Background & Aims

Brain fog is a phenomenon frequently reported by persons with chronic pain (1). The term ‘brain fog’ emerged in online discussions by persons with lived experiences (PWLE) (4). A scoping review of the medical literature defined brain fog as a subjective state of cognitive dysfunction that varies across and within individuals, impacting participation in daily activities (1). To expand our understanding of this complex phenomenon, we performed a discourse analysis to explore how brain fog is described in public discourses on social media. The objectives of this study were to a) explore?if brain fog is described differently across the social groups of researchers, health care professionals, and PWLE, b) synthesize how symptoms of brain fog are described in public discourses, c) identify management strategies used by PWLE or suggested by others, and d) explore if brain fog is described differently pre and post the COVID-19 pandemic.

Methods

A systematic data search using terms “brain fog” and “chronic pain” was conducted on social media sites Twitter and Facebook. We included posts that were 1) discussing brain fog in adults with a painful chronic condition (e.g., chronic pain, chronic musculoskeletal pain), 2) explicitly referring to chronic pain in the post, profile, or adjacent thread posts, 3) text posts about or in response to a video or image, and 4) public posts in English. All posts were reviewed for inclusion by two reviewers. The data extraction form was informed by a) Foley’s concept analysis framework to support systematic elaboration of the concept of brain fog (5), b) Internet Specific Ethical Questions Framework to protect data anonymity (6), c) the International Classification of Functioning to categorize the impacts described (7), and d) Dass et al’s (2023) model of brain fog (1). Data was analyzed using a deductive content analysis and mapping analysis.

Results

Our search identified 274 posts for extraction. In our content analysis [in progress] we will explore how persons in online discourses describe the attributes, antecedents, symptoms, and management strategies of brain fog. We will then compare and contrast these features in two mapping analyses. In the first, we will demonstrate the similarities and differences in how people with lived experiences, healthcare professionals, and researchers discuss brain fog. In the second, we will display how the discourse around brain fog has changed since the onset of the pandemic. Finally, we will provide key recommendations for future research of brain fog that is informed by the perspectives of persons with lived experiences.

Conclusions

To conclude, by incorporating an innovative and current methodology with theory-informed data extraction for both inductive and deductive analysis, we anticipate this ongoing discourse analysis of social media sources will generate nuanced insights in the phenomenon of brain fog. This enhanced understanding will refine existing models of the phenomenon, and identify promising candidate interventions while promoting mutual understanding and collaboration between researchers, clinicians and lived experts.

References

Dass R, Kalia M, Packham T. Brain fog in chronic pain: A scoping review. Canadian Journal of Pain. 2023;7(1):1-20.
2. Lucius K. Brain Fog”: Exploring a Symptom Commonly Encountered in Clinical Practice”. Mary Ann Liebert. 2021;27(1):1–9.
3. Ocon AJ. Caught in the thickness of brain fog: Exploring the cognitive symptoms of Chronic Fatigue Syndrome. Front Physiol. 2013;4:63.
4. Yong E. One of long COVID’s worst symptoms is also its most misunderstood. Atl [Internet]. 2022; Available from: https://www.theatlantic.com/health/archive/2022/09/long-covid-brain-fog-symptom-executive-function/671393/
5. Foley AS, Davis AH. A guide to concept analysis. Clin Nurse Spec. 2017;31(2):70–3.
6. Markham A, Buchanan E. Ethical decision making and internet research recommendations from the AoIR Ethics Working Committee (Version 2.0). AoIR Ethics Work Comm. 2012;2.
7. Organization WH. International classification of functioning checklist. World Health Organization. 2003;

Presenting Author

Ronessa Dass

Poster Authors

Ronessa Dass

BCS,MSc

McMaster University

Lead Author

Topics

  • Access to Care