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Long COVID & tDCS

Approximately one third of patients have developed severe chronic symptoms following mild or severe infection from Long COVID aka Post-Acute Sequelae of Sars-Cov2 (PASC). Common symptoms include cognitive impairment(aka brain fog), insomnia, and mood disorders, with fatigue reported as the most frequent and debilitating symptom. Due to the challenges and difficulty of resolving these post sequelae symptoms, and due to any consensus to how to reverse this disorder, many studies have been undertaken to find relief with atypical therapies many of which treat the brain. 

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation intervention with potential as a Long COVID treatment as it modulates brain vascular function, enhances ongoing synaptic plasticity. These effects result in modulation of neural circuits underlying common neurological, cognitive, and psychiatric disorders including depression and anxiety. With a history of  tDCS trials for non-COVID-19 patients showing mood and cognitive improvement, tDCS presents a rational approach to consider. Results to date with transcranial Direct Current Stimulation (tDCS) for long COVID find reduced fatigue and improved mood. More studies are needed as it is likely that utilizing a variety of therapies are more likely to result in improving long COVID symptoms. Due to its ease of use and flexibility and low adverse profile tDCS provides one more therapy that can provide a viable option. tDCS sessions last 20 minutes are easily implemented in a flexible at home therapy that is very safe and convenient.

Improve Overall Function

  • Improves fatigue from Long COVID
  • Improves mood
  • Improves recovery from acute respiratory challenges
  • Safe with no adverse effects
  • Enhances response to other therapies like NFB and HBOT

REFERENCE

  1. Silvia Oliver-Mas et al; Transcranial direct current stimulation for post-COVID fatigue: a randomized, double-blind, controlled pilot study. Brain Commun. 2023; 5(2): fcad117. Published online 2023 Apr 10. doi: 10.1093/braincomms/fcad117. PMID: 37091591. PMCID: PMC10116605
  2. Suellen Andrade et al; HD-tDCS in acute and long-term COVID-19. Brain Stimul. 2023 January-February; 16(1): 191–192. Published online 2023 Feb 15. doi: 10.1016/j.brs.2023.01.230. PMCID: PMC9930594
  3. Andre R. Brunoni et al; Efficacy of transcranial direct current stimulation and cognitive training for the neurocognitive symptoms of long covid-19. Brain Stimul. 2023 January-February; 16(1): 192. Published online 2023 Feb 15. doi: 10.1016/j.brs.2023.01.232. PMCID: PMC9930599
  4. Stefanie Linnhoff et al; The therapeutic potential of non-invasive brain stimulation for the treatment of Long-COVID-related cognitive fatigue. Front Immunol. 2023 Jan 9:13:935614. doi: 10.3389/fimmu.2022.935614. eCollection 2022. PMID: 36700201. PMCID: PMC9869163
  5. Beatriz A. Cavendish et al; Combination of transcranial direct current stimulation with online cognitive training improves symptoms of Post-acute Sequelae of COVID-19: A case series. Brain Stimul. 2022 November-December; 15(6): 1375–1377. Published online 2022 Oct 3. doi: 10.1016/j.brs.2022.09.008. PMID: 36202328. PMCID: PMC9528061
  6. Suellen Marinho Andrade et al; Efficacy and safety of HD-tDCS and respiratory rehabilitation for critically ill patients with COVID-19 The HD-RECOVERY randomized clinical trial. Brain Stimul. 2022 May-June; 15(3): 780–788. Published online 2022 May 11. Doi: 10.1016/j.brs. 2022.05.006. PMID: 35568312. PMCID: PMC9093082
  7. Craig Workman et al; Transcranial Direct Current Stimulation and Post-COVID-19-Fatigue. Brain Stimul. 2021 November-December; 14(6): 1672–1673. Published online 2021 Nov 18. doi: 10.1016/j.brs.2021.10.268. PMCID: PMC8598225
  8. Lázaro Gómez et al; Successful Treatment of Post-COVID Symptoms With Transcranial Direct Current Stimulation. Prim Care Companion CNS Disord. 2021 Dec 2;23(6):21cr03059. doi: 10.4088/PCC.21cr03059. PMID: 34861746
  9. Giuseppina Pilloni et al; Update on the Use of Transcranial Electrical Brain Stimulation to Manage Acute and Chronic COVID-19 Symptoms. Front Hum Neurosci. 2020; 14: 595567.Published online 2020 Nov 12. doi: 10.3389/fnhum.2020.595567. PMID: 33281589. PMCID: PMC7689057

Study: Transcranial direct current stimulation for post-COVID fatigue: a randomized, double-blind, controlled pilot study

Fatigue is one of the most frequent and disabling symptoms of the post-COVID syndrome. In this study, we aimed to assess the effects of transcranial direct current stimulation on fatigue severity in a group of patients with post-COVID syndrome and chronic fatigue. We conducted a double-blind, parallel-group, sham-controlled study to evaluate the short-term effects of anodal transcranial direct current stimulation (2 mA, 20 min/day) on the left dorsolateral prefrontal cortex. The modified fatigue impact scale score was used as the primary endpoint. Secondary endpoints included cognition (Stroop test), depressive symptoms (Beck depression inventory) and quality of life (EuroQol-5D). Patients received eight sessions of transcranial direct current stimulation and were evaluated at baseline, immediately after the last session, and one month later. Forty-seven patients were enrolled (23 in the active treatment group and 24 in the sham treatment group); the mean age was 45.66 ± 9.49 years, and 37 (78.72%) were women. The mean progression time since the acute infection was 20.68 ± 6.34 months. Active transcranial direct current stimulation was associated with a statistically significant improvement in physical fatigue at the end of treatment and 1 month as compared with sham stimulation. No significant effect was detected for cognitive fatigue. In terms of secondary outcomes, active transcranial direct current stimulation was associated with an improvement in depressive symptoms at the end of treatment. The treatment had no effects on the quality of life. All the adverse events reported were mild and transient, with no differences between the active stimulation and sham stimulation groups. In conclusion, our results suggest that transcranial direct current stimulation on the dorsolateral prefrontal cortex may improve physical fatigue. Further studies are needed to confirm these findings and optimize stimulation protocols.

REFERENCE

  1. Silvia Oliver-Mas et al; Transcranial direct current stimulation for post-COVID fatigue: a randomized, double-blind, controlled pilot study. Brain Commun. 2023; 5(2): fcad117. Published online 2023 Apr 10. doi: 10.1093/braincomms/fcad117. PMID: 37091591. PMCID: PMC10116605

These statements have not been evaluated or approved by the FDA. All of the statements made on this document are not anecdotal and have been taken directly from clinical data.