A new, neuromarker-based, form of combined neurofeedback EEG/tDCS training in the reduction of occupational burnout syndrome in an anaesthetic nurse working with COVID-19 patients

Abstract

Anesthesia nurses working with COVID-19 patients experience exceptional emotional and physical strain due to the nature of their work in a high-risk environment. This has negative consequences for their physical and mental health and often leads to the development of occupational burnout syndrome. The purpose of this study was to evaluate a new neuromarker-based form of combined EEG / TDCS training in reducing occupational burnout syndrome in a nurse anesthetist working with patients with COVID-19.The patient, an unmarried 30-year-old anaesthetic nurse who had been working in the profession for six years, was referred to the Reintegration and Training Center of the Polish Neuropsychological Society in late 2022. A clinical interview and analysis of her medical records established that for the past two years (from early April 2020 to mid-April 2022), during which she had worked at a closed Intensive Care Unit (ICU) for patients infected with SARS-CoV-2 and contracting COVID-19, had been extremely taxing and anxiety-producing. With each successive wave of the pandemic, when the ICU was in a critical situation full of all kinds of stressors, including numerous cardiac arrests and the deaths of those she was caring for, she became increasingly mentally and physically exhausted. In addition, she experienced two losses of consciousness, but EEG and CT scans showed no changes. Her medical condition, especially her attention deficit disorder, working memory and confusion, caused her to lose her ability to work. She went on a disability pension due to full-blown occupational burnout syndrome (ICD-10 code 273.0) with a variety of psychosomatic symptoms. Several episodes of epileptic seizures were observed during her 40-minute qEEG recording with eyes open and closed and her performance of the PsyTask. The independent component analysis (ICA) extracted, among other things, a delta that corresponded to a 3Hz seizure and was generated in the prefrontal-temporal region of the right cerebral hemisphere. Functional neuromarkers of anxiety and depression were also detected in both the raw EEG recordings and data obtained from qEEG/ERPs analysis compared to the norm from the Human Brain Index (HBI). The new, neuromarker-based, form of combined EEG/tDCS training carried out the basisof these neuromarkers, conducted in 32 treatment sessions, proved effective in reducing individual disorders, including seizure activity.The examined anaesthetic nurse recovered from anxiety and depression, as well as occupational burnout syndrome and other psychosomatic disorders after 32 sessions of the new, combined neurofeedback EEG/tDCS training, and she returned to work at the ICU. Specific patterns of qEEG and ERPs serve as neuromarkers for constructing the protocol and for monitoring the results of intervention. HBI methodology can be successfully used in neurodiagnosis and neurotherapy offered to patients with occupational burnout syndrome.