Guidelines for TMS/tES clinical services and research through the COVID-19 pandemic

Author(s):Show less -

Bikson, Marom ^[1] ; Hanlon, Colleen A. ^[2] ; Woods, Adam J. ^[3] ; Gillick, Bernadette T. ^[4] ; Charvet, Leigh ^[5] ; Lamm, Claus ^[6] ; Madeo, Graziella ^[7] ; Holczer, Adrienn ^[8] ; Almeida, Jorge ^{[9, 10]} ; Antal, Andrea ^{[11, 12]} ; Ay, Mohammad Reza ^[13] ; Baeken, Chris ^{[14, 15, 16]} ; Blumberger, Daniel M. ^{[17, 18]} ; Campanella, Salvatore ^[19] ; Camprodon, Joan A. ^[20] ; Christiansen, Lasse ^[21] ; Loo, Colleen ^{[22, 23]} ; Crinion, Jennifer T. ^[24] ; Fitzgerald, Paul ^{[25, 26]} ; Gallimberti, Luigi ^[7] ; Ghobadi-Azbari, Peyman ^{[27, 28]} ; Ghodratitoostani, Iman ^[29] ; Grabner, Roland H. ^[30] ; Hartwigsen, Gesa ^[31] ; Hirata, Akimasa ^[32] ; Kirton, Adam ^{[33, 34]} ; Knotkova, Helena ^{[35, 36]} ; Krupitsky, Evgeny ^[37] ; Marangolo, Paola ^{[38, 39]} ; Nakamura-Palacios, Ester M. ^[40] ; Potok, Weronika ^[41] ; Praharaj, Samir K. ^[42] ; Ruff, Christian C. ^[43] ; Schlaug, Gottfried ^{[44, 45]} ; Siebner, Hartwig R. ^{[21, 46]} ; Stagg, Charlotte J. ^{[47, 48]} ; Thielscher, Axel ^{[49, 21]} ; Wenderoth, Nicole ^[41] ; Yuan, Ti-Fei ^[50] ; Zhang, Xiaochu ^{[51, 52]} ; Ekhtiari, Hamed ^[53]

Affiliation:Show less -

^[1] CUNY, Dept Biomed Engn, City Coll New York, New York, NY 10021 - USA

^[2] Wake Forest Sch Med, Dept Canc Biol, Winston Salem, NC 27101 - USA

^[3] Univ Florida, Ctr Cognit Aging & Memory, McKnight Brain Inst, Dept Clin & Hlth Psychol, Gainesville, FL - USA

^[4] Univ Minnesota, Sch Med, Dept Rehabil Med, Minneapolis, MN 55455 - USA

^[5] NYU, Dept Neurol, Grossman Sch Med, New York, NY 10016 - USA

^[6] Univ Vienna, Fac Psychol, Dept Cognit Emot & Methods Psychol, Social Cognit & Affect Neurosci Unit, Vienna - Austria

^[7] Novella Fronda Fdn, Padua - Italy

^[8] Univ Szeged, Fac Med, Albert Szent Gyorgyi Hlth Ctr, Dept Neurol, Szeged - Hungary

^[9] Univ Coimbra, Fac Psychol & Educ Sci, Proact Lab, Coimbra - Portugal

^[10] Univ Coimbra, Fac Psychol & Educ Sci, CINEICC, Coimbra - Portugal

^[11] Univ Med Ctr Gottingen, Dept Clin Neurophysiol, Gottingen - Germany

^[12] Otto von Guericke Univ, Inst Med Psychol, Magdeburg - Germany

^[13] Univ Tehran Med Sci, Dept Med Phys & Biomed Engn, Tehran - Iran

^[14] Univ Hosp UZBrussel, Dept Psychiat, Brussels - Belgium

^[15] Eindhoven Univ Technol, Dept Elect Engn, Eindhoven - Netherlands

^[16] Univ Ghent, Fac Med & Hlth Sci, Ghent Expt Psychiat GHEP Lab, Ghent - Belgium

^[17] Univ Toronto, Fac Med, Dept Psychiat, Toronto, ON - Canada

^[18] Ctr Addict & Mental Hlth, Temerty Ctr Therapeut Brain Intervent, Toronto, ON - Canada

^[19] Univ Libre Bruxelles ULB, Lab Psychol M Edicale & Addict, ULB Neurosci Inst UNI, Pl Vangehuchten, B-1020 Brussels - Belgium

^[20] Harvard Med Sch, Massachusetts Gen Hosp, Boston, MA 02115 - USA

^[21] Copenhagen Univ Hosp Hvidovre, Danish Res Ctr Magnet Resonance DRCMR, Ctr Funct & Diagnost Imaging & Res, Hvidovre - Denmark

^[22] Univ New South Wales, Sch Psychiat, Sydney, NSW - Australia

^[23] Univ New South Wales, Black Dog Inst, Sydney, NSW - Australia

^[24] UCL, Inst Cognit Neurosci, London - England

^[25] Monash Univ, Epworth Ctr Innovat Mental Hlth, Epworth HealthCare, Camberwell, Vic - Australia

^[26] Monash Univ, Dept Psychiat, Camberwell, Vic - Australia

^[27] Shahed Univ, Dept Biomed Engn, Tehran - Iran

^[28] Iranian Natl Ctr Addict Studies INCAS, Tehran - Iran

^[29] Univ Sao Paulo, Ctr Math Sci Appl Ind, Inst Math & Comp Sci, Neurocognit Engn Lab NEL, Sao Paulo - Brazil

^[30] Karl Franzens Univ Graz, Inst Psychol, Educ Neurosci, Graz - Austria

^[31] Max Planck Inst Human Cognit & Brain Sci, Lise Meitner Res Grp Cognit & Plastic, Leipzig - Germany

^[32] Nagoya Inst Technol, Dept Elect & Mech Engn, Nagoya, Aichi - Japan

^[33] Univ Calgary, Cumming Sch Med, Dept Pediat, Calgary, AB - Canada

^[34] Univ Calgary, Cumming Sch Med, Dept Clin Neurosci, Calgary, AB - Canada

^[35] MJHS Inst Innovat Palliat Care, New York, NY - USA

^[36] Albert Einstein Coll Med, Dept Family & Social Med, The Bronx, NY - USA

^[37] First Pavlov State Med Univ, VM Bekhterev Natl Res Med Ctr Psychiat & Neurol, St Petersburg - Russia

^[38] Univ Federico II, Dept Humanities Studies, Naples - Italy

^[39] IRCCS Santa Lucia Fdn, Aphasia Res Lab, Rome - Italy

^[40] Univ Fed Espirito Santo, Dept Physiol Sci, Vitoria, ES - Brazil

^[41] Swiss Fed Inst Technol, Neural Control Movement Lab, Dept Hlth Sci & Technol, Zurich - Switzerland

^[42] Manipal Acad Higher Educ, Kasturba Med Coll, Dept Psychiat, Manipal - India

^[43] Univ Zurich, Zurich Ctr Neuroecon ZNE, Dept Econ, Zurich - Switzerland

^[44] UMass Med Sch, Beth Israel Deaconess Med Ctr, Dept Neurol, Neuroimaging Neuromodulat & Stroke Recovery Lab, Worcester, MA - USA

^[45] UMass Med Sch, Baystate Med Ctr, Worcester, MA - USA

^[46] Univ Copenhagen, Fac Hlth Sci & Med, Inst Clin Med, Copenhagen - Denmark

^[47] Univ Oxford, Wellcome Ctr Integrat Neuroimaging, Oxford - England

^[48] Univ Oxford, MRC Brain Network Dynam Unit, Nuffield Dept Clin Neurosci, Oxford - England

^[49] Tech Univ Denmark, Dept Hlth Technol, Lyngby - Denmark

^[50] Shanghai Jiao Tong Univ, Shanghai Mental Hlth Ctr, Sch Med, Shanghai - Peoples R China

^[51] Univ Sci & Technol China, CAS Key Lab Brain Funct & Dis, Hefei - Peoples R China

^[52] Univ Sci & Technol China, Sch Life Sci, Div Life Sci & Med, Hefei - Peoples R China

^[53] Laureate Inst Brain Res, 6655 South Yale Ave, Tulsa, OK 74136 - USA

• Document type: Journal article
• Source: BRAIN STIMULATION; v. 13, n. 4, p. 1124-1149, JUL-AUG 2020.
• Web of Science Citations: 13

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 e 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. (C) 2020 The Authors. Published by Elsevier Inc. (AU)

• FAPESP's process: 13/07375-0 - CeMEAI - Center for Mathematical Sciences Applied to Industry
• Grantee: Francisco Louzada Neto
• Support Opportunities: Research Grants - Research, Innovation and Dissemination Centers - RIDC