Prefrontal tDCS modulates autonomic responses in COVID-19 inpatients
Open accessAbstract
BACKGROUND: maladaptive changes in the autonomic nervous system (ANS) have been observed in short and long-term phases of COVID-19 infection. Identifying effective treatments to modulate autonomic imbalance could be a strategy for preventing and reducing disease severity and induced complications. OBJECTIVE: to investigate the efficacy, safety, and feasibility of a single session of bihemispheric prefrontal tDCS on indicators of cardiac autonomic regulation and mood of COVID-19 inpatients. METHODS: patients were randomized to receive a single 30-min session of bihemispheric active tDCS over the dorsolateral prefrontal cortex (2 mA; n = 20) or sham (n = 20). Changes in time [post-pre intervention] in heart rate variability (HRV), mood, heart rate, respiratory rate, and oxygen saturation were compared between groups. Additionally, clinical worsening indicators and the occurrence of falls and skin injuries were evaluated. The Brunoni Adverse Effects Questionary was employed after the intervention. RESULTS: there was a large effect size (Hedges' g = 0.7) of intervention on HRV frequency parameters, suggesting alterations in cardiac autonomic regulation. An increment in oxygen saturation was observed in the active group but not in the sham after the intervention (P = 0.045). There were no group differences regarding mood, incidence and intensity of adverse effects, no occurrence of skin lesions, falls, or clinical worsening. CONCLUSIONS: a single prefrontal tDCS session is safe and feasible to modulate indicators of cardiac autonomic regulation in acute COVID-19 inpatients. Further research comprising a thorough assessment of autonomic function and inflammatory biomarkers is required to verify its potential to manage autonomic dysfunctions, mitigate inflammatory responses and enhance clinical outcomes.
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Non-invasive brain stimulation via tDCS has been proposed as a viable solution.
“Non-invasive brain stimulation via transcranial direct current stimulation (tDCS) has been proposed as a viable solution [4][5][6].”
From Evaluating the efficacy of repetitive anodal transcranial direct current stimulation on cognitive fatigue in long COVID: A randomized controlled trial (2025) · cites this paper as [5]
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Klírová, M., Adamová, A., Biačková, N., Laskov, O., Renková, V., Stuchlíková, Z., Odnohová, K., & Novák, T. (2024) · Scientific Reports · doi:10.1038/s41598-024-52763-4 · Cited by 22 · see citing works
Ko, D.-K., Lee, H., Kim, D., Park, Y.-M., & Kang, N. (2024) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2024.111072 · Cited by 13 · see citing works
Mischke, M., & Zaehle, T. (2025) · Brain Stimulation · doi:10.1016/j.brs.2025.03.011 · Cited by 3 · see citing works
Neuromodulation of heart rate variability: A systematic review
Souza, R., de Souza, I. C., Andrade, S. M. M. D. S., & Ferreira, M. R. P. (2026) · Autonomic Neuroscience · doi:10.1016/j.autneu.2026.103379 · Cited by 2 · see citing works
Игнатенко, М. Ю., Кочкарова, Е. В., Викторовна, И. Н., & Zanin, S. A. (2025) · Кубанский научный медицинский вестник · doi:10.25207/1608-6228-2025-32-6-41-55 · Cited by 1 · see citing works
Lopes, T. D. S., Lopes, L. C. D., Antunes, T. P. C., Fernandes, I. R., Morimoto, M., Pinheiro, G., de Camargo, E. D. L. B., Nonato, B. F., Cantisani, M. S., Casali, K. R., et al. (2025) · European Journal of Neuroscience · doi:10.1111/ejn.70370
Lizhu, Y., Sun, J., Ao, F., Zhuo, Z., Tian, D., Weng, J., Belani, P. B., Xia, M., & Liu, Y. (2026) · European journal of medical research · doi:10.1186/s40001-026-04032-5
Противовоспалительный потенциал неинвазивной электростимуляции мозга
Klindukhova, M. O., & Литвинова, В. В. (2026) · International journal of medicine and psychology. · doi:10.58224/2658-3313-2026-9-4-79-86
Biačková, N., Laskov, O., Adamová, A., Piorecká, V., Štrobl, J., Jiříček, S., Hubený, J., Koudelka, V., Čechová, A., Böhmová, N.-A., et al. (2026) · PLoS ONE · doi:10.1371/journal.pone.0351407
- Authors
- Pinto, T. P., Inácio, J. C., de Aguiar, E., Ferreira, A. S., Sudo, F. K., Tovar-Moll, F., & Rodrigues, E. C.
- Affiliations
- D’Or Institute for Research and Education (BR)
- University Center Augusto Motta (BR)
- Venue
- Brain Stimulation
- Publisher
- Elsevier BV
- Published
- 2023-03
- Volume
- 16
- Issue
- 2
- Pages
- 657-666
- ISSN
- 1876-4754 (ISSN-L)
- 1935-861X
- PMC
- PMC10027235
- OpenAlex
- W4327919918
- Cited by
- 11
- References
- 87
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 2 · 2023: 1
- FWCI
- 1.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Brain stimulation (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Instituto D'Or de Pesquisa e Ensino
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- transcranial direct current stimulation, prefrontal cortex, COVID-19 pandemic, autonomic nervous system, heart rate variability, cardiac autonomic regulation, dorsolateral prefrontal cortex, oxygen saturation, mood, adverse effects, hospitalized patients, non-invasive neuromodulation
- MeSH terms
- COVID-19, Autonomic Nervous System, Double-Blind Method, Humans, Inpatients, Treatment Outcome, Prefrontal Cortex, Transcranial Direct Current Stimulation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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