Treatment of Chronic Fatigue Syndrome (CFS) in Post-SARS-CoV-2 Infection through combined outpatient Neuromodulation Therapy with Repetitive Transcranial Magnetic Stimulation (rTMS) and Ketamine IV Therapy - A Case Series

Abstract

The most reported symptom of post-COVID syndrome is pronounced fatigue (Malik et al., 2021; Venkatesan, 2021). In this case series, we present the treatment of four patients suffering from Post-COVID syndrome after more than 3 months since infection, presented diagnostically within the framework of chronic fatigue syndrome (CFS). They were treated with a combination of Low-frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) and ketamine intravenous (IV) infusion therapy for a period of 2 to 3 weeks. Three patients experienced significant improvement. Given the promising results further research is indicated.

Long-Term Effects of Ketamine Infusions in Comparison to Combination Therapy involving additional rTMS, Neurofeedback and Psychotherapy - A Retrospective Survey Study of Subjective Effects

“…Additionally, recent studies suggest another mode of action for rTMS, that being its glial activation which leads to anti-inflammatory effects (Lee & Giuliani, 2019). Regulatory agencies currently recognize repetitive transcranial magnetic stimulation as a viable treatment option for patients suffering from drug-resistant depression (Level A Evidence) and obsessive-compulsive disorder, as well as a potential therapy for fibromyalgia/neuropathic pain, drug addiction, chronic fatigue syndrome (CFS) as a Post-Covid-19 symptom (as examined in a case series our clinic conducted before; Rolle et al, 2022), gambling disorder and to treat the consequences of a stroke (Aceves-Serrano et al, 2022;Lefaucheur et al, 2020;Neva et al, 2020).…”