Cambios estructurales cerebrales y recuperación funcional tras intervenciones de neurorrehabilitación en el traumatismo craneoencefálico: una revisión sistemática
DOI:
https://doi.org/10.22379/anc.v42i1.1989Palabras clave:
Lesiones Cerebrales Traumáticas, Rehabilitación Neurológica, Plasticidad Neuronal, Recuperación de la Función, Entrenamiento Cognitivo, EncéfaloResumen
Antecedentes: el traumatismo craneoencefálico (TCE) sigue siendo una de las principales causas de discapacidad cognitiva y funcional a largo plazo a nivel mundial. Las estrategias de neurorrehabilitación han demostrado ser prometedoras para favorecer la recuperación, pero los cambios estructurales cerebrales subyacentes aún no se comprenden completamente.
Objetivo: evaluar sistemáticamente la evidencia disponible sobre los cambios estructurales cerebrales asociados a intervenciones de neurorrehabilitación en pacientes con TCE, y su relación con la recuperación cognitiva y funcional.
Materiales y métodos: se realizó una revisión sistemática siguiendo las directrices PRISMA 2020, con registro en PROSPERO (CRD420251072783). Se buscaron estudios en PubMed, Scopus, Web of Science y SciELO. La calidad metodológica se evaluó mediante la escala de Newcastle–Ottawa (NOS).
Resultados: se incluyeron once estudios. Las intervenciones evaluadas incluyeron entrenamiento cognitivo, musicoterapia neurológica y programas multimodales. La mayoría utilizó MRI, DTI o fMRI para analizar cambios neuroanatómicos. Se observaron mejoras consistentes en atención, memoria y funciones ejecutivas, correlacionadas con aumentos en el volumen de sustancia gris o una conectividad funcional mejorada en regiones prefrontales y frontoparietales. La mayoría de los estudios reportaron resultados estructurales y clínicos positivos.
Conclusión: las intervenciones de neurorrehabilitación pueden estar asociados a cambios cerebrales medibles, incluso en fases crónicas del TCE, lo que respalda la existencia de neuroplasticidad preservada. Estos hallazgos refuerzan el valor de integrar la neuroimagen en los protocolos de rehabilitación para guiar la recuperación. Se necesitan estudios más amplios y estandarizados para confirmar estos efectos y avanzar hacia una rehabilitación de precisión.
Biografía del autor/a
Sofia Isabella Leal , Escuela de Medicina, Universidad de Los Andes, Bogotá, Colombia
Cancer and Molecular Medicine Research Group (CAMMO), Bogotá, Colombia
Hospital Universitario, Fundación Santa Fe de Bogotá, Bogotá, Colombia
Mariana Acuña-Posada, Escuela de Medicina, Universidad de Los Andes, Bogotá, Colombia
Cancer and Molecular Medicine Research Group (CAMMO), Bogotá, Colombia
Hospital Universitario, Fundación Santa Fe de Bogotá, Bogotá, Colombia
Diana Valentina Echeverria-Sabillón, Escuela de Medicina, Universidad de Los Andes, Bogotá, Colombia
Cancer and Molecular Medicine Research Group (CAMMO), Bogotá, Colombia
Hospital Universitario, Fundación Santa Fe de Bogotá, Bogotá, Colombia
Magda Rocío Sequeda-Moreno, Escuela de Medicina, Universidad de Los Andes, Bogotá, Colombia
Cancer and Molecular Medicine Research Group (CAMMO), Bogotá, Colombia
Hospital Universitario, Fundación Santa Fe de Bogotá, Bogotá, Colombia
Jheremy Sebastian Reyes-Barreto, Escuela de Medicina, Universidad de Los Andes, Bogotá, Colombia
Cancer and Molecular Medicine Research Group (CAMMO), Bogotá, Colombia
Hospital Universitario, Fundación Santa Fe de Bogotá, Bogotá, Colombia
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