Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury - randomized prospective trial.
Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury - randomized prospective trial.
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DOI：
10.1371/journal.pone.0079995
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Efrati S
中科院分区：
文献类型：
--
作者：
Boussi-Gross R;Golan H;Fishlev G;Bechor Y;Volkov O;Bergan J;Friedman M;Hoofien D;Shlamkovitch N;Ben-Jacob E;Efrati S
创伤性脑损伤（TBI）是美国死亡和残疾的主要原因。大约70-90%的TBI病例被归类为轻度，其中高达25%的病例将无法恢复并遭受慢性神经认知障碍。这些病例中的主要病理学涉及弥漫性脑损伤，这很难通过解剖成像检测到，但在代谢成像中很明显。目前的研究测试了高压氧治疗（HBOT）在改善患有慢性神经认知障碍的mTBI患者的脑功能和生活质量方面的有效性。试验人群包括56名在损伤后1-5年患有长时间脑震荡后综合征（PCS）的mTBI患者。通过前瞻性、随机、交叉对照试验评价HBOT效果：患者被随机分配到治疗组或交叉组。治疗组患者在基线和40次HBOT治疗后进行评价;交叉组患者进行3次评价：基线、2个月无治疗对照期后和随后2个月40次HBOT治疗后。HBOT方案包括40次治疗（5天/周），每次60分钟，100%氧气，1.5 ATA。使用“Mindstreams”进行认知评估，通过EQ-5D评估生活质量（QOL），并通过SPECT成像评估大脑活动的变化。HBOT后两组的认知功能和QOL均得到显著改善，但对照期后未观察到显著改善。SPECT成像显示，大脑活动的增加与认知能力的改善非常一致。HBOT可以诱导神经可塑性，导致慢性受损的脑功能的修复，并改善慢性晚期PCS延长的mTBI患者的生活质量。ClinicalTrials.gov NCT00715052
Traumatic brain injury (TBI) is the leading cause of death and disability in the US. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. The current study tested the effectiveness of Hyperbaric Oxygen Therapy (HBOT) in improving brain function and quality of life in mTBI patients suffering chronic neurocognitive impairments. The trial population included 56 mTBI patients 1–5 years after injury with prolonged post-concussion syndrome (PCS). The HBOT effect was evaluated by means of prospective, randomized, crossover controlled trial: the patients were randomly assigned to treated or crossover groups. Patients in the treated group were evaluated at baseline and following 40 HBOT sessions; patients in the crossover group were evaluated three times: at baseline, following a 2-month control period of no treatment, and following subsequent 2-months of 40 HBOT sessions. The HBOT protocol included 40 treatment sessions (5 days/week), 60 minutes each, with 100% oxygen at 1.5 ATA. “Mindstreams” was used for cognitive evaluations, quality of life (QOL) was evaluated by the EQ-5D, and changes in brain activity were assessed by SPECT imaging. Significant improvements were demonstrated in cognitive function and QOL in both groups following HBOT but no significant improvement was observed following the control period. SPECT imaging revealed elevated brain activity in good agreement with the cognitive improvements. HBOT can induce neuroplasticity leading to repair of chronically impaired brain functions and improved quality of life in mTBI patients with prolonged PCS at late chronic stage. ClinicalTrials.gov NCT00715052
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