment of memory, attention, visual gnosis, visuospatial function, kinesthetic and dynamic praxis, verbal and non-verbal components of thinking. In 85% of children with post-Covid syndrome, two primary colors are in the last three places of the color gamut in the Luscher test. In 65% of cases, the presence of gray is at the beginning of the color scheme. Compensatory mechanisms were observed in 55% of cases. Conclusions. Complex psychological examination in children with post-COVID syndrome has showed that the revealed changes in the emotional and personal sphere have a common pathogenesis with cognitive impairments (auditory-speech memory disorders, insufficiency of optical-spatial gnosis and praxis, verbal and non-verbal intelligence). Disorders of higher mental functions, changes in the emotional and personal sphere and the nature of neurological complaints indicate the involvement of the mediobasal parts of the brain, reticular formation, brain stem, basal ganglia, which provide energetic activation of brain activity and modally nonspecific brain functions. When developing neuropsychological rehabilitation programs for children with post-Covid syndrome, it is necessary to observe the principle of unity of diagnosis and correction, which makes it possible to determine the topic of brain damage in the relationship of the cognitive and emotional-personal spheres, to conduct restorative training using the method of “replacement dysontogenesis”, relying on intact functions.
Key words: pediatric neuropsychology, long-term consequences of COVID-19, neurocognitive tests, cognitive functions, disorders in the emotional and personal sphere.