a pilot rtms trial for neuropsychiatric symptoms of long-covid

Conditions: Long Covid-19; PASC Post Acute Sequelae of COVID 19; Brain Fog; Fatigue

Summary: this is a pilot randomized trial of rtms for symptoms of fatigue and brain fog, and other neuropsychiatric symptoms of long-covid (post-covid, post-acute sequelae of covid-19 infection, pasc). twenty participants diagnosed with long-covid and recruited from the ucla long-covid clinic will be randomized to receive active rtms versus sham stimulation for 15 treatments followed by another 15 open-label rtms treatments. investigators will compare the safety and tolerability of rtms vs sham and examine within-group changes in symptoms of fatigue, sleep, pain, mood, and subjective and objective cognitive impairment. this project will provide information and pilot data for future larger clinical trials.


Eligibility criteria:
inclusion criteria: 1. 18+ years of age 2. prior hx of pcr confirmed covid-19 infection. determined by the pi or participant's physician. 3. subsequent development of post-acute neuropsychiatric symptoms with fatigue and brain fog as primary outcomes 4. use of psychotropic medications 5. stable on psychotropic medications for 4+ months 6. confirmed diagnosis of long covid 7. subjects are willing and able to adhere to the treatment schedule and required study visits exclusion criteria: 1. mentally or legally incapacitated or unable to give informed consent 2. moca \< or = 24 3. infection of poor skin condition over the scalp where the rtms device will be positioned 4. pregnancy: female participants will be tested for pregnancy at baseline and agree to use a medically acceptable form of birth control throughout the study, for women younger than 60. 5. lifetime history of diagnosed bipolar disorder; psychosis, such as schizophrenia, schizophreniform, or schizoaffective disorder; intellectual disability (intellectual developmental disorder); organic brain damage; or suicide attempts in the past 24 months. 6. severe mdd with suicidality of psychosis- excluded 7. as-needed use of benzodiazepines and beta-blockers will be permitted but discouraged during assessment days. 8. current abuse or dependence on alcohol or any illicit drug of abuse (disorder in last 6 months). any recent use of cocaine or opiates will also be exclusionary. 9. participants with asthma or with a history of serious, uncontrolled medical illness or instability (including significant cardio-pulmonary disease, organic brain including significant cardio-pulmonary syndrome, pre-existing dementia, seizure disorder, cerebrovascular disease, and diabetes) 10. taking medications known to lower seizure thresholds (clozaril/ wellbutrin) 11. neurological conditions that include epilepsy, cerebrovascular disease, dementia, increased intracranial pressure, having a history of repetitive or severe head trauma, or primary or secondary tumors in the central nervous system. 12. presence of an implanted metallic and magnetic-sensitive medical device present in the body scan, including but not limited to a cochlear implant, infusion pump, implanted cardioverter defibrillator, pacemaker, vagus nerve stimulator, aneurysm clip, metal prosthesis, or metal aneurysm clips or coils, staples, or stents.