为战斗相关创伤后应激障碍的退伍军人进行高压氧气疗法:一个随机化,虚假控制的临床试验
Keren Doenyas-Barak1,2,3, Ilan Kutz1, Erez Lang1,2
1Sagol Center for Hyperbaric Medicine and Research, Shamir Medical Center, Zerifin, Israel.
The Journal of clinical psychiatry
|November 20, 2024
概括
高压氧疗法 (HBOT) 在退伍军人中显著改善了与战斗相关的创伤后应激障碍 (CA-PTSD) 症状. 这种临床改善与增强的大脑连接相关,表明HBOT是可行的治疗选择.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 高压医学高压医学
背景情况:
- 创伤后应激障碍 (PTSD) 显著影响退伍军人的生活质量.
- 新出现的证据表明,高压氧疗法 (HBOT) 可能为PTSD提供神经可塑性益处.
- 需要进行随机化,模拟控制试验,以严格评估HBOT对战斗相关的PTSD (CA-PTSD).
研究的目的:
- 评估专门的HBOT协议在改善男性退伍军人的CA-PTSD临床症状方面的有效性.
- 通过静止状态功能磁共振成像 (rsfMRI) 来研究HBOT效应的神经生物学基础.
- 为了确定HBOT是否会导致与假干预相比,PTSD症状严重程度的显著降低.
主要方法:
- 一个随机的,假的受控试验,涉及男性退伍军人 (25-60岁) 被诊断患有CA-PTSD.
- 参与者每天接受60次HBOT (100%氧气在2 ATA) 或假干预.
- 评估了症状严重程度 (CAPS-5),抑郁症 (BDI-II),焦虑和压力 (DASS-21),以及脑连接分析的rsfMRI.
主要成果:
- 在HBOT组显示CAPS-5得分显著降低 (P<.001),与假装组不同,该组的CAPS-5得分有所增加.
- 在HBOT组的抑郁症得分 (DASS-21抑郁症域,BDI-II) 中观察到显著的改善 (P=.03,P=.04).
- 与假的相比,rsfMRI在HBOT组的关键大脑网络 (默认模式,中央执行,突出) 中显示了增强的功能连接.
结论:
- 一个特定的HBOT协议有效地缓解了CA-PTSD退伍军人的PTSD症状.
- 观察到的HBOT的临床益处与大脑功能连接的可测量的改善有关.
- 通过临床和神经成像数据支持,HBOT为管理CA-PTSD提供了一个有希望的治疗途径.
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