Amygdala and Insula Retraining (AIR) Significantly Reduces Fatigue and Increases Energy in People with Long COVID.
Toussaint, Loren L, Bratty, Alexandra J · Evidence-based complementary and alternative medicine : eCAM · 2023 · DOI
Quick Summary
This study tested whether a brain retraining program called Amygdala and Insula Retraining (AIR) could help people with Long COVID feel less exhausted and have more energy. Over 3 months, people who did the AIR program reported significantly less fatigue and more energy compared to a control group that received a different wellness program. The AIR group showed roughly twice the improvement in energy levels and four times the improvement in fatigue compared to the control group.
Why It Matters
This research is significant because it offers ME/CFS and Long COVID patients a non-pharmacological intervention option based on neuroplasticity principles, which may complement existing treatment approaches. The findings suggest that brain-based retraining programs warrant further investigation as potential therapeutic tools for fatigue-dominant conditions. For researchers, this work bridges Long COVID and ME/CFS symptomatology and strengthens evidence for mechanism-specific neurobiological interventions.
Observed Findings
Participants in the AIR group experienced significant fatigue reduction after 3 months compared to controls.
The AIR group showed energy level increases significantly greater than the active control group.
Fatigue reduction in the AIR group had an effect size approximately four times that of the control group.
Energy enhancement in the AIR group had an effect size approximately twice that of the control group.
Absolute mean score improvements were more than double (fatigue) and almost double (energy) in AIR versus control groups.
Inferred Conclusions
AIR is a viable non-pharmacological intervention for reducing fatigue and increasing energy in Long COVID patients.
The magnitude of AIR's benefits substantially exceeds those of an active control intervention, suggesting intervention-specific effects.
Neuroplasticity-based approaches targeting emotion-processing brain regions may be therapeutic for fatigue in chronic post-infectious conditions.
Remaining Questions
Does AIR produce sustained benefits beyond the 3-month intervention period, and what is the trajectory of fatigue/energy over longer follow-up?
Are there specific Long COVID or ME/CFS phenotypes (e.g., post-exertional malaise severity, immune profiles) that predict better or worse AIR response?
What This Study Does Not Prove
This study does not prove that AIR works through the proposed mechanisms of amygdala/insula retraining, as neuroimaging biomarkers were not reported. It does not establish whether improvements result from the specific retraining protocol or from non-specific factors like attention, expectancy, or therapeutic contact. The study's applicability to ME/CFS populations specifically remains unclear, as the research focused on Long COVID.
What are the active mechanisms of change in AIR—does improvement correlate with measurable changes in amygdala/insula function, immune markers, or psychological factors?
How does AIR's efficacy compare to other neuroplasticity interventions, pharmacological treatments, or multimodal rehabilitation approaches in head-to-head trials?