Therapeutic Effects of Meditation, Yoga, and Mindfulness-Based Interventions for Chronic Symptoms of Mild Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

BACKGROUND: Chronic symptoms of mild traumatic brain injury (mTBI) vary greatly and are difficult to treat; we investigate the impact of meditation, yoga, and mindfulness-based interventions on this treatment group.
METHOD: Search included four databases, allowing studies of any design containing pre/post outcomes for meditation, yoga, or mindfulness-based interventions in people suffering from brain injury acquired by mechanical force. Analyses used robust variance estimation to assess overall effects and random-effects models for selected outcomes; we evaluated both between- and within-group changes.
RESULTS: Twenty studies (N = 539) were included. Results revealed significant improvement of overall symptoms compared to controls (d = 0.41; 95% CI [0.04, 0.77]; τ2  = 0.06), with significant within-group improvements in mental health (d = 0.39), physical health (d = 0.39), cognitive performance (d = 0.24), quality of life (d = 0.39), and self-related processing (d = 0.38). Symptoms showing greatest improvement were fatigue (d = 0.96) and depression (d = 0.40). Findings were homogeneous across studies. Study quality concerns include lack of randomisation, blinding, and recording of adverse events.
CONCLUSIONS: This first-ever meta-analysis on meditation, yoga, and mindfulness-based interventions for chronic symptoms of mTBI offers hope but highlights the need for rigorous new trials to advance clinical applications and to explore mechanistic pathways.