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.

中文翻译：

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用于减少轻度创伤性脑损伤患者脑震荡后症状的认知和心理干预：系统评价。

客观的

评估认知和心理干预对减轻轻度创伤性脑损伤（MTBI）患者脑震荡后症状（PCS）的效果。

数据源

CINAHL、Medline、PubMed、PsycINFO、Web of Science 和 Cochrane Database of Systematic Reviews 的数据库。

审查方法

对随机对照试验进行荟萃分析，其中包括使用 Rivermead 脑震荡后症状调查问卷作为主要结果，通过酌情使用固定/随机效应模型计算平均差/标准化平均差来评估 PCS。

结果

截至2018年3月最后一次检索，系统综述共收录16080篇文章，其中17篇文章、3081名参与者纳入最终综述。干预措施包括心理教育（n = 8）、电话解决问题治疗（n = 4）、基于个体的认知行为治疗（n = 4）和认知训练（n = 1）。在 3 至 6 个月的随访中，没有任何干预措施能够有效减少 PCS，但在 6 个月时的汇总功能结果中发现总体效果较小。

结论

PCS 干预对 3 至 6 个月时的症状减轻没有效果，但 MTBI 患者在 6 个月时的功能结果有所改善。没有研究 12 个月或之后干预措施的长期影响。