Evaluating Repetitive Transcranial Magnetic Stimulation for Neuropsychiatric Symptoms in Long COVID: A Case Series.

IF 1.8 4区 医学 Q3 BEHAVIORAL SCIENCES
Jonathan Bock, Simon Kung, Ravindra Ganesh, Ryan T Hurt, Maria I Lapid
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引用次数: 0

Abstract

Objective: To describe the immediate clinical outcomes of repetitive transcranial magnetic stimulation (rTMS) in treating long COVID symptoms. Long COVID currently impacts approximately 5.3% of US adults, presenting with persistent fatigue, depression, anxiety, cognitive impairments, and social function decline. Repetitive transcranial magnetic stimulation targeting the left dorsolateral prefrontal cortex has improved these symptoms in some studies.

Methods: Five patients (ages 52-63 years, 3 female patients) underwent accelerated rTMS using intermittent theta burst stimulation (600 pulses over 3 minutes 20 seconds, 80%-120% of resting motor threshold) to the left dorsolateral prefrontal cortex. The treatment consisted of twice-daily sessions over 20-30 treatments. Outcomes were measured using the Patient-Reported Outcomes Measurement and Information System (PROMIS) questionnaires, assessing fatigue, depression, anxiety, cognitive function, and social function at baseline and immediately posttreatment.

Results: One patient discontinued immediately due to intolerable scalp pain. Posttreatment PROMIS scores showed the following: fatigue decreased from 74.5 to 61.8, depression from 60.3 to 51.5, and anxiety from 62.0 to 54.0. Scores increased for cognitive (26.8 to 32.3) and social (31.0 to 32.5) function. These changes, although not statistically significant, indicate a trend toward symptom reduction. Subjectively, 3 of 4 patients who completed the rTMS course reported improvements.

Conclusion: This case series suggests that rTMS may offer symptomatic relief in long COVID patients. Although the observed improvements in PROMIS were not statistically significant, even minimal improvements are clinically significant for patients enduring prolonged suffering. These preliminary findings are encouraging and underscore the need for further research with larger cohorts to validate the efficacy of rTMS in long COVID symptom relief.

评估重复性经颅磁刺激对长期 COVID 患者神经精神症状的影响:病例系列。
目的描述重复经颅磁刺激(rTMS)治疗长期慢性阻塞性脑损伤症状的直接临床效果。目前,约有 5.3% 的美国成年人受到长期 COVID 的影响,表现为持续疲劳、抑郁、焦虑、认知障碍和社会功能下降。在一些研究中,针对左侧背外侧前额叶皮层的重复经颅磁刺激改善了这些症状:5名患者(52-63岁,3名女性患者)接受了加速经颅磁刺激,对左侧背外侧前额叶皮层进行间歇性θ脉冲群刺激(600个脉冲,3分20秒,静息运动阈值的80%-120%)。治疗包括每天两次的疗程,每次 20-30 个疗程。结果采用患者报告结果测量和信息系统(PROMIS)问卷进行测量,评估基线和治疗后的疲劳、抑郁、焦虑、认知功能和社会功能:结果:一名患者因无法忍受头皮疼痛而立即停止治疗。治疗后的 PROMIS 评分显示:疲劳从 74.5 分降至 61.8 分,抑郁从 60.3 分降至 51.5 分,焦虑从 62.0 分降至 54.0 分。认知功能(26.8 分至 32.3 分)和社交功能(31.0 分至 32.5 分)的得分有所上升。这些变化虽然没有统计学意义,但表明了症状减轻的趋势。主观上,完成经颅磁刺激疗程的 4 名患者中有 3 人表示症状有所改善:本系列病例表明,经颅磁刺激可缓解长期 COVID 患者的症状。尽管在 PROMIS 中观察到的改善在统计学上并不显著,但对于忍受长期痛苦的患者来说,即使是微小的改善也具有重要的临床意义。这些初步研究结果令人鼓舞,同时也强调了进一步研究的必要性,即通过更大规模的队列研究来验证经颅磁刺激对缓解长期 COVID 症状的疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Ect
Journal of Ect 医学-行为科学
CiteScore
3.70
自引率
20.00%
发文量
154
审稿时长
6-12 weeks
期刊介绍: ​The Journal of ECT covers all aspects of contemporary electroconvulsive therapy, reporting on major clinical and research developments worldwide. Leading clinicians and researchers examine the effects of induced seizures on behavior and on organ systems; review important research results on the mode of induction, occurrence, and propagation of seizures; and explore the difficult sociological, ethical, and legal issues concerning the use of ECT.
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