AUTHOR=Hallock Harry , Collins Daniel , Lampit Amit , Deol Kiran , Fleming Jennifer , Valenzuela Michael 

TITLE=Cognitive Training for Post-Acute Traumatic Brain Injury: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Human Neuroscience

VOLUME=10

YEAR=2016

URL=https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2016.00537

DOI=10.3389/fnhum.2016.00537

ISSN=1662-5161

ABSTRACT=<p><bold>Objective:</bold> To quantitatively aggregate effects of cognitive training (CT) on cognitive and functional outcome measures in patients with traumatic brain injury (TBI) more than 12-months post-injury.</p><p><bold>Design:</bold> We systematically searched six databases for non-randomized and randomized controlled trials of CT in TBI patients at least 12-months post-injury reporting cognitive and/or functional outcomes.</p><p><bold>Main Measures:</bold> Efficacy was measured as standardized mean difference (Hedges’ <italic>g</italic>) of post-training change. We investigated heterogeneity across studies using subgroup analyses and meta-regressions.</p><p><bold>Results:</bold> Fourteen studies encompassing 575 patients were included. The effect of CT on overall cognition was small and statistically significant (<italic>g</italic> = 0.22, 95%CI 0.05 to 0.38; <italic>p</italic> = 0.01), with low heterogeneity (<italic>I</italic><sup>2</sup> = 11.71%) and no evidence of publication bias. A moderate effect size was found for overall functional outcomes (<italic>g</italic> = 0.32, 95%CI 0.08 to 0.57, <italic>p</italic> = 0.01) with low heterogeneity (<italic>I</italic><sup>2</sup> = 14.27%) and possible publication bias. Statistically significant effects were also found only for executive function (<italic>g</italic> = 0.20, 95%CI 0.02 to 0.39, <italic>p</italic> = 0.03) and verbal memory (<italic>g</italic> = 0.32, 95%CI 0.14 to 0.50, <italic>p</italic> &lt; 0.01).</p><p><bold>Conclusion:</bold> Despite limited studies in this field, this meta-analysis indicates that CT is modestly effective in improving cognitive and functional outcomes in patients with post-acute TBI and should therefore play a more significant role in TBI rehabilitation.</p>