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Can We Use qEEG and Neurostimulation for COVID-19?

Early studies show promise in using neurostimulation for COVID and long COVID.

Shireen Anne Jeejeebhoy/Collage of Pixabay images
Source: Shireen Anne Jeejeebhoy/Collage of Pixabay images

Although pandemic experts had long predicted a worldwide pandemic was coming, COVID-19 still surprised most of us. But few were prepared for the effects to persist for months or years after people's initial recovery. One thing this new virus, and new post-viral condition, is teaching us is that well-known viruses from the past likely created long-term, debilitating conditions we hadn’t treated as post-viral. Like the discoverers of H. pylori revolutionized the understanding and treatment of gastric ulcers, long COVID and this pandemic may revolutionize both brain treatments and the understanding of many long-term conditions as arising from viruses.

Standard medical care for brain injury remains mostly strategies and rest, with or without medications. But more health care professionals are turning to qEEG and neurostimulation and neuromodulation to, first, pinpoint the exact neurophysiological dysfunction and, second, create individualized treatment programs to restore healthy neuronal and neural network functioning.

As with brain injury, brain fog and fatigue are two common symptoms of long COVID’s neurological effects. According to the Government of Canada’s 2022 survey on longer-term symptoms following COVID-19, the most common were:

  • fatigue, tiredness or loss of energy (72.1%)
  • coughing (39.3%)
  • shortness of breath or difficulty breathing (38.5%)
  • difficulty thinking or problem solving (32.9%)
  • general weakness (30.9%)

Fatigue may possibly be the neuro-fatigue that those with brain injury suffer from and which neurostimulation and neuromodulation therapies help to alleviate. And so the question becomes, how much research is being done on using qEEG and these therapies for long COVID?

This question becomes critical when countries around the world reveal life-changing rates of long COVID: 14.8% of Canadian adults; 39% in the Faroe Islands; 34% of adults in Moscow who were hospitalized; and 3.5% (self-reported) in the UK population. In the US, the CDC uses multiple ways to measure prevalence (varying from 2.5% to 30%) and post-COVID conditions can be considered a disability under the Americans with Disabilities Act.

Although some of these percentages seem small, translated into absolute numbers, they’re in the millions: Millions of people in a very short time who have become disabled, taken out of the labor force, and requiring income, health, and/or social support, which has a profound impact on societies.

It becomes critical, then, that we find ways to either significantly decrease the health burden or cure long COVID. Marta Kopańska et al reported in July 2022 on academic staff who’d contracted COVID-19 and had qEEG prior to the COVID-19 era and follow-up qEEG after they developed brain fog, as determined by a clinical specialist. They found:

“increased Theta and Alpha activity, as well as more intensive sensimotor rhythm (SMR) in C4 (right hemisphere) in relation to C3 (left hemisphere). Moreover, a visible increase in Beta 2 in relation to SMR in both hemispheres”

Other researchers will need to confirm these findings as reflecting a long COVID pattern, but it shows that SARS-CoV-2 changes the electrical activity of the brain. We know that neurostimulation and neuromodulation can retrain the brain. Some researchers and clinicians have begun using these therapies to treat both COVID-19 and long COVID.

Suellen Marinho Andrade et al used high-definition transcranial direct current stimulation in severe patients with COVID-19 suffering from acute respiratory distress syndrome in the ICU and found "[t]he primary outcome was ventilator-free days during the first 28 days, defined as the number of days free from mechanical ventilation.”

Fred Kahn, low-intensity laser therapy pioneer and BioFlex founder, and Ronaldo Santiago wrote in a 2020 review of photobiomodulation therapy in the treatment of COVID-19, “Whereas clinical trials can be used to objectively evaluate the effects of PBM on COVID-19, the record of therapeutic application of the technology in the past, at this time justifies the immediate employment of PBM to resolve this encompassing disaster.”

P. Verbanck et al piloted transcutaneous auricular vagus nerve stimulation on patients suffering from chronic COVID syndrome. All the patients in their study both completed the study and improved dramatically. They suggested that “tVNS improves chronic COVID syndrome through a ‘sympathetic reset.’”

These studies had small cohorts and the ones on neurostimulation or neuromodulation didn’t rely on qEEG diagnosis to determine which areas and brainwave frequencies needed modulation; however, they represent a first step toward proving that these therapies are worth investigating and implementing in clinical practice, especially since current therapies are leaving millions suffering with no clear end in sight.

South African neurologist Ashleigh Bhanjan of the Entabeni Hospital and Durban Neuro Laser Clinic, treats people with long COVID and has said:

“We do treatments for these patients sometimes twice or even three times a week. And within two weeks, all of a sudden, they can breathe again, they can walk up stairs. They don’t feel that fatigue and exertional dyspnea that they had. Usually the brain fog starts to settle. After time, they start sleeping better and overall they feel more alive.”

Ideally, researchers would confirm classic long COVID qEEG patterns to add to well-developed applied psychophysiological knowledge on other conditions. Clinicians could test a number of different individualized therapies, based on qEEG readings, and develop protocols for neurostimulation and neuromodulation therapies that worked best or in combination. Meanwhile, these initial studies suggest that people with long COVID would benefit from accessing qEEG diagnosis—to diagnose dysfunctional electrical activity and target neurostimulation and neuromodulation therapies. Eliza Strickland reported in her overview of this area in IEEE Spectrum:

Marom Bikson of Soterix Medical notes … "We don’t have Pfizers of neuromodulation,” he says, “but you can only imagine what would happen if it shows an effect on long COVID.” It could lead to millions of people having stimulators in their homes, he suggests, which could open other doors. “Once you start stimulating for long COVID, you can start stimulating for other things like depression,” he says. But he says it’s crucial to proceed cautiously and not make unsupported claims for neurostimulation’s powers. “Otherwise,” he says, “it could have the opposite effect.

More and more people with brain injury use neurostimulation home devices such as audiovisual entrainment by Mind Alive. People with long COVID need similar help.

Copyright ©2022 Shireen Anne Jeejeebhoy

References

Thompson, M. & Thompson, L. (2015) The Neurofeedback Book: An Introduction to Basic Concepts in Applied Psychophysiology. Wheat Ridge, CO: The Association for Applied Psychophysiology and Biofeedback.

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