Department of Neurology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany.
Front Immunol. 2023 Jan 9;13:935614. doi: 10.3389/fimmu.2022.935614. eCollection 2022.
Following an acute COVID-19 infection, a large number of patients experience persisting symptoms for more than four weeks, a condition now classified as Long-COVID syndrome. Interestingly, the likelihood and severity of Long-COVID symptoms do not appear to be related to the severity of the acute COVID-19 infection. Fatigue is amongst the most common and debilitating symptoms of Long-COVID. Other symptomes include dyspnoea, chest pain, olfactory disturbances, and brain fog. Fatigue is also frequently reported in many other neurological diseases, affecting a broad range of everyday activities. However, despite its clinical significance, limited progress has been made in understanding its causes and developing effective treatment options. Non-invasive brain stimulation (NIBS) methods offer the unique opportunity to modulate fatigue-related maladaptive neuronal activity. Recent data show promising results of NIBS applications over frontoparietal regions to reduce fatigue symptoms. In this current paper, we review recent data on Long-COVID and Long-COVID-related fatigue (LCOF), with a special focus on cognitive fatigue. We further present widely used NIBS methods, such as transcranial direct current stimulation, transcranial alternating current stimulation, and transcutaneous vagus nerve stimulation and propose their use as possible therapeutic strategies to alleviate individual pathomechanisms of LCOF. Since NIBS methods are safe and well-tolerated, they have the potential to enhance the quality of life in a broad group of patients.
在急性 COVID-19 感染后,大量患者出现持续超过四周的症状,这种情况现在被归类为长新冠综合征。有趣的是,长新冠症状的可能性和严重程度似乎与急性 COVID-19 感染的严重程度无关。疲劳是长新冠最常见和最使人虚弱的症状之一。其他症状包括呼吸困难、胸痛、嗅觉障碍和脑雾。疲劳也经常在许多其他神经系统疾病中报告,影响广泛的日常活动。然而,尽管其具有临床意义,但在理解其原因和开发有效的治疗方法方面进展有限。非侵入性脑刺激(NIBS)方法提供了调节与疲劳相关的适应性神经元活动的独特机会。最近的数据显示,NIBS 在额顶区域的应用有希望减轻疲劳症状。在当前这篇论文中,我们回顾了长新冠和长新冠相关疲劳(LCOF)的最新数据,特别关注认知疲劳。我们进一步介绍了广泛使用的 NIBS 方法,如经颅直流电刺激、经颅交流电刺激和经皮迷走神经刺激,并提出将其用作减轻 LCOF 个体发病机制的可能治疗策略。由于 NIBS 方法安全且耐受性良好,它们有可能提高广泛患者群体的生活质量。
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