Neurostimulation in Long COVID

Neurostimulation techniques are emerging as promising interventions for addressing neurocognitive impairments associated with Long COVID, including brain fog, fatigue, memory deficits and executive dysfunction. Non-invasive modalities such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have demonstrated potential in modulating neural activity, enhancing cognitive recovery and alleviating neuroinflammatory processes linked to post-viral syndromes. Vagus nerve stimulation (VNS) and transcutaneous auricular VNS (taVNS) offer additional therapeutic avenues by targeting autonomic dysfunction, which is often implicated in Long COVID-related dysautonomia and cognitive fatigue. Neuromodulation approaches combined with neurofeedback and cognitive rehabilitation may optimise neuroplasticity and functional outcomes in affected individuals. Wearable neurostimulation devices and home-based therapies further improve accessibility, offering scalable solutions for post-COVID neurorehabilitation. However, challenges such as variability in patient response, optimal stimulation parameters and long-term efficacy require further investigation. Integrating neurostimulation into multidisciplinary rehabilitation frameworks that include cognitive training, exercise therapy and pharmacological support may enhance recovery trajectories. Future research should prioritise personalised stimulation protocols, biomarker-driven treatment strategies and longitudinal studies to establish evidence-based guidelines for neurostimulation in Long COVID.