Neurotherapy in long neuro-COVID Parkinson’s-like syndrome

The purpose of this article is to present: 1) the problem of neurodiagnosis of complex symptoms occurring after SARS-CoV-2 virus infection, and Covid-19 disease in a visual artist, using new neurotechnologies, which led to the diagnosis of long neuro-COVID Parkinson's-like syndrome; 2) the individualized neurotherapy program using EEG-Neurofeedback and art therapy, in the recovery of this artist and in improving her quality of life.A 51-year-old female patient, an artist, divorced and in good health, became ill in November 2021. First, there were supposed flu-like symptoms, temperature 38.9, dry cough, and muscle pain. She had also noticed a loss of smell. After a few days, dyspnea joined in. She was found positive for SARS-CoV-2 by use of a real-time RT-PCR test after a nasopharyngeal swab done on the day of admission to the ICU. The patient was treated with oxygen therapy for 11 days. Four months after the acute phase of COVID-19, the patient weakened and presented a set of neurological symptoms resembling Parkinson's disease (PD). Neurodiagnosis was conducted by a multidisciplinary team (a neurologist, a neuropsychiatrist, and a neuropsychologist) during several stays in neurology and psychiatry departments. As a result, long neuro-COVID Parkinson's-like syndrome was diagnosed. After a year of illness, the patient experienced increased cognitive symptoms, speech difficulties, and motor symptoms related to intentional tremor of all limbs. Gradually, bradykinesis (slowness of movement), asymmetric walking difficulties, postural instability, and falls typical of PD joined in. She moved exclusively with the help of a rehabilitation walker. The patient's health condition prevented her not only from the creative process but also from daily functioning. In the neurodiagnosis conducted by our team, not only MRI, but also the Human Brain Index (HBI) methodology was used, which provides diagnostics of various disease syndromes using quantitative qEEG and event-related potentials (ERPs) neuromarkers. Comparison of EEG spectra in all conditions with normative data from HBI revealed two striking facts in the patient: excess Rolandic beta (a neuromarker of Parkinson's disease) and frontal alpha asymmetry with a strong alpha component generated in the left frontal-temporal areas (a neuromarker of depression). Due to the identified changes, the patient was referred to specialized care, dopaminergic treatment, and antidepressants were introduced. An individualized neurotherapy program using EEG-Neurofeedback and art therapy tailored to the patient's needs was also proposed. The latest examination revealed that the artist, after a difficult period, returned to society. She supports herself, among other things, by selling her artworks, which significantly improved her quality of life.This case study highlights the complexity of diagnosing and treating long neuro-COVID Parkinson's-like syndrome in a visual artist. The use of advanced neurotechnologies, such as the Human Brain Index (HBI) methodology, was crucial in identifying specific neurological markers. The individualized neurotherapy program, incorporating EEG-Neurofeedback and art therapy, played a significant role in the patient's recovery and improvement in quality of life. This approach underscores the importance of personalized treatment plans and multidisciplinary care in managing long-term neurological effects of COVID-19.