scholarly journals Effects of Cognitive Behavioral Therapy on Pain and Sleep in Adults with Traumatic Brain Injury: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Xin Li ◽  
Yuwei Feng ◽  
Jianping Xia ◽  
Xuan Zhou ◽  
Nan Chen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Adverse Events ◽  
Cognitive Behavioral Therapy ◽  
Sleep Quality ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Severity Index ◽  
Cognitive Behavioral ◽  
Cochrane Library

The objective of this study was to systematically review the literature on the effects of cognitive behavioral therapy (CBT) on insomnia and pain in patients with traumatic brain injury (TBI). PubMed, Embase, the Cochrane Library, Cumulative Index to Nursing and Allied Health, and Web of Science databases were searched. Outcomes, including pain, sleep quality, and adverse events, were investigated. Differences were expressed using mean differences (MDs) with 95% confidence intervals (CIs). The statistical analysis was performed using STATA 16.0. Twelve trials with 476 TBI patients were included. The included studies did not indicate a positive effect of CBT on pain. Significant improvements were shown for self-reported sleep quality, reported with the Pittsburgh Self-Reported Sleep Quality Index (MD, -2.30; 95% CI, -3.45 to -1.15; P < 0.001 ) and Insomnia Severity Index (MD, -5.12; 95% CI, -9.69 to -0.55; P = 0.028 ). No major adverse events related to CBT were reported. The underpowered evidence suggested that CBT is effective in the management of sleep quality and pain in TBI adults. Future studies with larger samples are recommended to determine significance. This trial is registered with PROSPERO registration number CRD42019147266.

scholarly journals A blended eHealth intervention for insomnia following acquired brain injury study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Marthe Ford ◽  
Gert J. Geurtsen ◽  
Erny Groet ◽  
Coen A.M. Van Bennekom ◽  
Eus J.W. Van Someren
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Behavioral Therapy ◽  
Cognitive Functioning ◽  
Behavioral Therapy ◽  
Acquired Brain Injury ◽  
Cognitive Behavioral ◽  
Face To Face ◽  
Trial Register ◽  
Insomnia Severity

Abstract Background: Up to a third of stroke patients and patients with traumatic brain injury suffer from insomnia, including problems to fall asleep or stay asleep at night. Insomnia may exacerbate other brain damage-related problems, for example regarding cognitive functioning and emotional well-being, may lead to poorer quality of life, and may complicate recovery processes. Cognitive behavioral therapy for insomnia, delivered face-to-face or online, is found to be effective in the general population. However, despite the high prevalence and serious consequences of insomnia following acquired brain injury, studies on the efficacy of face-to-face cognitive behavioral treatment in this population are scarce, and this applies even more for studies on online cognitive behavioral therapy. Therefore, this study aims to evaluate the efficacy of a newly developed guided online cognitive behavioral therapy for insomnia following acquired brain injury.Methods: A multicenter, prospective, randomized, open-label, blinded end point study (PROBE) will be conducted, in which 48 patients diagnosed with stroke or traumatic brain injury, and insomnia will be randomly allocated to the online cognitive behavioral therapy for insomnia treatment group or the treatment as usual group. The treatment consists of 6 online cognitive behavioral therapy sessions given on a weekly basis and personalized feedback after each session, combined with 2 face-to-face sessions. Outcomes will be assessed at baseline, immediately after the intervention period and at 6 weeks follow up. The primary outcome is the insomnia severity assessed with the insomnia severity index. Secondary outcome measures include sleep quality, sleep features derived from the sleep diary, fatigue, anxiety and depression, subjective cognitive functioning and societal participation.Discussion: This study will provide insight on the efficacy of online cognitive behavioral therapy for insomnia following stroke and traumatic brain injury.Trial Register: Netherlands Trial Register, NTR7082, 12 March 2018

scholarly journals Efficacy and safety of erythropoietin for traumatic brain injury

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Motao Liu ◽  
Amy J. Wang ◽  
Yu Chen ◽  
Gexin Zhao ◽  
Zhifeng Jiang ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Adverse Effects ◽  
Adverse Events ◽  
Hospital Mortality ◽  
Meta Analysis ◽  
Survival Rates ◽  
Neurological Function ◽  
Cochrane Library

Abstract Background Recent studies regarding the effects of erythropoietin (EPO) for treating traumatic brain injury (TBI) have been inconsistent. This study conducts a meta-analysis of randomized controlled trials (RCTs) to assess the safety and efficacy of EPO for TBI patients at various follow-up time points. Methods A literature search was performed using PubMed, Web of Science, MEDLINE, Embase, Google Scholar and the Cochrane Library for RCTs studying EPO in TBI patients published through March 2019. Non-English manuscripts and non-human studies were excluded. The assessed outcomes include mortality, neurological recovery and associated adverse effects. Dichotomous variables are presented as risk ratios (RR) with a 95% confidence interval (CI). Results A total of seven RCTs involving 1197 TBI patients (611 treated with EPO, 586 treated with placebo) were included in this study. Compared to the placebo arm, treatment with EPO did not improve acute hospital mortality or short-term mortality. However, there was a significant improvement in mid-term (6 months) follow-up survival rates. EPO administration was not associated with neurological function improvement. Regarding adverse effects, EPO treatment did not increase the incidence of thromboembolic events or other associated adverse events. Conclusions This meta-analysis indicates a slight mortality benefit for TBI patients treated with EPO at mid-term follow-up. EPO does not improve in-hospital mortality, nor does it increase adverse events including thrombotic, cardiovascular and other associated complications. Our analysis did not demonstrate a significant beneficial effect of EPO intervention on the recovery of neurological function. Future RCTs are required to further characterize the use of EPO in TBI.

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