Brain retraining
What is it: A structured program leveraging neuroplasticity, mindfulness, and cognitive strategies.- ⬤ Minimal research: Very little scientific study exists, with no or very few peer-reviewed studies. Insufficient data for conclusions.
- ⬤⬤ Limited research: Few studies exist, mostly small trials or case reports. Findings are preliminary and lack strong validation.
- ⬤⬤⬤ Moderately researched: Multiple studies, including mid-sized trials, exist. Some findings are replicated, but more research is needed.
- ⬤⬤⬤⬤ Well-researched: Supported by substantial evidence, including at least one large trial or meta-analysis.
- ⬤⬤⬤⬤⬤ Extensively studied: Numerous large studies and meta-analyses exist. Findings are widely accepted with strong scientific consensus.
- ⬤ Extremely Difficult to Access: Rare, experimental, or highly specialized. Requires multiple referrals, long wait times, travel, and strict follow-up.
- ⬤⬤ Difficult to Access: Limited to select centers with moderate barriers. Requires referral, potential travel, and wait times of weeks to months.
- ⬤⬤⬤ Moderately Accessible: Available in larger hospitals or clinics. Requires a basic referral, with moderate wait times and some coordination.
- ⬤⬤⬤⬤ Easy to Access: Widely available in most clinics. Minimal referral, short wait times, and simple preparation or follow-up.
- ⬤⬤⬤⬤⬤ Trivial to Access: Easily found in pharmacies or clinics. No referral needed, minimal wait, and straightforward access.
- ⬤ Up to $100
- ⬤⬤ Up to $500
- ⬤⬤⬤ Up to $2000
- ⬤⬤⬤⬤ Up to $10,000
- ⬤⬤⬤⬤⬤ More than $10,000
To calculate the reported effectiveness for a patient view, the model first analyses whether it can be ascertained that the person writing the review has had direct experience of the treatment for themselves or a loved one. If so, it then uses sentiment analysis to rate their view from 1-5 on how effective this treatment was for them, with 1 being the least effective, and 5 the most effective.
24 Resources
Referenced in this guide
3 Research papers
Referenced in this guide
24 Expert views
Contributed in this guide
40 Patient views
Contributed in this guide
Figure out what Brain retraining means for you
Page contents
Basics: What you need to know
Dynamic Neural Retraining System (DNRS) is a tool designed to address maladaptive neural pathways linked to persistent symptoms. It combines concepts of neuroplasticity, cognitive-behavioral principles, mindfulness, and repetition-based exercises to help the brain establish healthier responses. Individuals with lingering symptoms can follow a structured program of daily training modules, designed to reduce stress responses and shift the nervous system away from a state of hypervigilance.
History and development
- Created by Annie Hopper: She initially developed this system after her own struggles with chronic sensitivities, aiming to retrain the brain’s threat-detection circuitry.
- Roots in limbic retraining: DNRS focuses on the limbic system, the part of the brain involved in emotion, behavior, and long-term memory formation.
- Influenced by neuroplasticity research: The program incorporates emerging research showing the brain can adapt and form new neural connections even in adulthood.
- Adapted for multiple conditions: Though it originated for conditions like multiple chemical sensitivity, it has since grown to target various chronic syndromes.
What is known
- Neural pathway change: DNRS aims to overwrite patterns of overactive threat response by engaging in repeated, structured exercises.
- Mindfulness integration: Techniques often include breathing exercises and guided visualization to calm the nervous system.
- Cognitive reconditioning: Users are encouraged to replace negative thought patterns with more neutral or positive ones, lessening stress-induced flare-ups.
- Potential risk awareness: If individuals overexert themselves or push too hard, it may momentarily trigger emotional distress or worsen some symptoms before improvement is noticed.
- Some reported benefits: Anecdotal reports suggest better energy, reduced pain, and overall improved resilience in day-to-day activities.
- Secondary impacts: Participants sometimes note improved mood and enhanced ability to handle routine stressors.
What is not known
- Exact mechanism: While the approach draws on neuroplasticity, the precise way DNRS reshapes brain function remains under study.
- Long-term efficacy: Research on enduring outcomes for large populations is still limited, especially in the context of persistent conditions.
- Optimal delivery methods: Whether in-person guidance, online modules, or group sessions produce the best results is not yet definitively established.
- Who benefits most: Some individuals see marked progress, while others perceive minimal change. Clear predictive factors are not fully identified.
- Impact on complex cases: It is uncertain how DNRS interacts with additional health concerns such as autoimmune conditions or other comorbidities.
- Neuroplasticity principles: Trains the brain to form new, healthier pathways by repeated mental exercises.
- Cognitive-behavioral strategies: Uses systematic thought replacement techniques to reduce negative feedback loops.
- Mindfulness exercises: Promotes awareness of triggers and calmer responses to stressful sensations.
- Repetitive training: Involves consistent daily sessions to reinforce positive neural changes and reduce automated stress reactions.
- Emotional discomfort: Intensive focus on past traumas or triggers can bring up distress.
- Temporary strain: Repetitive or long training sessions may lead to mental fatigue or frustration.
- Overexertion concerns: Individuals can worsen symptoms if they push too hard or ignore pacing.
- Possible stress increase: Shifting habitual mindsets can initially feel unsettling or overwhelming.
- Limited large studies: Critics point out the need for more rigorous, peer-reviewed evidence.
- Subjective success: Some doubt the reliability of self-reported improvements when objective measures are lacking.
- Possible placebo effect: Certain experts wonder if perceived benefits are partly influenced by expectation or belief.
- Varied acceptance: While some medical professionals see potential, others remain skeptical or unfamiliar with the method.
Patient views
Experiences
- Patients appreciate the focus on calming the nervous system.
- Some report reduced symptoms like brain fog and fatigue.
- Programs like Curable and Gupta are praised for accessibility.
- Many find it helpful for mindset and coping strategies.
Challenges
- Some find brain retraining ineffective or even harmful.
- Concerns about pre-selection bias in programs.
- High time commitment and cost are common complaints.
- Lack of scientific evidence for efficacy frustrates patients.
Tips
- Combine brain retraining with pacing and nervous system exercises.
- Research programs thoroughly before committing.
- Start with free trials to test compatibility.
- Focus on gradual progress and patience.
To calculate the reported effectiveness for a patient view, the model first analyses whether it can be ascertained that the person writing the review has had direct experience of the treatment for themselves or a loved one. If so, it then uses sentiment analysis to rate their view from 1-5 on how effective this treatment was for them, with 1 being the least effective, and 5 the most effective.
Patient view
Brain retraining did help with my fragrance sensitivity, not so much with other things. But the impact on that was profound. As in it pretty much disappeared after a week and it's something I've had an issue with for over 20 years.
February 2025 • Turnto Comment
Patient view
I had a similar recovery (mostly) story to yours. Recognized that it was my brain that really took the hit. The rest of my body did its thing to heal everything else, but my brain desperately needed to be retrained from the ground up. Some days are more difficult than others, but ever since I recognized that my brain was the issue I started to gradually get better. I'm different now because of it, but I believe it changed me for the better honestly.
October 2024 • /r/covidlonghaulers
Expert views
What they liked
- Experts appreciate brain retraining's focus on neuroplasticity.
- It helps patients regain cognitive function and emotional balance.
- Promotes self-advocacy and community support for recovery.
- Effective for managing symptoms like brain fog and fatigue.
What they didn't like
- Some experts find brain retraining too generalized for complex cases.
- Concerns about its accessibility in rural areas or for severe cases.
- Mixed evidence on its effectiveness for all patients.
- May not address underlying structural or biochemical issues.
What are they unsure about
- Experts are unsure about long-term effectiveness of brain retraining.
- Questions remain about its impact on severe neurological damage.
- Uncertainty about its role in treating physical symptoms beyond cognition.
- Lack of standardized protocols for brain retraining programs.
24 expert views
Expert view
Dr. Jim Jackson, a research professor at Vanderbilt University Medical Center, has extensive experience in neuropsychology and cognitive rehabilitation. He emphasizes that Long Covid should be treated as a brain injury, as it often involves neurological symptoms like brain fog, anxiety, and PTSD. Dr. Jackson advocates for cognitive rehabilitation, which he describes as physiotherapy for the brain, and highlights the importance of mindfulness and breathing exercises. He also runs support groups for Long Covid patients, providing them with tools to cope, advocate for themselves, and connect with others facing similar challenges.
May 2023 • Episode 56: Dr Jim Jackson - Neuropsychology and Cognitive Rehabilitation
Expert view
Dr. Becca Kennedy explains that Long Covid symptoms often stem from issues with brain signaling rather than structural damage in the body. She emphasizes the importance of calming the nervous system and sending safe signals to the brain to help restore health. Techniques like meditation, breathing exercises, and expressive writing can be helpful, but some patients may need additional methods, such as emotional awareness and expression therapy. These approaches aim to rewire neural pathways and address stored emotions, helping the brain interpret safety rather than danger.
September 2024 • Long Covid Podcast
What and who it targets
Post-exertional malaise group
Helps manage exertion-related symptoms.
Fatigue sufferers
Addresses energy regulation and mental stamina.
Cognitive dysfunction patients
Targets cognitive recovery and mental clarity.
Relevant research
How much evidence on this?
- Multiple studies show promising results for brain retraining.
- Research spans over a decade, including recent trials.
- At least 5 peer-reviewed studies on AIR for chronic conditions.
- Randomized controlled trials and self-reported data available.
Research focusing on
- AIR reduces fatigue and boosts energy in Long COVID.
- Mindfulness combined with AIR improves quality of life.
- AIR shows large effect sizes for chronic conditions.
- Researchers exploring neural network-based interventions.
What needs more research?
- Long-term effects of AIR for Long COVID unclear.
- Optimal duration and intensity of AIR not established.
- Mechanisms behind AIR's effectiveness need more study.
- Applicability to diverse populations remains uncertain.
- ⬤ Minimal research: Very little scientific study exists, with no or very few peer-reviewed studies. Insufficient data for conclusions.
- ⬤⬤ Limited research: Few studies exist, mostly small trials or case reports. Findings are preliminary and lack strong validation.
- ⬤⬤⬤ Moderately researched: Multiple studies, including mid-sized trials, exist. Some findings are replicated, but more research is needed.
- ⬤⬤⬤⬤ Well-researched: Supported by substantial evidence, including at least one large trial or meta-analysis.
- ⬤⬤⬤⬤⬤ Extensively studied: Numerous large studies and meta-analyses exist. Findings are widely accepted with strong scientific consensus.
Research
This study investigated the effectiveness of Amygdala and Insula Retraining (AIR), a neuroplasticity program, in reducing fatigue and increasing energy levels in people with Long COVID. It compared AIR to a similar health and wellness intervention over a 3-month period in a randomized controlled trial.
The study found that participants in the AIR group experienced a significant reduction in fatigue and a notable increase in energy levels compared to the control group. The AIR group showed a fatigue reduction effect size four times greater and an energy enhancement effect size twice as large as the control group, with absolute improvements in scores being substantially higher for AIR participants.
For individuals living with Long COVID, this study suggests that AIR could be a promising treatment option to alleviate fatigue and boost energy levels, potentially improving daily functioning and quality of life. Caregivers and healthcare providers might consider AIR as a viable intervention to address these debilitating symptoms.
As a randomized controlled trial published in a peer-reviewed journal focused on evidence-based complementary medicine, this study is a reliable source. However, further research is needed to confirm these findings and address any limitations mentioned in the study.
July 2023 • Evidence-based complementary and alternative medicine : eCAM
Research
This study set out to evaluate the effects of a program combining amygdala and insula retraining (AIR) with mindfulness training on improving quality of life, psychological well-being, and cognition in patients with Long COVID. It involved a single-blind randomized controlled trial with 100 participants diagnosed with Long COVID, comparing the AIR + Mindfulness program to a relaxation intervention as a control.
The study protocol outlines that the primary outcome will be quality of life measured using the Short Form-36 Health Survey (SF-36), with additional measures for fatigue, pain, anxiety, memory, and sleep quality. While the paper does not report results yet, it anticipates that positive findings could confirm the effectiveness of AIR + Mindfulness in managing Long COVID symptoms.
If the intervention proves effective, it could offer a new therapeutic option for improving the quality of life and mental health of individuals living with Long COVID. This could also help caregivers and healthcare providers better support patients by incorporating psychological and mindfulness-based strategies.
The study is a randomized controlled trial, which is considered a high standard in clinical research. It is published in a reputable journal, BMC Complementary Medicine and Therapies, and registered on ClinicalTrials.gov, adding to its credibility.
November 2023 • BMC complementary medicine and therapies
Accessibility
- ⬤ Extremely Difficult to Access: Rare, experimental, or highly specialized. Requires multiple referrals, long wait times, travel, and strict follow-up.
- ⬤⬤ Difficult to Access: Limited to select centers with moderate barriers. Requires referral, potential travel, and wait times of weeks to months.
- ⬤⬤⬤ Moderately Accessible: Available in larger hospitals or clinics. Requires a basic referral, with moderate wait times and some coordination.
- ⬤⬤⬤⬤ Easy to Access: Widely available in most clinics. Minimal referral, short wait times, and simple preparation or follow-up.
- ⬤⬤⬤⬤⬤ Trivial to Access: Easily found in pharmacies or clinics. No referral needed, minimal wait, and straightforward access.
- ⬤ Up to $100
- ⬤⬤ Up to $500
- ⬤⬤⬤ Up to $2000
- ⬤⬤⬤⬤ Up to $10,000
- ⬤⬤⬤⬤⬤ More than $10,000
Method to access
- Access specialized programs like DNRS or Gupta Program online.
- Participate in clinical trials such as RECOVER-NEURO.
- Clinics like Neuroperforma offer in-person neurofeedback sessions.
- At-home options include tDCS equipment rental programs.
Cost
- DNRS program costs approximately $250–$400.
- Gupta Program offers free trials; full program costs vary.
- tDCS sessions cost $30 each, including equipment rental.
- Neurofeedback sessions typically range from $100–$200 per session.
Insurance cover
- Neurofeedback services are reimbursed by some insurance providers in Canada.
- Clinical trials like RECOVER-NEURO offer free participation.
- tDCS programs are not covered by insurance.
- Coverage varies by region and provider.
Locations
- Neuroperforma clinics in Quebec, Canada.
- Penn Neuro COVID Clinic in Pennsylvania, USA.
- RECOVER-NEURO clinical trials across the USA.
- DNRS and Gupta Program available online.
Related clinical trials
Frequently asked questions
Key resources
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