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]. 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 selfisolate to limit the spread of COVID-19. To be clear, this selfisolation 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]. However, the call for self-isolation has resulted in the reduction of inperson social interactions on a magnitude that the world has not experienced since the Spanish Flu pandemic of 1918e1919. This social isolationwill likely lead to an increase in depression, a link that has been established with previous studies in humans [3] and nonhuman mammals such as prairie voles [4]. 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 selfadministered, 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 underactivated 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]. Preliminary results using this approach have been promising, with 37.2% of

中文翻译：

---

治疗 COVID-19 的心理健康影响：现在需要家庭神经疗法

COVID-19 是一种全球性大流行病，预计会感染数百万人并导致数十万人死亡，而且每天的病例数也在以令人不安的速度增加 [1]。它首先是一种致命的病毒。但是，许多人尚未考虑的是，为减少 COVID-19 的影响而进行的持续努力可能会产生继发性心理健康影响。在这里，我们讨论了家庭神经治疗学，包括远程医疗和自我管理的脑刺激，如何帮助减少 COVID-19 引起的一些可能的心理健康连锁反应。目前，全世界有数十亿人被告知要自我隔离以限制 COVID-19 的传播。要清楚，这种自我隔离策略是正确且必要的策略，并得到了模型的支持，该模型强调了减少人与人之间的接触如何有助于减轻疾病的影响 [2]。然而，自我隔离的呼吁导致了人际社交互动的减少，这是自 1918 年至 1919 年西班牙流感大流行以来世界从未经历过的程度。这种社会孤立可能会导致抑郁症的增加，这与之前对人类 [3] 和草原田鼠等非人类哺乳动物 [4] 的研究已经建立了联系。社会孤立的次要限制了获得心理健康资源的机会，使许多需要心理帮助的人无法获得。总之，在 COVID-19 自我隔离期间，迫切需要更容易获得的心理健康服务。现在需要家庭神经疗法。当前用于家庭心理健康治疗的工具箱主要限于远程医疗，提供者通过电话或视频与患者进行远程通信。需要快速生产和传播其他工具，例如自我管理的家庭大脑刺激，这可能有助于减少自我隔离对心理健康的影响。一种选择是将现有的用于抑郁症的临床脑刺激技术应用于家庭环境。例如，高频 (>5Hz) 重复经颅磁刺激 (rTMS) 已被美国食品和药物管理局 (FDA) 批准用于治疗抵抗性抑郁症 (TRD)。治疗通常需要 TMS 操作员将 TMS 线圈保持在左背外侧前额叶皮层 (DLPFC) 上，以无创地将电磁脉冲传递到抑郁症中未激活的大脑区域。这种抑郁症治疗的最新变体是对右侧 DLPFC 使用 360 次每日低频 (1Hz) rTMS 脉冲，具体目的是评估这种在家给药的治疗范例 [5]。使用这种方法的初步结果很有希望，37.2%