Efficacy of Cognitive Rehabilitation in Patients With Brain Tumors: A Meta-analysis
Maheen Hamid1, Kainat Mehmood2, Maryam Mirza2, Nouraiz Abbas3, Hafsa Ahsun2, Shah Jahan2, Mohammad Hassan2, Muhammad Saad Khan2, Ahmed Mueed4
1MBBS, Multan Medical and Dental College, Multan, Pakistan, 2MBBS, Jinnah Sindh Medical University, Karachi, Pakistan, 3MBBS, Abwa Medical College, Faislabad, Pakistan, 4MBBS, Fatima Memorial Hospital, Lahore, Pakistan
Objective:
To determine the aid of cognitive rehabilitation in promoting improved cognitive performance in patients with primary and treated brain tumors.
Background:
Cognitive dysfunction is a common and debilitating consequence of brain tumors and their treatments, significantly affecting cognitive performance and quality of life. Cognitive rehabilitation has been proposed as a promising intervention to restore or compensate for these deficits, yet its overall efficacy remains uncertain. This meta-analysis aimed to evaluate the effectiveness of cognitive rehabilitation among patients with brain tumors.
Design/Methods:

This meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered with PROSPERO (CRD420251131469). Comprehensive searches of PubMed, Embase, Scopus, Cochrane Library, Google Scholar, and ClinicalTrials.gov were performed up to July 2025. Eligible studies included randomized controlled trials (RCTs) and observational studies comparing cognitive rehabilitation with standard care. Risk of bias was assessed using Cochrane RoB 2.0 and Newcastle-Ottawa Scale; certainty of evidence was graded using GRADE.

Results:

Out of 152 records identified, four studies met inclusion criteria (three RCTs and one cohort). Cognitive rehabilitation was associated with significant improvements in verbal recall (SMD 0.59, 95% CI 0.16–1.03) and digit span (SMD 0.49, 95% CI 0.19–0.79), both supported by high-certainty evidence. In contrast, no significant effects were observed for attention (SMD 0.14, 95% CI –0.30–0.58) or global cognition (SMD 0.07, 95% CI –0.22–0.36).

Conclusions:

Cognitive rehabilitation enhances verbal recall and working memory in brain tumor patients, while benefits for attention and global cognition remain inconclusive. Larger, multicenter RCTs with standardized protocols are needed to validate and extend these findings.

10.1212/WNL.0000000000215159
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