Non-invasive brain stimulation to improve visual perception after stroke: a systematic review and meta-analysis.

OBJECTIVE

To assess the efficacy of non-invasive brain stimulation (NIBS) in improving visual perception in stroke patients.

METHODS

A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. PubMed, Scopus, Web of Science (WoS), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Cochrane Controlled Register of Trials (CENTRAL) were searched for randomized controlled trials (RCTs) evaluating the efficacy of NIBS in improving visual perception in stroke patients up to 5 September 2025. Meta-analyses, forest and funnel plots and risk of bias assessment were performed using RevMan Web, and the certainty of evidence was assessed using GRADEpro GDT.

RESULTS

A total of 7 RCTs met the eligibility criteria, of which 6 had data available for meta-analysis. Random effects meta-analyses showed that NIBS versus sham stimulation had a large effect size on visual perception in stroke patients as determined by the Motor-free Visual Perception Test (MVPT) (4 RCTs, n = 124, 82 men, 42 women; SMD [95% CI]: 0.83 [0.48 - 1.19]; I2: 0%); and that NIBS combined with other therapies versus other therapies alone had a large effect size on visual perception in stroke patients as determined by the MVPT (2 RCTs, n = 32, 14 men, 18 women; SMD [95% CI]: 1.20 [-0.42 - 2.82]; I2: 70%). There was no publication bias.

CONCLUSIONS

There is low-certainty evidence in favor of NIBS versus sham stimulation and very low-certainty evidence in favor of NIBS combined with other therapies versus other therapies alone for improving visual perception in stroke patients.

PROSPERO REGISTRATION NUMBER: CRD42024594263.