{"doi":"10.1016/j.brs.2020.04.005","title":"Treating the mental health effects of COVID-19: The need for at-home neurotherapeutics is now","abstract":"COVID-19 is a global pandemic that is expected to infect millions and kill up to hundreds of thousands of people, with a troubling rise in cases each day [[1]Worldometer COVID-19 coronavirus pandemic.2020Google Scholar]. It is first and foremost a deadly virus. However, what many have not yet considered are the secondary mental health effects that will likely occur the ongoing efforts to reduce the impact of COVID-19. Here we discuss how at-home neurotherapeutics, including telehealth and self-administered brain stimulation, could help to curtail some of the possible mental health ripple effects caused by COVID-19. Currently, billions of people worldwide have been told to self-isolate to limit the spread of COVID-19. To be clear, this self-isolation strategy is the correct and necessary one and is supported by modeling that highlights how reducing human-to-human contact could help to lessen the impact of the disease [[2]Team Icc-R Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand.2020Google Scholar]. However, the call for self-isolation has resulted in the reduction of in-person social interactions on a magnitude that the world has not experienced since the Spanish Flu pandemic of 1918–1919. This social isolation will likely lead to an increase in depression, a link that has been established with previous studies in humans [[3]Matthews T. Danese A. Wertz J. Odgers C.L. Ambler A. Moffitt T.E. et al.Social isolation, loneliness and depression in young adulthood: a behavioural genetic analysis.Soc Psychiatr Psychiatr Epidemiol. 2016; 51: 339-348Crossref PubMed Scopus (277) Google Scholar] and non-human mammals such as prairie voles [[4]Grippo A.J. Gerena D. Huang J. Kumar N. Shah M. Ughreja R. et al.Social isolation induces behavioral and neuroendocrine disturbances relevant to depression in female and male prairie voles.Psychoneuroendocrinology. 2007; 32: 966-980Crossref PubMed Scopus (265) Google Scholar]. Social isolation secondarily limits access to mental health resources, preventing many who need psychological help from getting it. Put together, there is an urgent demand for more accessible mental health services during this COVID-19 self-isolation period. The need for at-home neurotherapeutics is now. The current toolbox for at-home mental health treatments is largely limited to telehealth, where providers remotely communicate with patients over the phone or using video. There is a need for the rapid production and dissemination of other tools such as self-administered, at-home brain stimulation, which could help to curtail the mental health effects from self-isolation. One option could be to adopt existing clinical brain stimulation technologies that are used for depression to at-home settings. For instance, high frequency (>5Hz) repetitive transcranial magnetic stimulation (rTMS) is a United States Food and Drug Administration (FDA) approved for treatment resistant depression (TRD). Treatments typically require a TMS operator to hold a TMS coil over the left dorsolateral prefrontal cortex (DLPFC) to noninvasively pass electromagnetic pulses into this brain region that is under-activated in depression. A recent variant of this treatment for depression is using 360 pulses of daily low frequency (1Hz) rTMS to the right DLPFC, with the specific intention of evaluating this treatment paradigm for at-home administration [[5]Miron J.P. Voetterl H. Mansouri F. Blumberger D.M. Daskalakis Z.J. Downar J. A case series of a novel 1 Hz right-sided dorsolateral prefrontal cortex rTMS protocol in major depression.Brain Stimul. 2020; 13: 372-374Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar]. Preliminary results using this approach have been promising, with 37.2% of patients having a 50% or greater reduction in depression symptoms after four weeks of daily treatments [[5]Miron J.P. Voetterl H. Mansouri F. Blumberger D.M. Daskalakis Z.J. Downar J. A case series of a nov","journal":"Brain stimulation","year":2020,"id":94710,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":37,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9593,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":106043,"name":"Mark S. George","orcid":"0000-0003-1767-1815","position":1,"is_corresponding":false},{"id":289790,"name":"Kevin A. Caulfield","orcid":"0000-0001-8268-4204","position":0,"is_corresponding":true}],"reference_count":10,"raw_metadata":null,"created_at":"2026-07-18T22:33:00.770265Z","pmid":"32283246","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}