Cognitive and psychological interventions for the reduction of post-concussion symptoms in patients with mild traumatic brain injury: a systematic review.

OBJECTIVE

To evaluate the effects of cognitive and psychological interventions for the reduction of post-concussion symptoms (PCS) in patients with mild traumatic brain injury (MTBI).

DATA SOURCES: The databases of CINAHL, Medline, PubMed, PsycINFO, Web of Science, and Cochrane Database of Systematic Reviews.

REVIEW

METHODS

Meta-analysis was conducted for randomized-controlled trials that have included an assessment of PCS using the Rivermead Post-concussion Symptoms Questionnaire as primary outcomes by calculating the mean difference/standardized mean difference using fixed/random effect models as appropriate.

RESULTS

Systematic review with the date of the last search in Mar 2018 yielded 16080 articles, 17 articles including 3081 participants were included in the final review. Interventions included psychoeducation (n = 8), telephone problem-solving treatment (n = 4), individual-based cognitive behavioral therapy (n = 4), and cognitive training (n = 1). No intervention is effective in reducing PCS at 3 to 6 months follow-up, however, an overall small effect size was found in pooled functional outcomes at 6 months.

CONCLUSIONS

There was no effect on symptom reduction at 3 to 6 months for PCS interventions but improved functional outcomes were shown for patients with MTBI at 6 months. Long-lasting effects of interventions at 12 months or after were not studied.