Transcranial direct current stimulation as a strategy to manage COVID-19 pain and fatigue

Silva-Filho, Edson; Moura, Stephanney Karolinne Mercer Souza Freitas de; Santos, Amilton da Cruz; Brasileiro-Santos, Maria do Socorro; Albuquerque, Jéssica Andrade de

doi:10.1590/1806-9282.67.01.20200671

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…Although these have not yet been formally evaluated in patients with Long COVID, they may improve the symptom burden in this patient population. For example, case reports have demonstrated benefits of neuromodulation particularly in the management of the mental health effects of COVID-19 and consequently, there are RCTs underway, such as the Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (STIMULATE-ICP) and Home-based Brain Stimulation Treatment for Post-acute Sequelae of COVID-19 (PASC) trials to examine the efficacy of this therapy modality in patients with Long COVID [ 103 , 104 , 105 , 106 , 107 ].…”

Section: Discussionmentioning

confidence: 99%

Non-Pharmacological Therapies for Post-Viral Syndromes, Including Long COVID: A Systematic Review

Chandan

Brown

Simms-Williams

et al. 2023

IJERPH

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Background: Post-viral syndromes (PVS), including Long COVID, are symptoms sustained from weeks to years following an acute viral infection. Non-pharmacological treatments for these symptoms are poorly understood. This review summarises the evidence for the effectiveness of non-pharmacological treatments for PVS. Methods: We conducted a systematic review to evaluate the effectiveness of non-pharmacological interventions for PVS, as compared to either standard care, alternative non-pharmacological therapy, or placebo. The outcomes of interest were changes in symptoms, exercise capacity, quality of life (including mental health and wellbeing), and work capability. We searched five databases (Embase, MEDLINE, PsycINFO, CINAHL, MedRxiv) for randomised controlled trials (RCTs) published between 1 January 2001 to 29 October 2021. The relevant outcome data were extracted, the study quality was appraised using the Cochrane risk-of-bias tool, and the findings were synthesised narratively. Findings: Overall, five studies of five different interventions (Pilates, music therapy, telerehabilitation, resistance exercise, neuromodulation) met the inclusion criteria. Aside from music-based intervention, all other selected interventions demonstrated some support in the management of PVS in some patients. Interpretation: In this study, we observed a lack of robust evidence evaluating the non-pharmacological treatments for PVS, including Long COVID. Considering the prevalence of prolonged symptoms following acute viral infections, there is an urgent need for clinical trials evaluating the effectiveness and cost-effectiveness of non-pharmacological treatments for patients with PVS. Registration: The study protocol was registered with PROSPERO [CRD42021282074] in October 2021 and published in BMJ Open in 2022.

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Section: Discussionmentioning

confidence: 99%

Non-Pharmacological Therapies for Post-Viral Syndromes, Including Long COVID: A Systematic Review

Chandan

Brown

Simms-Williams

et al. 2023

IJERPH

View full text Add to dashboard Cite

show abstract

“…For example, case reports have demonstrated benefits of neuromodulation particularly in the management of the mental health effects of COVID-19 and consequently, there are RCTs underway such as the Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (STIMULATE-ICP) and Homebased Brain Stimulation Treatment for Post-acute Sequelae of COVID-19 (PASC) trials to examine the efficacy of this therapy modality in patients with Long COVID. [98][99][100][101][102] A key challenge with these interventions (Pilates, resistance exercises and neuromodulation) relates to their scalability, which is particularly important when considering the scale of the public health burden in a context of limited health service capacity. However, these therapies were not assessed in trials for home use.…”

Section: Discussionmentioning

confidence: 99%

Non-pharmacological therapies for post-viral syndromes, including Long COVID: A systematic review

Chandan

Brown

Simms-Williams

et al. 2022

Preprint

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Background: Post-viral syndromes (PVS), including Long COVID, are symptoms sustained from weeks to years following an acute viral infection. Non-pharmacological treatments for these symptoms are poorly understood. This review summarises evidence for the effectiveness of non-pharmacological treatments for symptoms of PVS. It also summarises the symptoms and health impacts of PVS in individuals recruited to studies evaluating treatments. Methods and findings: We conducted a systematic review to evaluate the effectiveness of non-pharmacological interventions for PVS, as compared to either standard care, alternative non-pharmacological therapy, or placebo. The outcomes of interest were changes in symptoms, exercise capacity, quality of life (including mental health and wellbeing), and work capability. We searched five databases (Embase, MEDLINE, PsycINFO, CINAHL, MedRxiv) for randomised controlled trials (RCTs) published between 1st January 2001 to 29th October 2021. We anticipated that there would be few RCTs specifically pertaining to Long COVID, so we also included observational studies only if they assessed interventions in individuals where the viral pathogen was SARS-COV-2. Relevant outcome data were extracted, study quality appraised using the Cochrane Risk of Bias tool, and the findings were synthesised narratively. Quantitative synthesis was not planned due to substantial heterogeneity between the studies. Overall, five studies of five different interventions (Pilates, music therapy, telerehabilitation, resistance exercise, neuromodulation) met the inclusion criteria. Aside from music-based intervention, all other selected interventions demonstrated some support in the management of PVS in some patients. Conclusions: In this study, we observed a lack of robust evidence evaluating non-pharmacological treatments for PVS, including Long COVID. Considering the prevalence of prolonged symptoms following acute viral infections, there is an urgent need for clinical trials evaluating the effectiveness and cost-effectiveness of non-pharmacological treatments for patients with PVS as well as what may work for certain sub-groups of patients with differential symptom presentation. Registration: The study protocol was registered with PROSPERO [CRD42021282074] in October 2021 and published in BMJ Open in 2022. Keywords: Post-viral syndromes, PVS, COVID-19, Long COVID, post-COVID-19 condition, post-acute sequelae of SARS-CoV-2 infection (PASC), rehabilitation, systematic review, non-pharmacological intervention

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“…Transcranial approaches share the goal of directly activating intra-cranial brain structures ( 99 ), though ancillary peripheral [e.g., cranial nerve ( 100 )] stimulation cannot be excluded. The rational for tES, and especially tDCS, for COVID-19 brain disorders have been reviewed ( 77 , 101 , 102 ). Several early trials and case series suggest efficacy of tDCS of post-acute sequelae SARS-CoV-2 infection (PASC)/Long-COVID ( 103 – 105 ).…”

Section: Neuromodulation Technologies For Covid-19mentioning

confidence: 99%

“…In addition to modulation of neural pathways that directly modify end-organ stimulation cannot be excluded. The rational for tES, and especially tDCS, for COVID-19 brain disorders have been reviewed (77,101,102). Several early trials and case series suggest efficacy of tDCS of post-acute sequelae SARS-CoV-2 infection (PASC)/Long-COVID (103)(104)(105).…”

Section: Electrical and Magnetic Transcranial Approachesmentioning

confidence: 99%

Neuromodulation Strategies to Reduce Inflammation and Improve Lung Complications in COVID-19 Patients

Czura¹,

Bikson

Charvet

et al. 2022

Front. Neurol.

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Since the outbreak of the COVID-19 pandemic, races across academia and industry have been initiated to identify and develop disease modifying or preventative therapeutic strategies has been initiated. The primary focus has been on pharmacological treatment of the immune and respiratory system and the development of a vaccine. The hyperinflammatory state (“cytokine storm”) observed in many cases of COVID-19 indicates a prognostically negative disease progression that may lead to respiratory distress, multiple organ failure, shock, and death. Many critically ill patients continue to be at risk for significant, long-lasting morbidity or mortality. The human immune and respiratory systems are heavily regulated by the central nervous system, and intervention in the signaling of these neural pathways may permit targeted therapeutic control of excessive inflammation and pulmonary bronchoconstriction. Several technologies, both invasive and non-invasive, are available and approved for clinical use, but have not been extensively studied in treatment of the cytokine storm in COVID-19 patients. This manuscript provides an overview of the role of the nervous system in inflammation and respiration, the current understanding of neuromodulatory techniques from preclinical and clinical studies and provides a rationale for testing non-invasive neuromodulation to modulate acute systemic inflammation and respiratory dysfunction caused by SARS-CoV-2 and potentially other pathogens. The authors of this manuscript have co-founded the International Consortium on Neuromodulation for COVID-19 to advocate for and support studies of these technologies in the current coronavirus pandemic.

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Transcranial direct current stimulation as a strategy to manage COVID-19 pain and fatigue

Cited by 5 publications

References 9 publications

Non-Pharmacological Therapies for Post-Viral Syndromes, Including Long COVID: A Systematic Review

Non-Pharmacological Therapies for Post-Viral Syndromes, Including Long COVID: A Systematic Review

Non-pharmacological therapies for post-viral syndromes, including Long COVID: A systematic review

Neuromodulation Strategies to Reduce Inflammation and Improve Lung Complications in COVID-19 Patients

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