Brain fog can feel every bit as mystifying to those who study it as it does to those who endure it. But research is, at last, beginning to shed some light on this confounding collection of symptoms
PHOTOGRAPHY: GETTY IMAGES. ILLUSTRATIONS: BEN KOTHE. *SOURCE: FRONTIERS IN AGING NEUROSCIENCE
When you think of brain fog, what comes to mind? Perhaps it’s those moments where you can’t put together a sentence or lose your train of thought. Or maybe it’s a general malaise, a lack of focus. If you can’t put your finger on what it is, you’re in good company. Brain fog is perplexing, even to those in the medical profession, and unique to each person who suffers from it.
The issue is increasingly common; as many as one in four people who contract Covid may develop brain fog, per a study in the journal JAMA Open. And yet, we still don’t have a single definition of it. The term is colloquial rather than scientific, with experts referring instead to ‘cognitive impairment’.
But we do know that Covid-related brain fog tends to affect attention, memory and executive function – the latter a term that Jacqueline Becker, clinical neuropsychologist at Mount Sinai Health System, a hospital in New York, explains as the CEO of your brain; it oversees the other tasks and helps you with some of the more difficult ones, such as making plans, organising information and solving problems.
These are regulated by the frontal lobe, the brain’s processing centre. Evolutionarily speaking, it’s a newer region because we have more advanced cognitive abilities compared with other species. It’s also the last to develop; it doesn’t mature until you’re 25 years old. It remains fluid and vulnerable to change, says Erica Cotton, neuropsychologist at Northwestern Memorial Hospital in Chicago.
Even people who don’t think they deal with fogginess know what poor frontal lobe functioning feels like. ‘At the end of the day, when you get home tired, hungry and can’t think – that’s a frontal lobe issue,’ says Dr Cotton. This part of the brain doesn’t work well when you’re in pain, overwhelmed or unwell, either. Covid aside, this impairment is linked with central nervous system disorders such as chronic fatigue syndrome and multiple sclerosis, as well as with treatments such as chemotherapy. ‘We’ve known [for a while] that people can develop chronic cognitive symptoms from other diseases, but it’s quite rare,’ says Gina Perez-Giraldo, a neurologist at Northwestern Memorial Hospital. ‘Now, with long Covid, we’re seeing a lot more people being impacted.’
The assumed cause? Inflammation, which damages brain cells and impedes your brain’s ability to communicate with your body, according to
