IS NEUROSTIMULATION A POTENTIAL THERAPEUTIC TOOL IN PATIENTS WITH NEUROCOGNITIVE PROBLEMS IN LONG-COVID?

Abstract

Abstract Brain micropolarization has long been recognized as a therapeutic approach for the treatment of neurological disorders. In both neurological and psychiatric treatment, due to their functionality, noninvasive methods, such as Transcranial Magnetic Stimulation (TMS), transcranial Electrical Stimulation (tES), and transcutaneous Vagal Nerve Stimulation (tVNS), are preferred. The above methods are registered for clinical use worldwide as adjuvant therapy for many neurological disorders such as Parkinson’s disease, Alzheimer’s disease, depression, brain stroke, vascular dementia, chronic pain, and others. Although SARS-CoV-2 is considered a respiratory pathogen, it also displays a potent neurotropism with neuropsychiatric consequences that may occur during the acute phase of infection or may be delayed even months after COVID-19 illness. People with long COVID conditions most commonly experience a ‘brain fog’, which is associated with cognitive deficits, concentration and memory disturbances, and headaches. Long-COVID may also include neuropsychiatric disorders such as dyssomnia, dementia, depression, or even psychosis. Neurological lesions have a multifactorial background and may be induced by the direct viral invasion of the neurons and glial cells, an inflammatory response with excessive cytokine reaction, or hypoxic injury due to respiratory impairment. Recently, as the COVID-19 pandemic continues, it has been suggested to implement brain neurostimulation for the treatment of neurological manifestations. However, until now there are only a few studies, including clinical trials, presenting the practical use of this method. Since no authorized strategies and standards for long-COVID treatment are developed, neurostimulation may be considered as a potential therapeutic tool for alleviating neurological symptoms in patients with long-COVID19. Materials and methods To identify relevant papers, we searched PubMed and Wiley Online Library databases using the following keywords: neurostimulation, long-COVID, brain fog, and neuropsychiatric symptoms. A literature search was based on the current articles describing neurostimulation and Long-COVID conditions. Aim This paper aims to present neurostimulation as a potential therapy to alleviate persistent and chronic neuro-symptoms in patients infected with SARS-CoV2.