A cognitive energy crisis: A systematic review & meta-analysis of effective interventions for pediatric cognitive fatigue post-acquired brain injury.

Acquired Brain Injuries (ABIs) cause long-term disruption to young individuals' development. Persistent cognitive fatigue is a commonly reported sequela following pediatric ABI. Currently, there are no evidence-based interventions targeting cognitive fatigue post-ABI amongst pediatric patients. The current systematic review and meta-analysis aimed to review research on the efficacy of pharmacological and non-pharmacological interventions for cognitive fatigue following pediatric ABI. The review searched terms through relevant databases (including Medline, PsychInfo, Embase, Cinahl and Scopus), using specific inclusion criterion. A total of 6,511 articles were identified. Five articles met the inclusion criteria, and three were of excellent quality. These were categorized into behavioural (Gagnon et al., 2016; Gauvin-Lepage et al., 2020; Hypher et al., 2022; Renaud et al., 2020) and pharmacological interventions (Sakellaris et al., 2008). A meta-analysis of the behavioural interventions using random-effects models was conducted and demonstrated a statistically significant effect on reducing cognitive fatigue from both a self-report and caregiver-report perspective. Although not included in the meta-analysis, Sakellaris et al. (2008) findings also demonstrated creatin as an effective pharmacological intervention. The scarcity of available studies impacted the findings, and thus, further investigation is warranted to support specific treatment guidelines.