Cognitive Outcomes Following Paediatric Mild Traumatic Brain Injury: A Systematic Review and Meta-Analysis of Studies...

The purpose of this review was to provide a systematic and quantitative summary of recent literature relating to cognitive outcomes following paediatric mild traumatic brain injury (mTBI). Variable findings and diverse methodologies have thus far made it difficult to meaningfully integrate the extant literature. In this context, there is a need to examine the factors that define heterogeneity in this population and to critically evaluate the methodologies from which variable outcomes are derived. Studies identified in this review (PROSPERO, identification number CRD42015030098) were obtained through systematic searches of PubMed, PsycInfo and Scopus. Inclusion criteria specified that studies were to report on cognitive functioning using validated neuropsychological measures, with children aged 8-18 years of age and in a case-control design protocol. In this review, 62 observational studies published pre-2025 were summarised in terms of participant, injury-related and methodological characteristics, with 49 of these studies also contributing to meta-analyses on nine cognitive-factor domains at five distinct time points post-injury. Data from 14,234 participants were represented across all studies, including 5,000 injury cases, and 9,234 controls. Findings from this review revealed that studies reporting on cognitive outcomes varied largely as a function of methodology. There appears to have been little refinement in methodologies over the last decade, with multiple possible sources of heterogeneity identified. Therefore, in line with previous research, the findings of this review suggest little to no evidence of clinically meaningful long-term cognitive impacts post mTBI. The review highlights a number of areas for improvement in future research.