Effects of transcranial direct current stimulation on motor and cognitive function in paediatric brain damage: a systematic review and meta-analysis.

PURPOSE: Transcranial direct current stimulation (tDCS) emerges as a secure therapy in paediatric brain damage rehabilitation. Our purpose is to acknowledge its evidence in motor and cognitive variables, examine correlations between tDCS effects and parameters, and identify associations between motor and cognitive outcomes. METHODS: A systematic review and meta-analysis were conducted, registered in PROSPERO (CRD42023448441). 5 databases were consulted in September 2024. Randomised controlled trials evaluating tDCS effectiveness on motor or cognitive outcomes in paediatric brain injuries were included. Methodological quality was assessed using PEDro scale and ROB-2. Certainty of evidence was assessed by GRADE. RESULTS: Nineteen studies were selected (447 participants). tDCS seems to be beneficial in gait (SMD: 0.83–0.90 (p < 0.0001)), balance (COP oscillations SMD: −0.51 - −1.13 (p < 0.02), PBS SMD: 0.48–0.56 (p < 0.0001)), functionality (SMD: 0.40 (p < 0.01)). Effects on cognition showed promising results. Effects in upper limb are controversial, due to fewer publications. CONCLUSIONS: tDCS seems beneficial in motor and cognitive functions in paediatric brain damage. Motor and cognitive functions appears to be interconnected, so combined protocols could be an effective approach. Meta-analysis results are promising but may be considered carefully as few articles could be included. Further research is needed. IMPLICATIONS FOR REHABILITATION: Paediatric brain damage causes a broad spectrum of impairments that lead to long-term disability. Transcranial direct current stimulation (tDCS) emerges as a complementary therapy to enhance rehabilitation results. Current evidence shows positive effects with tDCS interventions in gait, balance and functional performance and effects on cognitive function are promising. tDCS effects on upper limb function remains uncertain due to limited publications.