Abstract
Objectives The aim of the study is to evaluate the effect of hyperbaric oxygen therapy (HBOT) in participants suffering from chronic neurological deficits due to traumatic brain injury (TBI) of all severities in the largest cohort evaluated so far with objective cognitive function tests and metabolic brain imaging.
Methods A retrospective analysis was conducted of 154 patients suffering from chronic neurocognitive damage due to TBI, who had undergone computerised cognitive evaluations pre-HBOT and post-HBOT treatment.
Results The average age was 42.7±14.6 years, and 58.4% were men. All patients had documented TBI 0.3–33 years (mean 4.6±5.8, median 2.75 years) prior to HBOT. HBOT was associated with significant improvement in all of the cognitive domains, with a mean change in global cognitive scores of 4.6±8.5 (p<0.00001). The most prominent improvements were in memory index and attention, with mean changes of 8.1±16.9 (p<0.00001) and 6.8±16.5 (p<0.0001), respectively. The most striking changes observed in brain single photon emission computed tomography images were in the anterior cingulate and the postcentral cortex, in the prefrontal areas and in the temporal areas.
Conclusions In the largest published cohort of patients suffering from chronic deficits post-TBI of all severities, HBOT was associated with significant cognitive improvements. The clinical improvements were well correlated with increased activity in the relevant brain areas.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
https://doi.org/10.1136/bmjopen-2018-023387
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Footnotes
Contributors AH: concept, data collection, data analysis, manuscript draft and manuscript review. SA: data collection and data analysis. GS, YB: data collection and manuscript review. SE: concept, data analysis, manuscript draft and manuscript review.
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Data collected retrospectively were anonymised.
Ethics approval The study was approved by the institutional review board of Assaf Harfoeh Medical Center, Israel.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Extra data are available by emailing amir.had@gmail.com.
Presented at EUBS 2017, EANS 2017