Hadanny Amir, Abbott Stefanie, Suzin Gil, Bechor Yair, Efrati Shai
Neurosurgery Department, Galilee Medical Center, Nahariya, Israel.
Sagol Center for Hyperbaric Medicine and Research, Assaf Harofeh Medical Center, Zerifin, Israel.
BMJ Open. 2018 Sep 28;8(9):e023387. doi: 10.1136/bmjopen-2018-023387.
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.
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.
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.
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.
本研究旨在通过客观认知功能测试和脑代谢成像，在迄今为止评估的最大队列中，评估高压氧治疗（HBOT）对所有严重程度的创伤性脑损伤（TBI）所致慢性神经功能缺损患者的疗效。
对154例因TBI导致慢性神经认知损害的患者进行回顾性分析，这些患者在接受HBOT治疗前和治疗后均接受了计算机化认知评估。
平均年龄为42.7±14.6岁，男性占58.4%。所有患者在接受HBOT治疗前0.3 - 33年（平均4.6±5.8年，中位数2.75年）均有TBI记录。HBOT与所有认知领域的显著改善相关，整体认知评分的平均变化为4.6±8.5（p<0.00001）。最显著的改善是在记忆指数和注意力方面，平均变化分别为8.1±16.9（p<0.00001）和6.8±16.5（p<0.0001）。在脑单光子发射计算机断层扫描图像中观察到的最显著变化出现在前扣带回、中央后皮质、前额叶区域和颞叶区域。
在已发表的所有严重程度的TBI后慢性缺损患者的最大队列中，HBOT与显著的认知改善相关。临床改善与相关脑区活动增加密切相关。
