Effectiveness of biomedical interventions on the chronic stage of traumatic brain injury: a systematic review of randomized controlled trials.

Journal: Frontiers in neurology

Volume: 15

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Kinesiology, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States. Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, United States. Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States.

Abstract summary 

Traumatic brain injury (TBI), in any form and severity, can pose risks for developing chronic symptoms that can profoundly hinder patients' work/academic, social, and personal lives. In the past 3 decades, a multitude of pharmacological, stimulation, and exercise-based interventions have been proposed to ameliorate symptoms, memory impairment, mental fatigue, and/or sleep disturbances. However, most research is preliminary, thus limited influence on clinical practice. This review aims to systematically appraise the evidence derived from randomized controlled trials (RCT) regarding the effectiveness of pharmacological, stimulation, and exercise-based interventions in treating chronic symptoms due to TBI. Our search results indicate that despite the largest volume of literature, pharmacological interventions, especially using neurostimulant medications to treat physical, cognitive, and mental fatigue, as well as daytime sleepiness, have yielded inconsistent results, such that some studies found improvements in fatigue (e.g., Modafinil, Armodafinil) while others failed to yield the improvements after the intervention. Conversely, brain stimulation techniques (e.g., transcranial magnetic stimulation, blue light therapy) and exercise interventions were effective in ameliorating mental health symptoms and cognition. However, given that most RCTs are equipped with small sample sizes, more high-quality, larger-scale RCTs is needed.

Authors & Co-authors:  Kawata Rettke Thompson Mannix Bazarian Datta

Study Outcome 

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Statistics
Citations :  Hyder AA, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. The impact of traumatic brain injuries: a global perspective. NeuroRehabilitation. (2007) 22:341–53. doi: 10.3233/NRE-2007-22502, PMID:
Authors :  6
Identifiers
Doi : 1321239
SSN : 1664-2295
Study Population
Male,Female
Mesh Terms
Other Terms
chronic traumatic encephalopathy;exercise;pharmacology;stimulation;traumatic brain injury
Study Design
Study Approach
Country of Study
Publication Country
Switzerland