High Amplitude Low Frequency–Music Impulse Stimulation (HALF‐MIS) for LONG COVID

[rapidboson]

Hey guys,

I'm wondering if there's anybody that has an opinion on High Amplitude Low Frequency–Music Impulse Stimulation (HALF‐MIS) therapy, specifically for long COVID.

I was recently contacted by a neurologist that has researched this over the past 30 years and just finished a RCT for long COVID. According to him with great results - paper should be done within the next month. Clinically significant results for fatigue and brain fog within just 4 weeks. He seemed very confident in his technology, overconfident in my opinion.

Naturally, I'm very skeptical but it seems very low risk and basically just another VNS, so I'll likely give it a go (for free and with no expectations of efficacy). He found my case of long COVID + recent Lyme's neuroborreliosis quite interesting and wanted to see if he can help me.

They did a (non blinded) pilot trial on depression a couple years back and some interviews:

https://pmc.ncbi.nlm.nih.gov/articles/PMC6790306/

I feel like blinding would have been as easy as introducing a switch in the chair that would turn it on or off and then hiding the switch position by putting it in a black box or something. But maybe they just didn't have enough chairs?

https://www.hbkworld.com/en/knowledge/resource-center/articles/doktor-nielsen

https://www.sn.dk/art2098665/holbaek-kommune/laes-eller-genlaes-bassens-dybe-summen-fjerner-smerter/

And a PDF of a presentation of his.

Would love to hear your inputs on this esoteric therapy.

 

[Kitty]

Would love to hear your inputs on this esoteric therapy.

Isn't it based on a significant misunderstanding? The therapy is for pain and depression—that's not long Covid.

I wonder if it would just provoke PEM. The old fashioned way of getting exposure to sound like this (sitting near massive bass cabinets) wears out people with ME/CFS very rapidly.

Vibration, even the low-level type you get travelling in a car, is as exhausting as any other activity. More so if you have sound sensitivity, because even when sounds are below the frequencies we can hear, the impact is the same. The brain seems to treat it as sound, regardless of which structure 'hears' it.

 

[rapidboson]

Isn't it based on a significant misunderstanding? The therapy is for pain and depression—that's not long Covid.

Yeah, that's what it seems like it was initially developed for. But they have now supposedly trialed it on long COVID patients, from what I understood specifically for neurological symptoms. Let's say "off-label". Paper will be released soon, according to him.
He did not specifically mention ME/CFS and has also not shared his inclusion criteria, it's all a black box for now. He did mention that there were patients that could not concentrate/work for more than 2h/day and then could go back to full-time within a month.
All very up in the air, I am as skeptical as you haha

 

[Utsikt]

But they have now supposedly trialed it on long COVID patients, from what I understood specifically for neurological symptoms.

Keep in mind that LC simply means symptoms due to covid-infection that lasta for more than 3 months. So LC really doesn’t tell us much about the patients.

‘Neurological’ symptoms also doesn’t tell us much about the patients. It’s a very broad category.

He did mention that there were patients that could not concentrate/work for more than 2h/day and then could go back to full-time within a month.

If you’re able to work 25 %, getting back to 100 % in a month or two might just be natural recovery.

I wonder if it would just provoke PEM.

I’m worried about this.

I was recently contacted by a neurologist that has researched this over the past 30 years and just finished a RCT for long COVID.

He just contacted you randomly? Or did you know him already?

 

[rapidboson]

100% agree. LC could be anything really and without being able to scrutinize their methods, it's impossible to know what patients they included (and how many).

I hadn't thought about PEM, as listening to music is fine for me, but it's true that the vibrations could elicit such a response. I'll be vigilant. Thanks!

The doctor that diagnosed and treated my LNB in the infectious diseases department of national hospital then afterwards was trying to see if she can help me with long COVID somehow and she heard about his trial and forwarded my info to him. He then contacted me.

 

[Utsikt]

I hadn't thought about PEM, as listening to music is fine for me, but it's true that the vibrations could elicit such a response. I'll be vigilant. Thanks!

Most people learn this the hard way, so you’re not alone! I think it’s fair to assume that anything can cause PEM for anyone, the only individual difference is the threshold.

 

[EndME]

I was recently contacted by a neurologist that has researched this over the past 30 years and just finished a RCT for long COVID.

Very likely it wasn't a RCT in any meaningful way of the word.

 

[rapidboson]

Very likely it wasn't a RCT in any meaningful way of the word.

Probably not, but let's see what the study says once it's out.

Do we know of any similar studies in which stimulation of the Pacinian corpuscles is supposed to be therapeutic in the context of ME or LC?

 

[Jonathan Edwards]

I feel like blinding would have been as easy as introducing a switch in the chair that would turn it on or off and then hiding the switch position by putting it in a black box or something. But maybe they just didn't have enough chairs?

If you feel the vibration through Pacinian corpuscles then it wouldn't be blindable. But you could easily do a dose response study which would be as good as blinding if not better.

Looking at the presentation slides this does not come across as meaningful science.

 

[rapidboson]

Yeah, I am not sure how much you actually feel it, but you could just tell the participants that it's barely noticeable, if at all - so the placebo receiving patients don't realize it's placebo.

Another way would be to use different frequencies or amplitudes in both groups, or as you say a dose response.

Also agree on the slides.

 

[Peter T]

Not read the paper itself but how do you control for other sound stimulation outside the experimental setting. This rather like much activity/exercise based research that gets people to do fixed amounts of exercise without considering their total activity levels. In such exercise research they have no idea if any short term improvement is an actual increase in overall activity or reflects stopping doing other things in order to focus of the research activity.

In this study it would be hard to say what relates to the experimental condition and what relates to sound stimulation outside the lab. There would need to be some justification of any assumption that such extraneous sound stimulation is consistent between the different study arms.

(Note - I personally find music as well as any other sound fatiguing and it contributes with other activities to triggering PEM. I only listen to music occasionally if there is something I particularly want to hear. So whether the LC subjects also experience PEM would be relevant to the study. Certainly in people with any sound hypersensitivity it could be that the active arm sees them also altering their behaviour outside the experimental setting.)

 

[rapidboson]

Not read the paper itself but how do you control for other sound stimulation outside the experimental setting.

In this study it would be hard to say what relates to the experimental condition and what relates to sound stimulation outside the lab.

Good point!

If I understood the concept correctly, the main efficacy is supposed to come from the inaudible frequencies of the chair that stimulate Pacinian corpuscles and not from the sound listened to via headphones.

I'm not sure how or if this would be affected by external factors such as commuting by train for example.