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Cognitive assessment in the context of hyperbaric oxygen: a scoping review
Michala Torp1, Camilla Strøm1, Bjørn Arenkiel1
1Department of Anaesthesiology, Centre of Head and Orthopedics, Section of Hyperbaric Medicine, Rigshospitalet, Copenhagen, Denmark.
Background:
Hyperbaric oxygen (HBO2) treatment is used to treat a variety of conditions, but its effects on cognitive functioning are inconsistently assessed. This scoping review identifies the current literature on cognitive testing in relation to HBO2 treatment.
Objective:
We aimed to 1) identify which cognitive domains have been investigated in relation to HBO2; 2) identify the neurocognitive tests used; and 3) propose a standardized cognitive assessment program applicable to future HBO2 clinical trials.
Methods:
A systematic search of four databases was conducted up to March 2025 for clinical studies involving adult patients treated with HBO2, with neurocognitive testing as one of the outcomes. Cognitive domains were categorized using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, and test sensitivity was evaluated in randomized controlled trials.
Results:
Of 3,238 records, 98 studies published between 1963 and 2025 met the inclusion criteria. The findings reveal considerable variation in the cognitive domains investigated and in the assessment methods employed, reflecting the diversity of disorders treated and a lack of consensus in the field of HBO2 treatment. To improve consistency and comparability across future HBO2 research, we propose a standardized, computerized cognitive test battery assessing psychomotor speed, attention, memory, and executive function.
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