Non-pharmacological interventions show potential but uncertain cognitive benefits in TBINew Research Looks at Non-Drug Treatments for Brain Injury

Frontiers in Medicine Published June 29, 2026 DOI ↗ Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain

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Key Takeaway

Interpret these non-pharmacological TBI cognitive findings as exploratory due to low evidence certainty.

This network meta-analysis evaluated non-pharmacological interventions for cognitive function in patients with traumatic brain injury (TBI), including music therapy, comprehensive nursing intervention, and electroacupuncture combined with hyperbaric oxygen therapy. The analysis included 528 patients from multiple studies.

For cognitive function measured by MMSE, music therapy showed a potential benefit. For MoCA scores, comprehensive nursing intervention demonstrated a possible advantage. For the Modified Barthel Index (MBI), electroacupuncture combined with hyperbaric oxygen therapy showed a positive trend. However, no effect sizes, confidence intervals, or p-values were reported.

The authors note several limitations: the evidence network was sparse, most comparisons were informed by single studies, effect estimates were imprecise, and overall evidence certainty was low or very low for all outcomes. Adverse events and follow-up duration were not reported.

Given the high uncertainty, these findings are insufficient to support clinical prioritization of any specific intervention. The results should be interpreted as exploratory and hypothesis-generating rather than practice-changing.

How this fits prior evidence

This network meta-analysis extends prior coverage of non-pharmacological interventions for cognitive impairment, where a narrative review suggested music therapy may improve cognition. The current analysis adds a quantitative synthesis but with low certainty, contrasting with the stronger evidence for tranexamic acid reducing mortality in TBI patients with high brain voxel percentages (relative risk 0.41). It also addresses a gap in non-pharmacological options, unlike the preclinical focus of ligustilide and NINJ1 targeting.

Researchers looked at different non-drug ways to help people who have suffered a traumatic brain injury. They specifically studied three methods: music therapy, comprehensive nursing interventions, and a combination of electroacupuncture and hyperbaric oxygen therapy. The goal was to see if these methods could improve cognitive scores like the MMSE and MoCA.

The study included 528 patients. The results showed that music therapy had a potential benefit for some scores, while comprehensive nursing care showed a possible advantage in other areas. Additionally, the combination of electroacupuncture and hyperbaric oxygen therapy showed a positive trend for physical independence scores.

It is important to note that these findings come from a network meta-analysis with very limited data. Because many comparisons were based on only one study, the results are not very precise. The overall certainty of the evidence is low, meaning more research is needed before these methods can be recommended as standard care.

What this means for you:

Early research shows potential benefits from music and nursing care for brain injuries, but more data is needed.

Common questions

Can music therapy help people with brain injuries?

The study of 528 patients showed that music therapy had a potential benefit for certain cognitive scores. However, the evidence is currently considered to have low certainty, meaning more research is needed to confirm how much it helps and how often it should be used.

What role does nursing care play in recovery?

Comprehensive nursing interventions demonstrated a possible advantage for cognitive function scores. Because the evidence is currently sparse, these findings are not yet enough to decide exactly how nursing care should be prioritized in daily treatment plans.

Are there any side effects to these treatments?

The study did not report any specific adverse events or safety concerns for the non-pharmacological interventions. However, because the evidence is limited and imprecise, you should talk to a doctor about which treatment is safest for a specific patient.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJun 2026

View Original Abstract ↓

BackgroundNon-pharmacological interventions may improve cognitive function in patients with traumatic brain injury (TBI); however, their comparative effectiveness and clinical prioritization remain unclear. This study aimed to evaluate multiple non-pharmacological interventions using a network meta-analysis and to assess the certainty of evidence while identifying existing research gaps.MethodsRandomized controlled trials (RCTs) were systematically searched in English and Chinese databases up to August 15, 2025. Two reviewers independently performed study selection, data extraction, and risk of bias assessment using the Cochrane Risk of Bias Tool (RoB 1.0). A network meta-analysis was conducted using R to compare intervention effects on Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Modified Barthel Index (MBI). Evidence quality was assessed using the GRADE framework.ResultsNine RCTs involving 528 participants and eight non-pharmacological interventions were included. The evidence network was sparse, with most comparisons informed by single studies. Music therapy showed a potential benefit in improving MMSE scores. Comprehensive nursing intervention demonstrated a possible advantage in MoCA outcomes. Electroacupuncture combined with hyperbaric oxygen therapy showed a positive trend in improving MBI scores. However, effect estimates were imprecise, and overall evidence certainty was low or very low.ConclusionCurrent evidence suggests that several non-pharmacological interventions may offer potential benefits for cognitive and functional recovery in TBI patients; however, findings are highly uncertain and insufficient to support clinical prioritization. This study highlights important evidence gaps, and further large-scale, high-quality RCTs are needed to establish reliable comparative effectiveness.

Non-pharmacological interventions show potential but uncertain cognitive benefits in TBINew Research Looks at Non-Drug Treatments for Brain Injury

How this fits prior evidence

Common questions

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Non-pharmacological interventions show potential but uncertain cognitive benefits in TBINew Research Looks at Non-Drug Treatments for Brain Injury

How this fits prior evidence

Common questions

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