Table 1.
Characteristics of included studies.
| Author, year | No. of participants (% men) | Age (y), range/mean (SD) | Duration since TBI/concussion (yrs) | Severity of TBI (mild/moderate/severe/unconfirmed) | Medications used | Outcome measures | Time points |
|---|---|---|---|---|---|---|---|
| Stilling et al., 2020 | 20 TBI with persistent PTH and PPCS (10%) | 18-65; overall: 36.0 (11.4); G1: 40.3 (11.2); G2: 31.6 (10.4) | G1: 2.4(1.2); G2: 3.0(1.0) | G1: 10/0/0/0; G2: 10/0/0/0 | OnabotulinumtoxinA: G1: 3, G2: 7; preventative headache medication: (1) Amitriptyline: G1: 3; G2: 1 (2) Topiramate: G1: 1; G2: 1 (3) Duloxetine: G1: 2; G2: 0 (4) Venlafaxine: G1: 1; G2: 0 |
(1) Headache: NRS (2) Cognition: MoCA, BCPSI, RPSQ (3) Function: HIT-6 (4) Depression: PHQ-9 (5) Anxiety: GAD-7 (6) Posttraumatic stress disorder: PTSD, PCL-5 (7) Quality of life: QOLIBRI |
Baseline; midtreatment; posttreatment; 4 weeks/12 weeks/24 weeks posttreatment |
| Rao et al., 2019 | 30 TBI and anxiety G1: 13; G2:17 Men: 53.3% |
Overall: 40 (14.4); G1: 40.2 (14.6); G2: 39.8 (14.2) | Not mentioned | G1: 15/2/0/0 G2: 13/0/0/0 |
Not mentioned | (1) Depression: HRSD (2) Clinical global impression-severity (CGI-S) scale (3) Clinical global impression-improvement (CGI-I) scale (4) The Beck scale for suicide ideation (BSSI) (5) Cognition: MoCA, RPSQ, BCPSI |
Baseline; posttreatment; 4 weeks/8 weeks/12 weeks posttreatment |
| Moussavi et al., 2019 | 18 mild TBI; G1: 9; G2: 9; men: 50% | 49.5 (12.4) | G1: <1.0; G2: >1.2 | Not mentioned | Lamictal, zeldox, Zoloft, clonazapam, trazadone, amitriptyline, amitriptyline | (1) Symptom: RPSQ (2) Depression: MADRS |
Baseline; posttreatment; 4 weeks/12 weeks posttreatment |
| Neville et al., 2019 | 30 TBI with chronic DAI; G1: 17; G2: 13; men: 90% | 18-60; G1: 29.0 (10.35); G2: 32.62 (12.81) | >1.0 | Not mentioned | No plans to change during the 90-day study period | (1) Cognition: TMT, COWAT, Stroop test, FPT, DST, SDT (2) Memory: HVLT and BVMT (3) Motor function: GPT |
Baseline; posttreatment; 12 weeks posttreatment |
| Hoy et al., 2019 | 21 closed TBI; G1: 11; G2: 10; men: 47.6% | 25-78; 46.29 (12.65) | Not mentioned | G1: 7/2/2/0; G2: 5/2/2/1 | Antidepressant medication (yes/no): G1: 10/1; G2: 5/5; Mood stabiliser medication (yes/no): G1: 1/10; G2: 0/10; Benzodiazepine medication (yes regular/yes as needed/no): G1: 0/2/9; G2: 1/1/8; Antipsychotic medication (yes/no): G1: 1/10; G2:1/9; |
(1) Depression: MADRS, IDS-CR, IDS-SR (3) Cognition: DST, TMT, arithmetic, RVALT, BVSMT, verbal fluency, Stroop test |
Baseline; midtreatment; posttreatment |
| Siddiqi et al., 2019 | 15 mild TBI; G1: 9; G2: 5; men: 73.3% | G1: 43.0 (13.0); G2: 50.0 (18.0) | G1: 8.4 (8.2); G2: 8.1 (11.3) | Not mentioned | Not mentioned | (1) Depression: MADRS, DSM-5 (2) Personality: TCI, EB-SRMS, CB-CT, SRHLS, HIT-6 |
Baseline; midtreatment; posttreatment; 1 week/12 weeks/24 weeks posttreatment |
| Choi, et al., 2018 | 12 consecutive patients with mild TBI G1: 6; G2:6 Men: 50% |
30-56; overall: 42.6 (8.7) G1: 43.2 (9.7) G2: 42 (8.4) |
G1: 17.0 (7.5) G2: 14.3 (7.2) |
G1: 6/0/0/0 G2: 6/0/0/0 |
Not mentioned | (1) Central pain: NPRS (2) Life quality: SF-36 |
Baseline; midtreatment; posttreatment; 1 week/2 weeks/4 weeks posttreatment |
| Lee et al., 2018 | 13 TBI; G1: 7; G2: 6; men: 69.2% | G1: 42.4 (11.3); G2: 41.3 (11.0) | G1: 3.9 (1.7); G2: 3.9 (1.9) | Not mentioned | Not mentioned | (1) Depression: MADRS (2) Cognition: TMT, SCWT |
Baseline; posttreatment |
| Leung et al., 2018 | 29 mild TBI; G1: 14; G2: 15; men: 79.3% | G1: 33.0 (8.0); G2: 35.0 (8.0) | G1: 7.9 (6.9); G2: 8.3 (4.8) | Not mentioned | Maintain their existing medications | (1) Attention: CPT-II (2) Headache: NPRS, BPI (3) Cognition: WAIS-IV, Stroop test (4) Verbal: HVLT (5) Depression: HRSD (6) PTSD: CAPS |
Baseline; 1 week/4 weeks posttreatment |
| Leung et al., 2016 | 24 mild TBI; G1: 12; G2: 12; men: 91.7% | G1: 41.2 (14.0); G2: 41.4 (11.6) | G1: 14.8 (14.7); G2: 13.6 (11.8) | Not mentioned | Medications | (1) Headache: NPRS (2) Attention: CPT-II (3) Depression: HRSD (4) PTSD: M-PTSD (5) Pain: BPI |
Baseline; 1 week/4 weeks posttreatment |
| Franke et al., 2022 | 28 mild-to-moderate TBI; men: 85.7; G1 (active first): 13/14; G2 (sham first): 11/14 | Overall: 45.6 (10.1); G1: 45.1 (11.3); G2: 46.0 (9.0) | Overall: 12.04 (6.8); G1: 11.43 (3.5); G2: 12.64 (9.1) | Mild or moderate | Not mentioned | (1) Depression: CAPS; PHQ-9 (2) Pain: McGill pain questionnaire (3) EEG (4) GSE; PSQI; TBI-QOL |
Baseline; posttreatment for first condition (active or sham); pretreatment for second condition; posttreatment for second condition; 2 weeks posttreatment |
| Rodrigues et al., 2020 | 36 TBI and anxiety symptoms; G1: 18; G2: 18; men: 88.6% | 18-65; G1: 32.8 (13.3); G2: 31.6 (11.3) | Not mentioned | Not mentioned | Not mentioned | (1) STAI-state (2) BDI-I (3) EF index |
Baseline; midtreatment; posttreatment; 0 weeks posttreatment; 3 months |
BCPSI: British Columbia Postconcussion Symptom Inventory; BDI-II: Beck Depression Inventory-II; BI: Barthel Index; BPI: Brief Pain Inventory; BSSI: Beck Scale for Suicide Ideation; BVMT: Brief Visuospatial Memory Test; BVSMT: brief visual spatial memory test; CAPS: Clinician-Administered PTSD Scale; CB-CT: Cognitive Testing-Cognitive Battery; CGI-I/CGI-S: Clinical Global Improvement-Severity/Improvement Scale Score; CMCT: Central Motor Conduction Time; COWAT: Controlled Oral Word Association Test; CPT-II: Conner's Continuous Performance Test II; DAI: Diffuse Axonal Injury; DSM-5: Diagnostic and Statistical Manual of Mental Disorders; DST: Digit Span Test; EB-SRMS: Emotion Battery-Self-Report Mood Scale; EEG: Electroencephalogram; EF index: Executive Function Index; FMA: Fugl-Meyer Assessment; FPT: Five-Point Test; G1: TMS group; G2: sham group; GAD-7: Generalized Anxiety Disorder Scale-7; GPT: Grooved Pegboard Test; GSE: General Self-Efficacy Scale; HAM-D: Hamilton Rating Scale for Depression; HIT-6: Headache Impact Test 6; HRSA/HRSD: Hamilton Rating Scale for Anxiety/Depression; HVLT: Verbal Hopkins Verbal Learning Test; IDS-CR/IDS-SR: Inventory of Depressive Symptomatology-Clinician Rated Version/Self-Rated Version; M1: primary motor cortex; MADRS: Montgomery-Asberg Depression Rating Scale; MEP: Motor Evoked Potential; MoCA: Montreal Cognitive Assessment; M-PTSD: Mississippi Scale for PTSD; NIHSS: National Institutes of Health Stroke Scale; NPRS: numeric pain rating scale; PCL-5: PTSD Checklist for DSM-5; PCL-M: PTSD Checklist-Military Version; PHQ-9: Patient Health Questionnaire-9; PPCS: persistent postconcussion symptoms; PSQI: Pittsburgh Sleep Quality Index; PTH: Posttraumatic Headache; PTSD: Posttraumatic Stress Disorder; QOLIBRI: Quality of Life after Brain Injury Questionnaire; RPQ: Rivermead Post-Concussion Symptoms Questionnaire; RPSQ-3: Rivermead Post-Concussion Symptoms Questionnaire-3; RVALT: Rey Verbal Auditory Learning Test; SCID: Structured Clinical Interview for DSM-IV Axes I & II; SCWT: Stroop Color-Word Test; SDT: symbol digit test; SF-36: MOS 36-Item Short-Form Health Survey; SRHLS: Self-Report Headache Likert Scores; SSRIs: Selective Serotonin Reuptake Inhibitors; STAI: State-Trait Anxiety Inventory; TBI: traumatic brain injury; TBI-QOL: traumatic brain injury quality of life; TCI: Temperament and Character Inventory; TMS: transcranial magnetic stimulation; TMT: Trail Making Test; WAIS-IV: Wechsler Adult Intelligence Scale; WMFT: Wolf Motor Function Test.