{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:25:02Z","timestamp":1787117102036,"version":"build-2736575974"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cognitive impairment is a frequent and disabling consequence of traumatic brain injury (TBI). Non-invasive brain stimulation (NIBS), including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), has been investigated as a potential adjunctive intervention, but review-level conclusions remain inconsistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted an umbrella review of published systematic reviews evaluating NIBS for cognitive outcomes after TBI. PubMed, Cochrane Library, Embase, Web of Science, CNKI, and Wanfang were searched from inception to May 2026. The unit of analysis was the systematic review, not individual primary trials. Eligible reviews assessed rTMS, tDCS, or both, and reported cognitive outcomes. Methodological quality was reappraised using AMSTAR-2, and primary-study overlap was assessed from the existing review-by-study citation matrix using corrected covered area (CCA). Where reviews reported quantitative estimates for cognition, these estimates were summarized descriptively at the review level; no\n                      <jats:italic>de novo<\/jats:italic>\n                      primary-study meta-analysis and no independent treatment-effect estimation were performed. The protocol was registered in PROSPERO (CRD420261395308).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-nine records were identified. Ten review records were included, consisting of seven core evidence reviews and three supplementary reviews. Eight reviews directly addressed cognitive outcomes, while supplementary reviews provided contextual review-level evidence. Conservative AMSTAR-2 reassessment found no high- or moderate-quality reviews; two were rated low and eight critically low in the complete 10-record assessment. The citation matrix contained 42 unique primary studies and 92 primary-study occurrences across 10 review records, yielding a CCA of 13.23%, consistent with high overlap. Previously published quantitative review-level estimates showed inconsistent directions of evidence and did not demonstrate consistent evidence of an overall cognitive benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current review-level evidence does not demonstrate consistent evidence of an overall cognitive benefit of NIBS after TBI. Because available reviews are methodologically limited and clinically heterogeneous, routine use of NIBS for post-TBI cognitive rehabilitation is not supported outside research or carefully selected clinical contexts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1931683","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:38:07Z","timestamp":1787114287000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Non-invasive brain stimulation for cognitive impairment after traumatic brain injury: an umbrella review of systematic reviews"],"prefix":"10.3389","volume":"17","author":[{"given":"Shouli","family":"Li","sequence":"first","affiliation":[{"name":"Heilongjiang Academy of Chinese Medicine Sciences","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongyue","family":"Liu","sequence":"additional","affiliation":[{"name":"Heilongjiang Academy of Chinese Medicine Sciences","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyue","family":"Li","sequence":"additional","affiliation":[{"name":"Heilongjiang Academy of Chinese Medicine Sciences","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuemu","family":"Li","sequence":"additional","affiliation":[{"name":"Heilongjiang Academy of Chinese Medicine Sciences","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"110863","DOI":"10.1016\/j.pnpbp.2023.110863","article-title":"Effectiveness of rTMS and tDCS treatment for chronic TBI symptoms: a systematic review and meta-analysis","volume":"128","author":"Galimberti","year":"2024","journal-title":"Prog Neuro-Psychopharmacol Biol Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"840","DOI":"10.3390\/brainsci11070840","article-title":"Intervention effect of non-invasive brain stimulation on cognitive functions among people with traumatic brain injury: a systematic review and Meta-analysis","volume":"11","author":"Ahorsu","year":"2021","journal-title":"Brain Sci"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"175","DOI":"10.25259\/SNI_926_2024","article-title":"Use of repetitive transcranial magnetic stimulation in traumatic brain injury: a systematic review and meta-analysis of randomized controlled trials","volume":"16","author":"Aleid","year":"2025","journal-title":"Surg Neurol Int"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"16940","DOI":"10.1038\/s41598-021-95838-2","article-title":"Effect of repetitive transcranial magnetic stimulation on depression and cognition in individuals with traumatic brain injury: a systematic review and meta-analysis","volume":"11","author":"Tsai","year":"2021","journal-title":"Sci Rep"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1093\/arclin\/acab047","article-title":"The effectiveness of non-invasive brain stimulation alone or combined with cognitive training on the cognitive performance of patients with traumatic brain injury: a systematic review","volume":"37","author":"Nousia","year":"2022","journal-title":"Arch Clin Neuropsychol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1080\/23279095.2022.2091440","article-title":"Noninvasive brain stimulation for cognitive rehabilitation following traumatic brain injury: a systematic review","volume":"30","author":"Alashram","year":"2023","journal-title":"Appl Neuropsychol Adult"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"627","DOI":"10.3390\/diagnostics11040627","article-title":"The effect of non-invasive brain stimulation (NIBS) on executive functioning, attention and memory in rehabilitation patients with traumatic brain injury: a systematic review","volume":"11","author":"Hara","year":"2021","journal-title":"Diagnostics"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1590\/1980-57642018dn13-020005","article-title":"Transcranial direct current stimulation (tDCS) effects on traumatic brain injury (TBI) recovery: a systematic review","volume":"13","author":"Zaninotto","year":"2019","journal-title":"Dement Neuropsychol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"3683","DOI":"10.1007\/s10072-024-07530-8","article-title":"Efficacy of rTMS combined with cognitive training in TBI with cognition disorder: a systematic review and meta-analysis","volume":"45","author":"Chen","year":"2024","journal-title":"Neurol Sci."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1321239","DOI":"10.3389\/fneur.2024.1321239","article-title":"Effectiveness of biomedical interventions on the chronic stage of traumatic brain injury: a systematic review of randomized controlled trials","volume":"15","author":"Kawata","year":"2024","journal-title":"Front Neurol."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"187","DOI":"10.25259\/SNI_875_2025","article-title":"Repetitive transcranial magnetic stimulation for neuropathic pain and neuropsychiatric sequelae in traumatic brain injury: A meta-analysis and trial sequential analysis","volume":"17","author":"Oktaviani","year":"2026","journal-title":"Surg Neurol Int."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"8789","DOI":"10.12659\/MSM.911385","article-title":"Effect of Low Frequency Repetitive Transcranial Magnetic Stimulation on Depression and Cognition of Patients with Traumatic Brain Injury: A Randomized Controlled Trial","volume":"24","author":"Lee","year":"2018","journal-title":"Med Sci Monit."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1931683\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:38:15Z","timestamp":1787114295000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1931683\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":12,"alternative-id":["10.3389\/fneur.2026.1931683"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1931683","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]},"article-number":"1931683"}}