Attention Training for Long COVID

(LongCovAtten Trial)

Overseen By Kathryn Magee, MHS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Shirley Ryan AbilityLab

Disqualifiers: Neurological conditions, Severe depression, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 4 weeks

60 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if an Attention Processing Training program can alleviate brain fog in individuals with Long COVID. Participants will either engage in attention training (a cognitive therapy), listen to music, or begin the training at a later time. Ideal candidates are those in the Chicagoland area who have experienced COVID-19 and now face brain fog that disrupts daily life, beginning a few months post-infection. As an unphased trial, this study provides a unique opportunity to contribute to understanding new methods for alleviating brain fog symptoms.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Attention Training is generally safe for people. This training improves focus and the ability to switch attention. Studies have found it can assist with attention problems, such as those seen in Long COVID. No reports of serious side effects from Attention Training exist.

The enhanced music experience offered in the trial is also safe. Listening to music is usually harmless and can even aid relaxation and mood.

Since this trial does not involve drugs or invasive treatments, the risk of negative effects remains minimal. Participants can feel confident that the activities are low-risk. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Attention Training for Long COVID because it offers a novel approach to addressing cognitive issues linked with the condition. Unlike conventional treatments that might focus on pharmacological interventions or generalized cognitive therapy, this method uses a computer-based program called APT-3, which adapts to the individual's progress to enhance attention skills. Delivered through a combination of in-person and remote sessions, it offers flexibility and personalized progression, making it distinct from more traditional therapies. Additionally, the hybrid delivery model makes it accessible and convenient for participants, potentially improving adherence and outcomes.

What evidence suggests that this trial's treatments could be effective for brain fog symptoms in Long COVID?

Research shows that Attention Training, which participants in this trial may receive, can help improve focus and task-switching abilities. This might ease brain fog symptoms in people with Long COVID. Previous studies suggest that these exercises enhance concentration and thinking skills. These benefits are especially important for those who struggle with attention after having COVID-19. ^{1 6 7 8 9}

Who Is on the Research Team?

Shira Cohen-Zimerman, PhD

Principal Investigator

Shirley Ryan AbilityLab

Elliot Roth, MD

Principal Investigator

Shirley Ryan AbilityLab

Are You a Good Fit for This Trial?

This trial is for adults aged 18-65 who have had COVID-19 and are experiencing 'brain fog' that affects daily life. Participants must have attentional deficits, be able to use a keyboard, consent independently, and communicate in English. Those with severe depression, recent chemotherapy or radiation treatment, active substance abuse, or certain pre-existing neurological conditions cannot join.

Inclusion Criteria

I have attention issues confirmed by specific tests.

I've had memory or thinking problems since getting COVID-19.

I have had a confirmed case of COVID-19.

Exclusion Criteria

I have been diagnosed with severe depression.

I have had chemotherapy or radiation in the past 6 months.

Active substance abuse

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either the Attention Training or Music Program intervention for 4 weeks

4 weeks

Hybrid model: in-person, remote, and independent sessions

Follow-up

Participants are monitored for changes in attention test scores and completion of study tasks

2 years

Optional Attention Training

Participants in the Delayed Attention Training group have the option to complete the Attention Training after initial assessments

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Attention Training

Trial Overview

The study tests if an Attention Processing Training program can help improve the brain fog symptoms associated with Long-Covid. It also examines whether this training can be effectively completed online.

How Is the Trial Designed?

Group I: Music Program Experimental Treatment 1 Intervention

This group will receive an enhanced music experience. They will listen to pre determined music for 30 minutes per day, 5 days a week, for 4 weeks (10 hours total over 4 weeks). This will be delivered in a hybrid model that will combine, in person, remote, and independent sessions, similar to the Attention Training group. Once they complete the music program, they will have the option to complete the Attention Training.

Group II: Attention Training Experimental Treatment 1 Intervention

The computer based APT-3 intervention will be delivered in a hybrid model that will combine in-person therapy sessions at Shirley Ryan AbilityLab and practice sessions which will be completed remotely. The dosing of each intervention training will be 30 minutes per day, 5 days a week, for 4 weeks (10 hours total over 4 weeks). The difficulty of the tasks in both interventions will increase progressively as the participants improve in their skills. APT-3 treatment will be administered by a trained and certified speech-language pathologist.

Group III: Delayed Attention Training Active Control 1 Intervention

This group will not be provided any program for the initial 4 weeks. After they complete the week 5 assessments, they will have the option to complete the Attention Training.

Who Is Running the Clinical Trial?

Shirley Ryan AbilityLab

Lead Sponsor

Trials

212

Recruited

17,900+

Published Research Related to This Trial

The proposed hierarchical multimodal architecture effectively classifies sentiment and emotion from both text and audio data, addressing challenges in feature extraction and modality interaction.

This model outperforms existing state-of-the-art methods on published datasets and provides visual interpretability through synchronized attention across modalities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multimodal Affective Analysis Using Hierarchical Attention Strategy with Word-Level Alignment. Gu, Y., Yang, K., Fu, S., et al.[2023]

A pilot intervention training military veterans in emotion regulation strategies (Focused Attention and Cognitive Reappraisal) over 5-8 weeks showed significant improvements in psychological well-being, including enhanced working memory and self-efficacy.

Neuroimaging results indicated that the training led to changes in brain connectivity, suggesting that resilience and emotional well-being can be developed through targeted training, with observable effects on brain function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cultivating Affective Resilience: Proof-of-Principle Evidence of Translational Benefits From a Novel Cognitive-Emotional Training Intervention. Dolcos, S., Hu, Y., Williams, C., et al.[2021]

The proposed visual attention convolutional neural network (VACNN) significantly improves speech emotion recognition (SER) performance across different datasets, achieving overall accuracies of 83.33% for RAVDESS, 86.92% for EmoDB, and 75.00% for SAVEE.

By utilizing a bag of visual words (BOVW) to enhance feature extraction, the VACNN method outperformed existing state-of-the-art cross-corpus SER approaches by 7.73% on RAVDESS, 15.12% on EmoDB, and 2.34% on SAVEE, demonstrating its effectiveness in generalizing across different emotional speech datasets.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fusing Visual Attention CNN and Bag of Visual Words for Cross-Corpus Speech Emotion Recognition. Seo, M., Kim, M.[2021]

The proposed dyadic fusion network improves emotion recognition in communication by using an attention mechanism to efficiently fuse different types of data, achieving 3.8%-7.5% higher accuracy than previous models on the IEMOCAP and MELD datasets.

By transforming the annotation process into a regression problem, the model effectively addresses label disagreements, leading to more accurate emotion predictions and better utilization of the available data.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mutual Correlation Attentive Factors in Dyadic Fusion Networks for Speech Emotion Recognition. Gu, Y., Lyu, X., Sun, W., et al.[2020]

Neurofeedback training using real-time fMRI allowed 15 healthy participants to learn to control the activity levels between the sustained attention network (SAN) and the default-mode network (DMN), leading to improved self-regulation of attention.

While participants showed some improvement in sustained attention after training, the effects were temporary and similar to practice effects, indicating that further research is needed to establish the long-term efficacy of this non-invasive attention training method.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Network-based fMRI-neurofeedback training of sustained attention. Pamplona, GSP., Heldner, J., Langner, R., et al.[2021]

The Attention Training Technique (ATT) significantly improved attentional performance in healthy participants, as evidenced by faster reaction times in tasks like dichotic listening and attentional bias after both two and four doses of ATT.

These results suggest that ATT enhances attentional flexibility, which could potentially benefit individuals with psychiatric disorders such as depression and anxiety, making it a promising therapeutic tool.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Shifting Instead of Drifting - Improving Attentional Performance by Means of the Attention Training Technique. Barth, V., Heitland, I., Kruger, THC., et al.[2023]

Intensive working memory (WM) training can lead to improvements in cognitive functions beyond the training task, including gains in fluid intelligence, as shown in a study with 45 participants.

Training with emotional material specifically enhances the ability to control emotional information, indicating that the type of material used in brain-training is crucial for achieving transferable cognitive benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Extending brain-training to the affective domain: increasing cognitive and affective executive control through emotional working memory training. Schweizer, S., Hampshire, A., Dalgleish, T.[2022]

A 20-day training program focused on emotional working memory significantly improved the efficiency of the brain's frontoparietal network, which is crucial for both working memory and affective cognitive control.

Participants who underwent this emotional working memory training showed enhanced emotion regulation abilities compared to those who received placebo training, indicating that this approach could be beneficial in clinical and occupational settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training the emotional brain: improving affective control through emotional working memory training. Schweizer, S., Grahn, J., Hampshire, A., et al.[2023]

Selective attention to positive information can help regulate emotions, suggesting that attention is a valuable tool for improving emotional experiences.

Training in attentional regulation, particularly through meditative practices, has shown promise in enhancing emotional well-being, indicating that attention can be developed as a skill for better emotion management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fixing our focus: training attention to regulate emotion. Wadlinger, HA., Isaacowitz, DM.[2022]

The study presents a comprehensive audio-visual dataset of 7,442 clips featuring emotional expressions from 91 actors, which allows for the analysis of how emotions are conveyed through both facial and vocal cues.

Recognition of emotions is highest when both audio and visual cues are combined (63.6%), with visual-only recognition being more effective than audio-only, highlighting the importance of multi-modal cues in accurately perceiving emotions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

CREMA-D: Crowd-sourced Emotional Multimodal Actors Dataset. Cao, H., Cooper, DG., Keutmann, MK., et al.[2020]

The study successfully combined facial video, audio, and lexical features to create more accurate affect estimators during conversations, significantly outperforming the baseline method in recognizing emotional states.

Using a particle filtering approach to integrate these modalities resulted in a correlation performance of 0.344 and 0.280 for continuous and word-level affect recognition, respectively, indicating a robust method for estimating emotions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Combining Video, Audio and Lexical Indicators of Affect in Spontaneous Conversation via Particle Filtering. Savran, A., Cao, H., Shah, M., et al.[2021]

The novel online contingent attention training (OCAT) was tested in two studies involving 64 undergraduates and 58 individuals during stressful periods, showing significant improvements in attention towards negative information and interpretation biases compared to a sham-control group.

Participants who underwent OCAT experienced reductions in rumination and anxiety symptoms, indicating that this training may effectively enhance emotion regulation and help individuals cope with major stressors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Online Contingent Attention Training (OCAT): transfer effects to cognitive biases, rumination, and anxiety symptoms from two proof-of-principle studies. Blanco, I., Boemo, T., Martin-Garcia, O., et al.[2023]

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