When COVID-19 ‘Brain Fog’ hit, they turned to a language app
Meet Charlene Williams, a 56-year-old woman who practices Spanish on her smartphone every day. A language app, she says, is helping her deal with her post-COVID-19 brain fog. Williams contracted COVID-19 pneumonia in November 2020, just before Thanksgiving. After a few months of congestion, loss of taste and smell, hair loss and significant weight loss, the long-hauler began to recover but noticed some symptoms persisted.
The most shocking symptom for her was brain fog – a prolonged feeling of “fuzzy” or sluggish thinking – which she still deals with today. “It was quite distressing when people noticed it,” she says.
Brain fog may look different from person to person, but it’s pretty much “synonymous and analogous to traumatic brain injury,” says Neilank Jha, a Canadian brain injury and concussion neurosurgeon. For more than a decade, some argued that language training could help patients recover from traumatic brain injury, or TBI. TBI and some COVID cases involve inflammation in the brain, as well as a decrease in plasticity and volume of gray matter. In such cases, experts recommend that patients improve neuroplasticity (the brain’s ability to transform itself by strengthening or weakening neural connections) while decreasing neuroinflammation through stimulating and rehabilitative tasks.
One of the best ways to do this? Yes, language training.
“Language can be particularly useful because it’s not a unitary process,” says Alicia Walf, a neuroscientist and senior lecturer at Rensselaer Polytechnic Institute. “Language can include speaking, understanding spoken words, reading, writing, and the many brain regions associated with language and memory.” As for Williams, she was encouraged by her doctors to continue using the Duolingo language app to reap the neural benefits and help manage her fog.
The benefits of bilingualism
For years, studies have shown that bilingualism promotes auditory processing and can boost self-confidence, anxiety management and cognitive performance. The bilingual brain can also be more dementia resistant, according to Ellen Bialystok, associate scientist at the Rotman Research Institute. It is not so much the Spanish or French vocabulary as the process of learning a language that improves neuroplasticity and strengthens the brain.
“It makes neuropsychological sense,” says Eric Zillmer, professor of neuropsychology at Drexel University. “You access information in different ways, using other circuits or abilities that you have. It’s a really significant development that people can help themselves.
In fact, language learning could support memory, flexible thinking and self-control in much the same way brain-training apps do, according to a study published last October in the journal Aging, neuropsychology and cognition. The study compared Duolingo to an app called BrainHQ and found it was equally effective in boosting working memory and information processing in older adults.
“It may be the right place for a mentally engaging activity for someone who has mental difficulties due to an illness,” says Jed Meltzer, lead study author and cognitive neuroscientist at the University. of Toronto.
Additionally, respondents found the app more enjoyable than a typical brain workout. The app original sentences, like “The Loch Ness Monster Drinks Whisky”, slow users down and, instead of relying on context, rely on what they encounter. And this pleasure factor can help patients feel less stressed, which, in turn, can decrease neuroinflammation and allow them to rebuild synapses.
Brain fog: a silent symptom
The coronavirus is enigmatic in that it has even affected some patients’ language skills for up to six months after their first symptoms. A published research article in The Lancet last July found that 46% of patients with long-term COVID-19 had difficulty finding words when speaking or writing, and 28.85% of respondents saw changes in their second or third language skills. More than 100 million people worldwide have suffered from long COVID symptoms, according to a meta-analysis by researchers at Penn State College of Medicine published last October.
Allison Bailey, 24, first noticed symptoms on April Fool’s Day 2020. “I couldn’t tell anyone,” the Yale graduate says, “because I felt like they were going to think that It was the worst April Fool’s joke ever.” At a time when she wasn’t able to concentrate, Bailey, who lives in San Francisco, Calif., says her daily use of the app improved her mental health, which helped reduce brain fog.
Scientists say even those who have not been diagnosed with COVID-19 may have experienced a type of cognitive impairment and increased neuroinflammation aptly called “pandemic brainwhich is caused by stress and anxiety. “For the same reasons that I think it’s good for people with long COVID brain fog, it’s good for everyone else,” says Bialystok. “As we age, we all basically develop brain fog.”
Treatment: a balancing act
Mellica Telemacque, 48, works as a middle school teacher in Atlanta, Georgia. She contracted COVID in September 2020 and had symptoms for weeks. “I know what I’m talking about, but I can’t find the words – they just aren’t there. People have to fill in the gaps for me,” she says. She started practicing Spanish on the app to avoid “mental deterioration”, adding that her students also helped her stay on her toes.
Ultimately, can language learning help post-COVID patients like Telemacque deal with brain fog?
“The short answer is yes,” says Jha. “Learning a second language creates new neural pathways in the brain, which is why it can improve your cognitive function.” Nevertheless, it is not a panacea. Jha also recommends that TBI patients and “long haulers” avoid alcohol and drugs, adopt an anti-inflammatory diet, and meditate. Language learning is part of the equation, but it shouldn’t be the first thing brain-injured or COVID-19 patients look for.
Avi Nath, clinical director at the National Institute of Neurological Disorders and Stroke, says those with fog or other cognitive disorders should see a specialist. “They need proper neurocognitive testing done by a professional,” says Nath. “That’s usually a better approach than saying, ‘Oh, I’ll just do some language skills, and that’ll solve my problem.’ It’s a little too naive, I think.
Still, he says, brain training and language apps can be helpful in the recovery process. Alexandra Merlino, a speech therapist at the University of Pennsylvania who is leading post-COVID rehab, has yet to try language apps as a tool for rehabilitation, but says patients need to make sure they keep up their pace. “Patients need to exercise their body and brain, but also make sure they incorporate regular breaks so they don’t overdo it,” says Merlino.
If they push themselves too hard, patients may go into post-exertional malaise or “push-and-crash cyclewhere they find themselves trapped in a loop of overwork and rest. To avoid this, patients can use concepts such as the “spoon theory”, which involves a person rationing energy one imaginary spoonful at a time, and the “energy envelope”, which involves a patient focuses on his available energy, his energy expended and his symptoms. In one online forum on the Duolingo websiteusers who have experienced brain fog due to COVID-19 or other chronic illnesses have agreed that stimulation can be a key factor in regaining that forgotten second language or learning a new one.
Eventually, Telemacque, which came out on top on the app, climbed up the language rankings after a lot of perseverance and patience. “Knowing that I could find what I had seemingly lost was so…”
Telemacque walks away, allowing his next thought to launch.
“I know it’s not going to linger – it’s just a work in progress.”