Evidence map›Paper›PMID 40301279›Full record

SynthesisActa neurologica Belgica2025

Effects of non-invasive brain stimulation on arousal and alertness among traumatic brain injury patients with disorders of consciousness or persistent vegetative State: a systematic review.

Nidhi Sharma, Aksh Chahal, Richa Hirendra Rai, Bartosz Maciej Wójcik, Bushra J Alfaifi, Krishna Reddy Vajrala, Mohammad Sidiq, Abhishek Sharma

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Acta neurologica Belgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nidhi SharmaDepartment of Health Science, Uttaranchal College of Health Sciences Uttaranchal University, Uttarakhand, 248007, Dehradun, India.ORCID http://orcid.org/0000-0002-3177-0943
Aksh ChahalDepartment of Physiotherapy, Galgotias Multi-Disciplinary Research & Development Cell (G-MRDC), Galgotias University, Greater Noida, Uttar Pradesh, 201308, India.ORCID http://orcid.org/0000-0003-2871-3697
Richa Hirendra RaiSchool of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India.ORCID http://orcid.org/0000-0003-0102-2773
Bartosz Maciej WójcikCreator Specialization Center Wroclaw - Accredited Center of the Medical Center for Postgraduate, Education University in Warsaw, Wroclaw, Poland.ORCID http://orcid.org/0009-0007-4623-0775
Bushra J AlfaifiCollege of Nursing and Allied health Sciences, Jazan University, Jazan, Saudi Arabia.ORCID http://orcid.org/0009-0009-6046-2200
Krishna Reddy VajralaDepartment of Physiotherapy School of Allied Health Sciences, Galgotias University, Noida, Uttar Pradesh, 203201, India.ORCID http://orcid.org/0009-0000-2810-0909
Mohammad SidiqDepartment of Physiotherapy, Galgotias Multi-Disciplinary Research & Development Cell (G-MRDC), Galgotias University, Greater Noida, Uttar Pradesh, 201308, India.ORCID http://orcid.org/0000-0003-2448-8971
Abhishek SharmaDepartment of Physiotherapy Arogyam Institute of Paramedical and Allied Sciences, Affiliated to H.N.B. Uttarakhand Medical Education University, Roorkee, Uttarakhand, 247661, India. abhisheksharmampt@gmail.com.ORCID http://orcid.org/0000-0001-5968-1910

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTraumatic brain injury (TBI) often leads to disorders of consciousness (DOC) or persistent vegetative state (PVS), characterized by impaired arousal and awareness. Non-invasive brain stimulation (NIBS) techniques have shown promise in modulating cortical excitability and potentially enhancing arousal and alertness in these patients. This systematic review aims to synthesize existing literature on the effects of NIBS on arousal and alertness among TBI patients with DOC or PVS.

methodsA systematic search was conducted across multiple databases for studies investigating the use of NIBS techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in TBI patients with DOC or PVS. Studies were included if they assessed changes in arousal or alertness following NIBS intervention. Data extraction and quality assessment were performed using predefined criteria.

resultsA total of 11 studies with 475 patients (mean age 46.21 ± 12.31 years) met the inclusion criteria and were included in the review. The majority of studies utilized TMS or tDCS as the NIBS modality. Findings suggest that NIBS may lead to improvements in arousal and alertness among TBI patients with DOC or PVS. However, the magnitude and duration of these effects varied across studies.

conclusionNon-invasive brain stimulation shows promise as a potential intervention for enhancing arousal and alertness in TBI patients with DOC or PVS. Further well-controlled studies are warranted to elucidate optimal stimulation parameters, long-term effects, and potential synergies with other rehabilitation approaches.

Indexed as

ArousalBrain Injuries, TraumaticConsciousness DisordersPersistent Vegetative StateTranscranial Direct Current StimulationTranscranial Magnetic StimulationHumansBrain stimulationComaTraumatic brain injuryVegetative state

Identifiers

PMID40301279

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.