Non-invasive brain stimulation for fatigue in post-acute sequelae of SARS-CoV-2 (PASC)

Santana, Kelly de Jesus; França, Eduardo; Sato, João Ricardo; Silva, Ana; Queiroz, Maria Heloísa Bezerra Sales; Farias, Julia de; Rodrigues, Danniely; Souza, Iara Leão Luna de; Ribeiro, Vanessa; Caparelli-Dáquer, Egas; Teixeira, Antônio Lúcio; Charvet, Leigh; Datta, Abhishek; Bikson, Marom; Andrade, Suellen Marinho

doi:10.1016/j.brs.2023.01.1672

Cited by 22 publications

(25 citation statements)

References 73 publications

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“…Against the backdrop of a limited general cognitive impact of COVID-19, our findings suggest reduced cognitive function across multiple domains in people who needed hospitalisation due to COVID-19. This is consistent with recent literature suggesting that brain and cognitive impairment may be more salient in people with a severe infection [37] or hospitalisation [38], highlighting the need for longitudinal cognitive monitoring and improvement efforts in such cohorts [39], for example using non-invasive brain stimulation [40,41]. Furthermore, we found sizable associations between overall long-COVID symptom load and cognitive function across all domains, suggesting that affected individuals may also benefit from longitudinal cognitive monitoring and rehabilitation efforts.…”

Section: Discussionsupporting

confidence: 91%

COVID-19 and cognitive function: Evidence for increased processing speed variability in COVID-19 survivors and multifaceted impairment with long-COVID symptoms

Vakani

Ratto²,

Sandford-James³

et al. 2023

Eur. Psychiatr.

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Background There is increasing evidence for cognitive function to be negatively impacted by COVID-19. There is, however, limited research evaluating cognitive function pre- and post-COVID-19 using objective measures. Methods We examined processing speed, attention, working memory, executive function and memory in adults (≤69 years) with a history of COVID-19 (n = 129, none acutely unwell), compared to those with no known history of COVID-19 (n = 93). We also examined cognitive changes in a sub-group of COVID (n = 30) and non-COVID (n = 33) participants, compared to their pre-COVID-19 pandemic level. Results Cross-sectionally, the COVID group showed significantly larger intra-individual variability in processing speed, compared to the non-COVID group. The COVID sub-group also showed significantly larger intra-individual variability in processing speed, compared to their pre-COVID level; no significant change occurred in non-COVID participants over the same time scale. Other cognitive indices were not significantly impacted in the cross-sectional or within-subjects investigations, but participants (n = 20) who had needed hospitalisation due to COVID-19 showed poor attention and executive function relative to those who had not required hospitalisation (n = 109). Poor health and long-COVID symptoms correlated with poor cognitive function across domains in the COVID group. Conclusions The findings indicate a limited cognitive impact of COVID-19 with only intra-individual variability in processing speed being significantly impacted in an adult UK sample. However, those who required hospitalisation due to COVID-19 severity and/or experience long-COVID symptoms display multifaceted cognitive impairment and may benefit from repeated cognitive assessments and remediation efforts.

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Section: Discussionsupporting

confidence: 91%

COVID-19 and cognitive function: Evidence for increased processing speed variability in COVID-19 survivors and multifaceted impairment with long-COVID symptoms

Vakani

Ratto²,

Sandford-James³

et al. 2023

Eur. Psychiatr.

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“…The remaining 14 studies 64-67,72-81 (78%) (12 unique datasets) explored interventions for the management of long COVID ≥12 weeks following acute symptom onset (Table 4). Two studies 72,80 (14%) were pharmacological interventions and twelve [64][65][66][67][73][74][75][76][77][78][79]81 (86%) were non-pharmacological interventions, of which, half 64,65,73,[76][77][78] were exercise focused.…”

Section: ]mentioning

confidence: 99%

“…Seven RCTs explored psychological symptoms as secondary outcomes. [64][65][66][67]75,76,79 Significant intervention benefits for depression, but not anxiety, symptoms were shown following HBOT 66,67 and exercise training, 64 compared with a sham condition and exercise advice, respectively. A study exploring high-definition transcranial direct current stimulation (HD-tDCS) reported significant benefits for anxiety symptoms compared with a sham.…”

Section: Interventions Targeting Psychological Ttsmentioning

confidence: 99%

“…A study exploring high-definition transcranial direct current stimulation (HD-tDCS) reported significant benefits for anxiety symptoms compared with a sham. 79 T A B L E 4…”

Section: Interventions Targeting Psychological Ttsmentioning

confidence: 99%

“…No study included pain as a primary outcome. Three RCTs 66,67,79 included pain as a secondary outcome, of which, one study reported significant benefits for pain assessed via the Brief Pain Inventory following HBOT. 64…”

Section: Interventions Targeting Pain Ttsmentioning

confidence: 99%

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Treatable traits for long COVID

Lewthwaite,

Byrne,

Brew

et al. 2023

Respirology

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Long COVID, or post‐acute COVID‐19 sequelae, is experienced by an estimated one in eight adults following acute COVID‐19. Long COVID is a new and complex chronic health condition that typically includes multiple symptoms that cross organ systems and fluctuate over time; a one‐size‐fits‐all approach is, therefore, not likely to be appropriate nor relevant for long COVID treatment. ‘Treatable Traits’ is a personalized medicine approach, purpose‐built to address the complexity and heterogeneity of complex chronic conditions. This comprehensive review aimed to understand how a treatable traits approach could be applied to long COVID, by first identifying the most prevalent long COVID treatable traits and then the available evidence for strategies to target these traits. An umbrella review of 22 systematic reviews identified 34 symptoms and complications common with long COVID, grouped into eight long COVID treatable trait clusters: neurological, chest, psychological, pain, fatigue, sleep impairment, functional impairment and other. A systematic review of randomized control trials identified 18 studies that explored different intervention approaches for long COVID prevention (k = 4) or management (k = 14). While a single study reported metformin as effective for long COVID prevention, the findings need to be replicated and consensus is required around how to define long COVID as a clinical trial endpoint. For long COVID management, current evidence supports exercise training or respiratory muscle training for long COVID treatable traits in the chest and functional limitation clusters. While there are studies exploring interventions targeting other long COVID treatable traits, further high‐quality RCTs are needed, particularly targeting treatable traits in the clusters of fatigue, psychological, pain and sleep impairment.

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Effects of high‐definition transcranial direct current stimulation combined with inspiratory muscle training for treating respiratory sequelae of long COVID: A case series

de Souza,

dos Santos,

da Costa

et al. 2024

Physiotherapy Res Intl

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IntroductionLong COVID occurs when numerous symptoms begin 3 weeks after acute infection and last for 12 months or more. High‐definition transcranial direct current stimulation (HD‐tDCS) has been tested in patients with COVID‐19; however, previous studies did not investigate the HD‐tDCS use combined with inspiratory muscle training (IMT) for respiratory sequelae of long COVID.Case presentationSix individuals (four women and two men) aged between 29 and 71 years and presenting with respiratory sequelae of long COVID were included. They were submitted to an intervention that comprised HD‐tDCS combined with IMT twice a week for 5 weeks. Lung function and respiratory muscle assessments were performed at baseline and after 5 weeks of intervention.Implications on physiotherapy practiceHD‐tDCS may enhance the IMT effects by increasing respiratory muscle strength, efficiency, and lung function of individuals with long COVID.

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Non-invasive brain stimulation for fatigue in post-acute sequelae of SARS-CoV-2 (PASC)

Cited by 22 publications

References 73 publications

COVID-19 and cognitive function: Evidence for increased processing speed variability in COVID-19 survivors and multifaceted impairment with long-COVID symptoms

COVID-19 and cognitive function: Evidence for increased processing speed variability in COVID-19 survivors and multifaceted impairment with long-COVID symptoms

Treatable traits for long COVID

Effects of high‐definition transcranial direct current stimulation combined with inspiratory muscle training for treating respiratory sequelae of long COVID: A case series

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