A Pilot rTMS Trial for Neuropsychiatric Symptoms of Long-COVID

Inclusion criteria

• 18+ years of age
• Prior hx of PCR confirmed COVID-19 infection. Determined by the PI or participant's physician.
• Subsequent development of post-acute neuropsychiatric symptoms with fatigue and brain fog as primary outcomes
• USE of Psychotropic medications
• Stable on psychotropic medications for 4+ months
• Confirmed diagnosis of Long COVID
• Subjects are willing and able to adhere to the treatment schedule and required study visits

Exclusion criteria

• Mentally or legally incapacitated or unable to give informed consent
• MOCA < or = 24
• Infection of poor skin condition over the scalp where the rTMS device will be positioned
• 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.
• 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.
• Severe MDD with suicidality of Psychosis- excluded
• As-needed use of benzodiazepines and beta-blockers will be permitted but discouraged during assessment days.
• 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.
• 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)
• Taking medications known to lower seizure thresholds (Clozaril/ Wellbutrin)
• 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.
• 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.