SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Neurorehabilitation
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1585901
This article is part of the Research TopicCognitive enhancement by brain stimulation techniquesView all articles
Effect of Non-Invasive Brain Stimulation on Cognitive Function and Activities of Daily Living in Patients with Carbon Monoxide Poisoning: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Shanghai Normal University, Shanghai, China
- 2Shenyang Normal University, Shenyang, Liaoning Province, China
- 3Shanghai University of Sport, Shanghai, Shanghai Municipality, China
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Objective:This study aimed to evaluate the effectiveness of non-invasive brain stimulation (NIBS) in improving cognitive function and activities of daily living in patients with Delayed encephalopathy following acute carbon monoxide poisoning (DEACMP), and to explore the moderating effects of age, intervention duration, latency period, and stimulation site.Methods:A systematic search of seven databases was conducted to identify randomised controlled trials (RCTs) published up to August 2024. Meta-analyses and publication bias assessments were performed using RevMan 5.4.1 and Stata 17.0. Methodological quality was evaluated with the PEDro scale, and the certainty of evidence was assessed using GRADEpro.Results:Eight RCTs involving 607 participants were included. Pooled results indicated that NIBS significantly improved cognitive function (SMD = 1.03, P < 0.00001) and activities of daily living (SMD = 1.77, P < 0.00001). Subgroup analyses showed greater cognitive improvements in patients aged below 50 years, with interventions ≤20 days, and stimulation applied at the yin-yang poles. In contrast, improvements in daily activities were more pronounced in patients aged over 50 years under similar intervention conditions.Discussion:The included studies were of moderate-to-high quality (mean PEDro score = 6.3). Major limitations included inadequate blinding and incomplete allocation concealment. Heterogeneity was mainly attributable to patient age, stimulation site, and intervention duration. No significant publication bias was detected. Overall, NIBS demonstrated moderate-quality evidence in enhancing cognitive function and daily activity performance, with individual characteristics moderating its effects.
Keywords: non-invasive brain stimulation, Carbon Monoxide Poisoning, Cognitive Function, Activities of Daily Living, Systematic review, Meta-analysis
Received: 07 Mar 2025; Accepted: 04 Jul 2025.
Copyright: © 2025 DING, Wei, Chen, YU, WANG and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yuanwen Zhang, Shanghai Normal University, Shanghai, China
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