Sequential transcranial electrical stimulation in patients with dyscirculatory encephalopathy associated with post-COVID syndrome

BACKGROUND: The primary hypothesis for the use of sequential transcranial electrical stimulation therapy in the rehabilitation of patients with dyscirculatory encephalopathy associated with post-COVID syndrome is the potential synergistic effect on the central nervous system. Specifically, the method combines brain micropolarization — involving neocortex neurons and diencephalic brain stimulation — affecting limbic system structures. This synergy is expected to improve connections between cortical and subcortical structures, as well as neurohumoral regulation. AIM: To study the effectiveness of complex medical rehabilitation involving sequential transcranial electrical stimulation therapy in patients with dyscirculatory encephalopathy associated with post-COVID syndrome. MATERIALS AND METHODS: An open, prospective, randomized comparative study included 142 patients with dyscirculatory encephalopathy: 79 female (55.6%) and 63 male (44.4%) patients, aged 59 (45–69] years. The average disease duration was 8.4 years, with a period after coronavirus infection of 3.6 months. After randomization, patients in Group 1 (comparison group 1, n=48) received brain micropolarization; Group 2 (comparison group 2, n=46) received diencephalic brain stimulation; and Group 3 (main group, n=48) received both therapies sequentially. Treatment outcomes were evaluated based on changes in clinical symptoms over time and a battery of neuropsychological tests. RESULTS: In Group 3, which received sequential transcranial electrical stimulation therapy, all symptoms of dyscirculatory encephalopathy showed a significant improvement (1.2–1.6 times) compared to baseline (p 0.05–0.001). For brain micropolarization alone (Group 1), there was an average reduction in the severity of symptoms such as cranialgia, memory and attention deficits, irritability, and sleep disturbances by 1.2–1.4 times. In Group 2, diencephalic brain stimulation resulted in an improvement in tinnitus, fatigue, work productivity, and dizziness by 1.3–1.4 times. In the main group, there was an overall alleviation of all psychophysiological issues (1.1–2.0 times; p 0.05–0.01); in comparison groups 1 and 2, improvement was 1.1–1.5 times and 1.2–1.8 times, respectively. CONCLUSION: Medical rehabilitation using a combined approach (sequential application of brain micropolarization and diencephalic brain stimulation) alongside pharmacological support in patients with dyscirculatory encephalopathy associated with post-COVID syndrome is shown to be the most effective due to the pronounced neurotropic effect of the physical factors involved, allowing for the correction of a whole range of neurological, neuropsychological, and motor disorders.