Systematic review and meta-analysis on cognitive-motor interventions and BDNF in post-stroke adults
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Key Takeaway
Consider the evidence for cognitive-motor interventions increasing BDNF in post-stroke adults is preliminary due to high heterogeneity.
This is a systematic review and meta-analysis of cognitive-motor interventions for adults and older adults post-stroke. The review synthesized data from 457 participants across included studies. The primary finding was a statistically significant increase in serum BDNF levels, with a pooled effect size of Hedges' g = 2.51 (95% CI: 0.97 to 4.06; p = 0.001). The authors note that the I2 statistic was 92%, indicating very high heterogeneity across studies.
The authors conclude that the evidence supports a potential role for these interventions in promoting neuroplastic mechanisms during rehabilitation. However, they acknowledge that the very high heterogeneity limits the certainty of the pooled estimate. No specific study details, such as intervention protocols or follow-up duration, were reported in the source.
Limitations noted include the very high heterogeneity across studies, which the authors state warrants cautious interpretation. The review did not report on safety outcomes, such as adverse events or discontinuations. Practice relevance is framed as supporting the potential role of these interventions in neuroplasticity, but the evidence is not definitive.
Given the high heterogeneity, the findings should be considered preliminary. The review does not establish causality and highlights the need for more standardized research in this area.
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View Original Abstract ↓
IntroductionCognitive–motor interventions have emerged as promising rehabilitation strategies to enhance neuroplasticity following stroke; however, their effects on circulating brain-derived neurotrophic factor (BDNF) remain incompletely understood. This systematic review and meta-analysis aimed to quantify the effects of cognitive–motor interventions on serum BDNF levels in adults and older adults after stroke.MethodsA comprehensive literature search of MEDLINE/PubMed, Scopus, Cochrane, Web of Science (Core Collection), EBSCOhost, CINAHL, and ProQuest was conducted through December 2025. Randomized controlled trials evaluating cognitive–motor interventions and reporting serum brain-derived neurotrophic factor outcomes in post-stroke populations were included. Methodological quality and certainty of evidence were assessed according to PRISMA 2020 guidelines, the Oxford Centre for Evidence-Based Medicine framework, the RoB two tool, and GRADEpro. The review protocol was registered in PROSPERO (CRD420251140852).ResultsNine randomized controlled trials involving 457 participants met the inclusion criteria. Meta-analysis demonstrated that cognitive–motor interventions elicited a statistically significant increase in serum BDNF levels compared with control conditions (Hedges’ g = 2.51; 95% CI: 0.97 to 4.06; p = 0.001; I2 = 92%), indicating a large overall effect.ConclusionThese findings suggest that cognitive-motor interventions may increase circulating BDNF levels after stroke, supporting their potential role in promoting neuroplastic mechanisms during rehabilitation; however, the very high heterogeneity across studies warrants cautious interpretation.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251140852 identifer, PROSPERO 2025 CRD420251140852.
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