Intervention Effect of Non-Invasive Brain Stimulation on Cognitive Functions among People with Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

Daniel Kwasi Ahorsu,Bess Yin Hung Lam,Emma Sethina Adjaottor

doi:10.3390/brainsci11070840

Abstract

This systematic review and meta-analysis aggregated and examined the treatment effect of non-invasive brain stimulation (NIBS) (transcranial direct current stimulation and transcranial magnetic stimulation) on cognitive functions in people with traumatic brain injury (TBI). A systematic search was conducted using databases (PubMed, Web of Science, Scopus, PsycINFO, EMBASE) for studies with keywords related to non-randomized and randomized control trials of NIBS among people with TBI. Nine out of 1790 NIBS studies with 197 TBI participants (103 active vs. 94 sham) that met the inclusion and exclusion criteria of the present study were finally selected for meta-analysis using Comprehensive Meta-Analysis software (version 3). Results showed that the overall effect of NIBS on cognition in people with TBI was moderately significant (g = 0.304, 95% CI = 0.055 to 0.553) with very low heterogeneity across studies (I2 = 0.000, Tau = 0.000). Specifically, significant and marginally significant moderate effect sizes were found for cognitive sub-domains including attention, memory, and executive function. The present findings suggest that NIBS is moderately effective in improving cognitive functions among people with TBI. In particular, NIBS may be used as an alternative and/or an adjunct treatment to the traditional approach in rehabilitating cognitive functions in people with TBI.

Highlights

Traumatic brain injury (TBI) occurs when there is a sudden trauma caused by an external force to the brain
Nine non-invasive brain stimulation (NIBS) studies were generally included in this study which encompass eight randomized control trials (RCTs) and a quasi-experimental study (three anode transcranial direct current stimulation (tDCS) and six repetitive (r) transcranial magnetic stimulation (TMS))
It is revealed that NIBS may improve the cognition abilities and its domain-specific functions such as attention, memory and executive function among the people with TBI

Summary

Introduction

Traumatic brain injury (TBI) occurs when there is a sudden trauma caused by an external force to the brain. TBI leads to clinical and functional impairment in cognition, behavioural, and sensorimotor abilities that further deteriorate one’s quality of life and lifesatisfaction [1,2,3,4]. TBI can be classified based on the mechanism (open—broken fractured, or penetrated skull—or closed—blunt) [5,6] severity (mild (brief loss of consciousness for a few seconds or minutes), moderate (loss of consciousness for hours), or severe (loss of consciousness or coma for more than a day)) [6,7] and other features (e.g., location of injury) [5]. TBI is one of the growing public global health problems with more than 69 million people being affected worldwide annually. Given the detrimental effects of TBI, it is crucial to develop cost-effective interventions to tackle this “silent epidemic”

Methods

Results

Discussion

Conclusion