A therapeutic intervention using the AKL-T01 video game was found to improve cognitive processing speed and task-switching performance in individuals with persistent cognitive deficits following COVID-19 infection. While sustained attention did not significantly improve compared to the control group, participants reported improvements in quality of life. The study was published in Neuropsychopharmacology.
Cognitive deficits after COVID-19, often referred to as “brain fog,” have been reported in a substantial portion of individuals, even after mild or moderate illness. These deficits commonly affect attention, memory, executive function, and processing speed. Research indicates that such impairments can persist for months after the initial infection, impacting daily functioning and overall well-being.
In some cases, the severity of cognitive decline has been likened to aging by several years. Neuroinflammation, microvascular injury, and autoimmune responses are among the proposed mechanisms behind these changes. Brain imaging studies have shown structural and metabolic alterations in regions associated with memory and cognition in post-COVID patients. While some individuals gradually recover, others experience prolonged or worsening symptoms, particularly those with long COVID.
Study author Lindsay W. Victoria and her colleagues aimed to evaluate the effectiveness of the AKL-T01 intervention in individuals with cognitive dysfunction following COVID-19 infection. The intervention targeted deficits in attention and executive function.
AKL-T01 is a digital therapeutic program designed to improve attention and executive control. Delivered via smartphone or tablet, the program features a video game-like interface and uses a proprietary game engine to engage specific neural systems involved in attention regulation. The game dynamically adjusts its difficulty based on the user’s performance, offering personalized cognitive challenges intended to enhance attention and executive functioning.
The study included 98 participants with a confirmed history of COVID-19 and evidence of executive function impairment. Participants were recruited through physician referrals and post-COVID care programs.
Participants were randomly assigned to one of two groups. The intervention group was instructed to use AKL-T01 at least five days per week for six weeks, with each session lasting 20–25 minutes and consisting of five in-game missions. The control group was placed on a waitlist and did not receive any intervention during the study period.
All participants completed a series of assessments at baseline and after six weeks. These included measures of sustained attention (the TMB Digital Symbol Matching Task), functional disability (the WHO Disability Assessment Schedule), self-reported health-related quality of life, and cognitive dysfunction in everyday life. Additional cognitive tests evaluated working memory, processing speed, and executive control.
The results showed no significant difference in sustained attention between the intervention and control groups. However, participants who engaged with AKL-T01 demonstrated improvements in task-switching accuracy and processing speed. They also reported reduced functional disability and enhanced quality of life.
“Despite the lack of improvement in sustained attention, select post-COVID-19 cognitive deficits may be ameliorated by targeted cognitive training with AKL-T01, with associated improvements in quality of life and fatigue. If replicated, the scalable nature of this digital intervention may help address substantial need for accessible, effective treatments among individuals with long COVID,” the study authors concluded.
The findings highlight the potential of AKL-T01 as a digital intervention for cognitive symptoms related to long COVID. However, it is important to note that these results apply specifically to this particular therapeutic game. Outcomes from studies using different digital interventions may vary.
The paper, “A digital intervention for cognitive deficits following COVID-19: a randomized clinical trial,” was authored by Lindsay W. Victoria, Lauren E. Oberlin, Irena P. Ilieva, Abhishek Jaywant, Dora Kanellopoulos, Catherine Mercaldi, Caitlin A. Stamatis, Deborah N. Farlow, Scott H. Kollins, Ochuwa Tisor, Sama Joshi, Raura Doreste-Mendez, Roy H. Perlis, and Faith M. Gunning.