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

ObjectiveThis study aimed to evaluate the effectiveness of non-invasive brain stimulation (NIBS) in improving cognitive function and activities of daily living (ADL) in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). It also sought to explore the moderating effec...

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Main Authors: Hui Ding, Chen Wei, Jiwei Chen, Fen Yu, Xing Wang, Yuanwen Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1585901/full
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author Hui Ding
Chen Wei
Jiwei Chen
Fen Yu
Xing Wang
Yuanwen Zhang
author_facet Hui Ding
Chen Wei
Jiwei Chen
Fen Yu
Xing Wang
Yuanwen Zhang
author_sort Hui Ding
collection DOAJ
description ObjectiveThis study aimed to evaluate the effectiveness of non-invasive brain stimulation (NIBS) in improving cognitive function and activities of daily living (ADL) in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). It also sought to explore the moderating effects of age, intervention duration, latency period, and stimulation site.MethodsA systematic search of seven databases was conducted to identify randomized 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.ResultsA total of eight RCTs involving 607 participants were included. The pooled results indicated that NIBS significantly improved cognitive function (standardized mean difference (SMD = 1.03, p < 0.00001) and ADL (SMD = 1.77, p < 0.00001). The subgroup analyses showed greater cognitive improvements in patients aged below 50 years, with intervention durations of ≤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.DiscussionThe included studies were of moderate-to-high quality (mean PEDro score = 6.3). The major limitations included inadequate blinding and incomplete allocation concealment. The heterogeneity observed 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.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024598815.
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spelling doaj-art-c93a14d77fd84910aaa8658d3a7323262025-08-20T03:41:30ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-08-011610.3389/fneur.2025.15859011585901Effect of non-invasive brain stimulation on cognitive function and activities of daily living in patients with carbon monoxide poisoning: a systematic review and meta-analysisHui Ding0Chen Wei1Jiwei Chen2Fen Yu3Xing Wang4Yuanwen Zhang5School of Physical Education, Shanghai Normal University, Shanghai, ChinaSchool of Physical Education, Shenyang Normal University, Shenyang, ChinaSchool of Physical Education, Shanghai University of Sport, Shanghai, ChinaSchool of Physical Education, Shanghai University of Sport, Shanghai, ChinaSchool of Physical Education, Shanghai University of Sport, Shanghai, ChinaSchool of Physical Education, Shanghai Normal University, Shanghai, ChinaObjectiveThis study aimed to evaluate the effectiveness of non-invasive brain stimulation (NIBS) in improving cognitive function and activities of daily living (ADL) in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). It also sought to explore the moderating effects of age, intervention duration, latency period, and stimulation site.MethodsA systematic search of seven databases was conducted to identify randomized 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.ResultsA total of eight RCTs involving 607 participants were included. The pooled results indicated that NIBS significantly improved cognitive function (standardized mean difference (SMD = 1.03, p < 0.00001) and ADL (SMD = 1.77, p < 0.00001). The subgroup analyses showed greater cognitive improvements in patients aged below 50 years, with intervention durations of ≤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.DiscussionThe included studies were of moderate-to-high quality (mean PEDro score = 6.3). The major limitations included inadequate blinding and incomplete allocation concealment. The heterogeneity observed 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.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024598815.https://www.frontiersin.org/articles/10.3389/fneur.2025.1585901/fullnon-invasive brain stimulationcarbon monoxide poisoningcognitive functionactivities of daily livingsystematic reviewmeta-analysis
spellingShingle Hui Ding
Chen Wei
Jiwei Chen
Fen Yu
Xing Wang
Yuanwen Zhang
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
Frontiers in Neurology
non-invasive brain stimulation
carbon monoxide poisoning
cognitive function
activities of daily living
systematic review
meta-analysis
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic non-invasive brain stimulation
carbon monoxide poisoning
cognitive function
activities of daily living
systematic review
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1585901/full
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