Effect of hyperbaric oxygen therapy on chronic neurocognitive deficits of post-traumatic brain injury patients
Traumatic brain injury (TBI) is one of the leading causes of death and disability in the general population.1 Following TBI, patients may experience a set of symptoms known as postconcussion syndrome (PCS). PCS symptoms include headaches, dizziness, neuropsychiatric symptoms and cognitive impairments.2 PCS can continue for weeks or months, and up to 25% of all patients experience prolonged PCS in which the symptoms last for over 6months.3 In the past years, there is growing clinical evidence regarding the effect of hyperbaric oxygen therapy (HBOT) on PCS.4–6 Unfortunately, the clinical data gathered from those studies can be conflicting due to several inherent procedural issues, such as the use of non-objective endpoints, the lack of appropriate brain imaging as part of the inclusion criteria, the inappropriate placebo of a hyperbaric environment and the inclusion of patients that may gain secondary benefits from reporting sick.4 5 The current study represents the largest cohort evaluated until now of civilian participants suffering from PCS treated by HBOT, who had undergone objective metabolic brain imaging and a computerised neurocognitive test battery before and after the treatment.
HBOT was associated with significant cognitive improvements in patients who suffer from chronic neurocognitive deficits due to mild, moderate and severe TBI. Improvement in memory correlated with activation of the perirhinal cortex, improvement of executive functions correlated with activation of the inferior frontal gyrus and improvement in attention correlated with activation of the anterior cingulate gyrus.