Applications of Non-invasive Neuromodulation for the Management of Disorders Related to COVID-19

Abrahão Fontes Baptista, Adriana Baltar, Alexandre Hideki Okano, Alexandre Moreira, Ana Carolina Pinheiro Campos, Ana Mércia Fernandes, André Russowsky Brunoni, Bashar W Badran, Clarice Tanaka, Daniel Ciampi de Andrade, Daniel Gomes da Silva Machado, Edgard Morya, Eduardo Trujillo, Jaiti K Swami, Joan A Camprodon, Katia Monte-Silva, Katia Nunes Sá, Isadora Nunes, Juliana Barbosa Goulardins, Marom BiksonPedro Sudbrack-Oliveira, Priscila de Carvalho, Rafael Jardim Duarte-Moreira, Rosana Lima Pagano, Samuel Katsuyuki Shinjo, Yossi Zana

Research output: Contribution to journalReview articlepeer-review

38 Citations (Scopus)

Abstract

Background: Novel coronavirus disease (COVID-19) morbidity is not restricted to the respiratory system, but also affects the nervous system. Non-invasive neuromodulation may be useful in the treatment of the disorders associated with COVID-19. Objective: To describe the rationale and empirical basis of the use of non-invasive neuromodulation in the management of patients with COVID-10 and related disorders. Methods: We summarize COVID-19 pathophysiology with emphasis of direct neuroinvasiveness, neuroimmune response and inflammation, autonomic balance and neurological, musculoskeletal and neuropsychiatric sequela. This supports the development of a framework for advancing applications of non-invasive neuromodulation in the management COVID-19 and related disorders. Results: Non-invasive neuromodulation may manage disorders associated with COVID-19 through four pathways: (1) Direct infection mitigation through the stimulation of regions involved in the regulation of systemic anti-inflammatory responses and/or autonomic responses and prevention of neuroinflammation and recovery of respiration; (2) Amelioration of COVID-19 symptoms of musculoskeletal pain and systemic fatigue; (3) Augmenting cognitive and physical rehabilitation following critical illness; and (4) Treating outbreak-related mental distress including neurological and psychiatric disorders exacerbated by surrounding psychosocial stressors related to COVID-19. The selection of the appropriate techniques will depend on the identified target treatment pathway. Conclusion: COVID-19 infection results in a myriad of acute and chronic symptoms, both directly associated with respiratory distress (e.g., rehabilitation) or of yet-to-be-determined etiology (e.g., fatigue). Non-invasive neuromodulation is a toolbox of techniques that based on targeted pathways and empirical evidence (largely in non-COVID-19 patients) can be investigated in the management of patients with COVID-19.

Original languageEnglish
Article number573718
JournalFrontiers in Neurology
Volume11
ISSN1664-2295
DOIs
Publication statusPublished - 2020
Externally publishedYes

Bibliographical note

Copyright © 2020 Baptista, Baltar, Okano, Moreira, Campos, Fernandes, Brunoni, Badran, Tanaka, de Andrade, da Silva Machado, Morya, Trujillo, Swami, Camprodon, Monte-Silva, Sá, Nunes, Goulardins, Bikson, Sudbrack-Oliveira, de Carvalho, Duarte-Moreira, Pagano, Shinjo and Zana.

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