Effect of hyperbaric oxygenation therapy on post-concussion syndrome

Area of Science:

• Neurology
• Hyperbaric Medicine
• Evidence-Based Medicine

Background:

• Post-concussion syndrome (PCS) presents a complex challenge with limited effective treatments.
• Hyperbaric oxygenation (HBO) therapy, involving exposure to increased atmospheric pressure and oxygen, has been explored as a potential intervention for various neurological conditions.

Purpose of the Study:

• To systematically review and meta-analyze the available randomized controlled trials (RCTs) evaluating the efficacy of HBO therapy in patients with post-concussion syndrome.
• To determine if HBO therapy offers a significant benefit over sham treatment for PCS symptom reduction.

Main Methods:

• A comprehensive literature search was conducted across multiple electronic databases (Cochrane, EBSCOhost, Embase, Ovid MEDLINE, PubMed, Web of Science) up to early 2016.
• Four eligible RCTs were included in the meta-analysis, with data extraction and risk of bias assessment performed independently by two reviewers.
• Statistical analysis used Review Manager 5.3, estimating standardized mean difference (SMD) or mean difference (MD) with 95% confidence intervals (CI) using fixed or random effects models.

Main Results:

• The meta-analysis found no statistically significant differences in Rivermead Post-Concussion Symptoms Questionnaire scores between different oxygen doses (MD=1.23; 95% CI, -3.47-5.94; P>0.05).
• No significant differences were observed in Post-Traumatic Stress Disorder Checklist (PCL) scores between groups receiving different oxygen doses (SMD=0.12; 95% CI, -0.31-0.54; P>0.05) or between HBO and sham groups (SMD=-0.13, 95% CI, -0.80-0.53; P>0.05).
• Neurobehavioral symptoms also showed no significant improvement with HBO therapy compared to sham treatment (SMD=-1.00, 95% CI, -2.58-0.58; P>0.05).

Conclusions:

• Current evidence suggests that hyperbaric oxygenation therapy does not provide a significant therapeutic effect for post-concussion syndrome compared to sham interventions.
• The findings underscore the need for well-designed, large-scale clinical trials with robust control and sham groups to definitively assess HBO therapy's role in PCS management.