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Interventions for fatigue management after traumatic brain injury.

Hugh E Senior¹, Joan H Leung^2,3, Brigette Meehan⁴

¹School of Health Sciences, College of Health, Massey University, Auckland, New Zealand.

The Cochrane Database of Systematic Reviews

|February 17, 2026

Summary

Fatigue after traumatic brain injury (TBI) is common, but evidence for effective treatments is limited. Pharmacological and cognitive interventions show slight fatigue reduction, but more high-quality research is needed for TBI fatigue management.

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Area of Science:

Neuroscience and Rehabilitation
Clinical Trials and Evidence Synthesis

Background:

Fatigue is a prevalent and significant issue for individuals with post-traumatic brain injury (TBI).
Current management strategies for TBI-related fatigue lack validation, necessitating an evidence-based review.

Purpose of the Study:

To systematically evaluate the effectiveness of both pharmacological and non-pharmacological interventions for managing fatigue in TBI survivors.
To synthesize the best available evidence on current fatigue management practices for clinicians and patients.

Main Methods:

Conducted a comprehensive search of multiple databases (CENTRAL, MEDLINE, Embase, PsycINFO) and clinical trial registries.
Included randomized controlled trials (RCTs) and randomized cross-over trials, focusing on participants with TBI of any severity.
Prioritized interventions into four categories: pharmacological, cognitive, stimulation/biofeedback, and psychoeducational, comparing them against control groups.

Main Results:

Pharmacological interventions demonstrated a likely slight reduction in fatigue (moderate-certainty evidence).
Cognitive interventions showed a potential slight reduction in fatigue (low-certainty evidence).
Stimulation/biofeedback and psychoeducational interventions had very uncertain effects on fatigue, with limited evidence.

Conclusions:

The current evidence base for treating fatigue post-TBI is limited and of low to moderate certainty.
High-quality studies are lacking, highlighting a critical need for further research to identify effective fatigue management strategies for TBI patients.