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Publications

Randomized Controlled Trial Journal Article Research Support, Non-U.S. Gov't Ppublish 33 citations

PubMed: 36693536 DOI: 10.1016/j.brs.2023.01.1672

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

Brain Stimul 16(1):100-107

Authors: Kelly Santana, Eduardo França, João Sato, Ana Silva, Maria Queiroz, Julia de Farias, Danniely Rodrigues, Iara Souza, Vanessa Ribeiro, Egas Caparelli-Dáquer, Antonio L Teixeira, Leigh Charvet, Abhishek Datta, Marom Bikson, Suellen Andrade

Affiliations

  • Federal University of Paraíba, João Pessoa, Brazil.
  • Center of Mathematics, Computing and Cognition, Federal University of ABC, Santo André, Brazil.
  • Department of Health, Government of Paraíba, João Pessoa, Brazil.
  • Nervous System Electric Stimulation Lab, Rio de Janeiro State University, Rio de Janeiro, Brazil.
  • Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, United States; Faculdade Santa Casa BH, Belo Horizonte, Brazil.
  • Department of Neurology, New York University Langone Health, New York, United States.
  • Department of Biomedical Engineering, The City College of New York of CUNY, New York, United States; Research & Development, Soterix Medical, Inc. New York, United States.
  • Department of Biomedical Engineering, The City College of New York of CUNY, New York, United States.
  • Federal University of Paraíba, João Pessoa, Brazil.

Abstract

BACKGROUND

and purpose: Fatigue is among the most common persistent symptoms following post-acute sequelae of Sars-COV-2 infection (PASC). The current study investigated the potential therapeutic effects of High-Definition transcranial Direct Current Stimulation (HD-tDCS) associated with rehabilitation program for the management of PASC-related fatigue.

METHODS

Seventy patients with PASC-related fatigue were randomized to receive 3 mA or sham HD-tDCS targeting the left primary motor cortex (M1) for 30 min paired with a rehabilitation program. Each patient underwent 10 sessions (2 sessions/week) over five weeks. Fatigue was measured as the primary outcome before and after the intervention using the Modified Fatigue Impact Scale (MFIS). Pain level, anxiety severity and quality of life were secondary outcomes assessed, respectively, through the McGill Questionnaire, Hamilton Anxiety Rating Scale (HAM-A) and WHOQOL.

RESULTS

Active HD-tDCS resulted in significantly greater reduction in fatigue compared to sham HD-tDCS (mean group MFIS reduction of 22.11 points vs 10.34 points). Distinct effects of HD-tDCS were observed in fatigue domains with greater effect on cognitive (mean group difference 8.29 points; effect size 1.1; 95% CI 3.56-13.01; P < .0001) and psychosocial domains (mean group difference 2.37 points; effect size 1.2; 95% CI 1.34-3.40; P < .0001), with no significant difference between the groups in the physical subscale (mean group difference 0.71 points; effect size 0.1; 95% CI 4.47-5.90; P = .09). Compared to sham, the active HD-tDCS group also had a significant reduction in anxiety (mean group difference 4.88; effect size 0.9; 95% CI 1.93-7.84; P < .0001) and improvement in quality of life (mean group difference 14.80; effect size 0.7; 95% CI 7.87-21.73; P < .0001). There was no significant difference in pain (mean group difference -0.74; no effect size; 95% CI 3.66-5.14; P = .09).

CONCLUSION

An intervention with M1 targeted HD-tDCS paired with a rehabilitation program was effective in reducing fatigue and anxiety, while improving quality of life in people with PASC.

MeSH

Quality Of Life, Sars-Cov-2, Transcranial Direct Current Stimulation, Brain, Rehabilitation, Fatigue, Severe Acute Respiratory Syndrome-Related Coronavirus

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