Magnetic brain stimulation for fatigue and brain fog in long COVID
Mitigating Cognitive Problems and Fatigue With Brain Stimulation in Long COVID
This trial will see if repetitive transcranial magnetic stimulation (rTMS) can reduce severe fatigue and improve concentration in adults with long COVID.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 66 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Amsterdam UMC, location VUmc Academic / other |
| Locations | 1 site (Amsterdam) |
| Trial ID | NCT07278206 on ClinicalTrials.gov |
What this trial studies
This randomized, double-blind, sham-controlled trial will enroll 66 adults with long COVID who report severe fatigue and cognitive complaints and will use fMRI to guide stimulation targets. Participants will receive high-frequency (10 Hz) rTMS or a sham device over multiple sessions while investigators measure changes in fatigue, cognition, and related brain measures. The primary outcome is change in fatigue severity using the Checklist Individual Strength (CIS) fatigue subscale, with secondary measures of concentration and neuroimaging biomarkers. The study excludes people with contraindications to MRI or rTMS, recent medication changes, or a history of epilepsy, and participants must attend regular treatment sessions at the study site.
Who should consider this trial
Good fit: Adults (18+) who meet the WHO definition of long COVID, have severe fatigue (CIS fatigue ≥35) and notable concentration problems (CIS concentration ≥18), can attend regular sessions at the study site, and can give informed consent are ideal candidates.
Not a fit: People with epilepsy or a first-degree family history of epilepsy, contraindications to MRI or rTMS, recent changes in psychotropic medication, prior rTMS, or who cannot attend in-person sessions are unlikely to be eligible or benefit from this protocol.
Why it matters
Potential benefit: If successful, targeted rTMS could reduce fatigue and cognitive complaints and improve daily functioning and quality of life for people with long COVID.
How similar studies have performed: Small, uncontrolled studies in PASC and related fatigue conditions have suggested potential benefits of rTMS, but robust placebo-controlled evidence in long COVID is currently lacking.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Meet the World Health Organization (WHO) definition of long COVID. * Aged 18 years or older. * Severe fatigue, defined as a score ≥35 on the Checklist Individual Strength (CIS) fatigue subscale. * Significant cognitive complaints, defined as a score ≥18 on the CIS concentration subscale. * Commitment to actively undergo rTMS * Ability to attend the study site regularly for treatment sessions. * Capacity to provide written informed consent. Exclusion Criteria: * Prior rTMS treatment or current intensive/experimental treatment for long COVID. * History of epilepsy or first-degree family history of epilepsy. * Recent initiation or dosage change of psychotropic medication (less than six weeks for psychotropic medication including antidepressants and antipsychotic drugs, less than two weeks for benzodiazepines). Medication doses must remain stable during the study. * Other active concurrent pharmacological treatments for post-covid symptoms * Contraindications to MRI scanning (e.g., non-removable metallic implants, severe claustrophobia). * Presence of a cochlear implant. * Neurological disorders such as multiple sclerosis or other neurodegenerative conditions. * Pregnancy. * Known brain lesions or ischaemic scars influencing seizure threshold. * Severe uncontrolled migraines. * Severe cardiovascular disease * Raised intracranial pressure. * High alcohol consumption (males/females: 21/14 units per week) or use of epileptogenic drugs. * Severe sleep deprivation at the time of treatment.
Where this trial is running
Amsterdam
- Amsterdam UMC — Amsterdam, Netherlands (Recruiting)
Study contacts
- Principal investigator: Sander C.J. Verfaillie, Dr. — Amsterdam UMC, GGZ InGeest
- Study coordinator: Céline N Dietz, MSc, MA
- Email: c.n.dietz@amsterdamumc.nl
- Phone: +31634010994
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.