A Phase I study of low pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and posttraumatic stress disorder.

ABSTRACT:

Objective: This is a preliminary report on the safety and efficacy of 1.5 ATA HBOT in military subjects with chronic blast-induced mild-moderate traumatic brain injury (TBI)/post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD).

Methods: 16 military subjects received forty 1.5 ATA/60 minute HBOTs in 30 days. Symptoms, physical and neurological exams, SPECT brain imaging, neuropsychological and psychological testing were completed before and within one week after treatment.

Results: subjects experienced reversible middle ear barotrauma (5), transient deterioration in symptoms (4), and reversible bronchospasm (1); one subject withdrew. Post treatment testing demonstrated significant improvement in: symptoms, neurological exam, Full scale IQ (+14.8 points; p=.001), WMS IV Delayed Memory (p<.026), WMS-IV Working Memory (p=.003), Stroop Test (p=.001), TOVA Impulsivity (p=.041), TOVA Variability (p<.045), Grooved Pegboard (p=.028), PCS symptoms (Rivermead PCSQ: p=.0002), PTSD symptoms (PCL-M: p<.001), Depression (PHQ-9: p<.001), Anxiety (GAD-7: p<.007), quality of life (MPQoL: p<.003), and self-report of percent of normal (p<.001),SPECT coefficient of variation in all white matter and some gray matter ROIโ€™s after the first HBOT, and in half of white matter ROIs after 40 HBOTโ€™s, and SPECT statistical parametric mapping analysis (diffuse improvements in regional cerebral blood flow).

Conclusion(s): Forty 1.5 ATA HBOTs in 1 month was safe in a military cohort with chronic blast-induced PCS and PTSD. Significant improvements occurred in symptoms, abnormal physical exam findings, cognitive testing, and quality of life measurements, with concomitant significant changes/normalization of SPECT. Further study of the efficacy and safety of 1.5 ATA HBOT is underway in a larger group of subjects.

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