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The effect of hyperbaric oxygen on persistent postconcussion symptoms.

David X Cifu1, Brett B Hart, Steven L West

  • 1Physical Medicine and Rehabilitation Program Office, Department of Veterans Affairs, Washington, District of Columbia (Dr Cifu); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond (Drs Cifu, West, Walker, and Carne); Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (Drs Cifu, Walker, and Carne); Naval Medicine Operational Training Center, Pensacola, Florida (Dr Hart); and Richmond Defense and Veterans Brain Injury Center, Richmond, Virginia (Drs Walker and Carne).

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Summary

Hyperbaric oxygen therapy (HBOT) did not significantly improve persistent postconcussion symptoms in military service members after mild traumatic brain injury. This randomized controlled trial found no evidence of HBOT efficacy compared to sham compression.

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Area of Science:

  • Neurology
  • Hyperbaric Medicine
  • Military Health

Background:

  • Persistent postconcussion symptoms are common in service members with combat-related mild traumatic brain injury (mTBI).
  • Hyperbaric oxygen therapy (HBOT) has been investigated as a potential management strategy for mTBI sequelae.

Purpose of the Study:

  • To evaluate the efficacy of HBOT in treating persistent postconcussion symptoms in military personnel.
  • To compare the effects of different HBOT oxygen concentrations and pressures against a sham intervention.

Main Methods:

  • A single-center, double-blind, randomized, sham-controlled trial involving 60 military service members with combat-related mTBI.
  • Participants received 40 daily hyperbaric chamber sessions over 10 weeks, breathing oxygen at fractions equivalent to 1.5 or 2.0 atmospheres absolute (ATA) or sham compression.
  • Symptom assessment used the Rivermead Postconcussion Symptom Questionnaire and the Posttraumatic Disorder Checklist-Military Version.

Main Results:

  • No significant between-group differences were observed in total or individual scores on either symptom questionnaire.
  • HBOT at 1.5 or 2.0 ATA equivalent showed no significant effect compared to sham compression.
  • Within-group analysis revealed some scattered significant differences, potentially due to Type 2 errors or nonspecific effects.

Conclusions:

  • HBOT at 1.5 or 2.0 ATA equivalent demonstrated no efficacy in improving postconcussion symptoms following mild traumatic brain injury.
  • The study did not provide evidence supporting HBOT as a treatment for persistent postconcussion symptoms in this population.