Hyperbaric oxygen for blast-related postconcussion syndrome: three-month outcomes.

Area of Science:

• Neurology
• Hyperbaric Medicine
• Military Health

Background:

• Mild traumatic brain injury (mTBI) and postconcussion syndrome (PCS) are prevalent among military personnel.
• Hyperbaric oxygen (HBO2) therapy is a proposed treatment for mTBI/PCS but lacks rigorous scientific validation.

Purpose of the Study:

• To evaluate the efficacy of HBO2 therapy at two different dosing levels for treating PCS in military combatants.
• To identify potential subgroups that may benefit from HBO2 therapy.
• To investigate if other conditions masked any potential benefits of HBO2 therapy.

Main Methods:

• A randomized, double-blind, sham-controlled trial involving 61 male Marines with mTBI and PCS.
• Participants received 40 daily 60-minute hyperbaric chamber compressions at 2.0 ATA with varying oxygen fractions (sham, 1.5 ATA O2, or 2.0 ATA O2).
• The primary outcome measure was the Rivermead Post-Concussion Questionnaire-16 (RPQ-16), assessed pre-treatment and at two follow-up points.

Main Results:

• No significant interaction between time and intervention group was observed for RPQ-16 improvement.
• No evidence of efficacy was found for any subgroup on the RPQ-16.
• Secondary outcomes (functional, cognitive, psychomotor) also showed no significant time by intervention interaction.

Conclusions:

• This study found no evidence that hyperbaric oxygen therapy is effective in treating the symptomatic, cognitive, or behavioral effects of PCS following combat-related mTBI.
• The randomized controlled trial design with a sham group supports the conclusion of non-efficacy at three months post-treatment.