Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share By
Guidelines for Tms/Tes Clinical Services and Research Through the Covid-19 Pandemic Publisher Pubmed



Bikson M1 ; Hanlon CA2 ; Woods AJ3 ; Gillick BT4 ; Charvet L5 ; Lamm C6 ; Madeo G7 ; Holczer A8 ; Almeida J9, 10 ; Antal A11, 12 ; Ay MR13 ; Baeken C14, 15, 16 ; Blumberger DM17, 18 ; Campanella S19 Show All Authors
Authors
  1. Bikson M1
  2. Hanlon CA2
  3. Woods AJ3
  4. Gillick BT4
  5. Charvet L5
  6. Lamm C6
  7. Madeo G7
  8. Holczer A8
  9. Almeida J9, 10
  10. Antal A11, 12
  11. Ay MR13
  12. Baeken C14, 15, 16
  13. Blumberger DM17, 18
  14. Campanella S19
  15. Camprodon JA20
  16. Christiansen L21
  17. Loo C22
  18. Crinion JT23
  19. Fitzgerald P24
  20. Gallimberti L7
  21. Ghobadiazbari P25, 26
  22. Ghodratitoostani I27
  23. Grabner RH28
  24. Hartwigsen G29
  25. Hirata A30
  26. Kirton A31
  27. Knotkova H32, 33
  28. Krupitsky E34
  29. Marangolo P35, 36
  30. Nakamurapalacios EM37
  31. Potok W38
  32. Praharaj SK39
  33. Ruff CC40
  34. Schlaug G41
  35. Siebner HR21, 42
  36. Stagg CJ43
  37. Thielscher A21, 44
  38. Wenderoth N38
  39. Yuan TF45
  40. Zhang X46
  41. Ekhtiari H47

Source: Brain Stimulation Published:2020


Abstract

Background: The COVID-19 pandemic has broadly disrupted biomedical treatment and research including non-invasive brain stimulation (NIBS). Moreover, the rapid onset of societal disruption and evolving regulatory restrictions may not have allowed for systematic planning of how clinical and research work may continue throughout the pandemic or be restarted as restrictions are abated. The urgency to provide and develop NIBS as an intervention for diverse neurological and mental health indications, and as a catalyst of fundamental brain research, is not dampened by the parallel efforts to address the most life-threatening aspects of COVID-19; rather in many cases the need for NIBS is heightened including the potential to mitigate mental health consequences related to COVID-19. Objective: To facilitate the re-establishment of access to NIBS clinical services and research operations during the current COVID-19 pandemic and possible future outbreaks, we develop and discuss a framework for balancing the importance of NIBS operations with safety considerations, while addressing the needs of all stakeholders. We focus on Transcranial Magnetic Stimulation (TMS) and low intensity transcranial Electrical Stimulation (tES) - including transcranial Direct Current Stimulation (tDCS) and transcranial Alternating Current Stimulation (tACS). Methods: The present consensus paper provides guidelines and good practices for managing and reopening NIBS clinics and laboratories through the immediate and ongoing stages of COVID-19. The document reflects the analysis of experts with domain-relevant expertise spanning NIBS technology, clinical services, and basic and clinical research – with an international perspective. We outline regulatory aspects, human resources, NIBS optimization, as well as accommodations for specific demographics. Results: A model based on three phases (early COVID-19 impact, current practices, and future preparation) with an 11-step checklist (spanning removing or streamlining in-person protocols, incorporating telemedicine, and addressing COVID-19-associated adverse events) is proposed. Recommendations on implementing social distancing and sterilization of NIBS related equipment, specific considerations of COVID-19 positive populations including mental health comorbidities, as well as considerations regarding regulatory and human resource in the era of COVID-19 are outlined. We discuss COVID-19 considerations specifically for clinical (sub-)populations including pediatric, stroke, addiction, and the elderly. Numerous case-examples across the world are described. Conclusion: There is an evident, and in cases urgent, need to maintain NIBS operations through the COVID-19 pandemic, including anticipating future pandemic waves and addressing effects of COVID-19 on brain and mind. The proposed robust and structured strategy aims to address the current and anticipated future challenges while maintaining scientific rigor and managing risk. © 2020 The Authors
Other Related Docs
8. Fmri and Transcranial Electrical Stimulation (Tes): A Systematic Review of Parameter Space and Outcomes, Progress in Neuro-Psychopharmacology and Biological Psychiatry (2021)