Objectives

Mild traumatic brain injury (mTBI) is a controversial and under-researched area, despite most traumatic brain injuries being classed as mild. Our objective was to review the evidence underpinning these approaches to treat mTBI including educational, psychological, rehabilitative and pharmacological approaches and discuss their efficacy.

Methods

A systematic review of literature was carried out using Web of science, Scopus, Medline, Pubmed, Cinahl, and PsychInfo databases. Randomized Controlled Trials (RCTs) looking at treatment outcome in mTBI for adults were included, published between 1980 and 2019. Methodological quality of the studies was reviewed using the Scottish Intercollegiate Guideline Network (SIGN) checklist for RCTs.

Results

Searches identified 3993 studies, of which 25 met inclusion criteria, and a total number of participants of 3213. Mean age was 35, and 59% male. Ten studies had <100 participants, 15 studies 100–395. Studies were grouped into education and early intervention, rehabilitation (8), psychological interventions (4), and pharmacotherapy (4). Inconsistency of definitions and outcome measures used precluded meta-analysis.

Conclusions

Traditional education and reassurance can no longer be recommended as having the best evidence base for efficacy as compared to psychological and rehabilitative approaches, and guidelines should begin to reflect this.

中文翻译：

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轻度颅脑损伤的治疗结果：随机对照试验的系统评价。

目标

尽管大多数创伤性脑损伤被归为轻度，但轻度创伤性脑损伤（mTBI）是一个有争议且研究不足的领域。我们的目的是审查支持这些治疗mTBI方法的证据，包括教育，心理，康复和药理学方法，并讨论其功效。

方法

使用Web of Science，Scopus，Medline，Pubmed，Cinahl和PsychInfo数据库对文献进行了系统的综述。纳入了研究成年人mTBI治疗结局的随机对照试验（RCT），该试验于1980年至2019年之间发表。研究的方法学质量使用RCT的苏格兰校际指南网络（SIGN）清单进行了审查。

结果

搜索确定3993项研究，其中25项符合纳入标准，参加者总数3232。平均年龄为35岁，男性为59％。十项研究的参与者少于100名，其中十五项研究的参与者100-395名。研究分为教育和早期干预，康复（8），心理干预（4）和药物治疗（4）。所使用的定义和结果测量方法不一致，因此无法进行荟萃分析。

结论

与心理和康复方法相比，传统教育和放心不再被推荐为具有最佳疗效证据基础的，因此指南应开始体现这一点。