A phase I study of low-pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and post-traumatic stress disorder.
Level 4 - case-series / case-control
Uncontrolled prospective phase I before-and-after trial (case series design)
PubMed 22026588 · doi:10.1089/neu.2011.1895
What was done
Sixteen military subjects with chronic blast-induced mild-to-moderate traumatic brain injury (TBI)/post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD) received 40 sessions of 1.5 ATA hyperbaric oxygen therapy (HBOT) for 60 minutes each over 30 days. Assessments completed before and within one week after treatment included symptom checklists, physical and neurological examinations, SPECT brain imaging, and neuropsychological and psychological testing.
What was found
One subject withdrew. Adverse events included reversible middle ear barotrauma (5), transient symptom deterioration (4), and reversible bronchospasm (1). Testing within one week post-treatment showed statistically significant improvements across multiple domains: full-scale IQ (+14.8 points, p < 0.001), WMS-IV Delayed Memory (p = 0.026), WMS-IV Working Memory (p = 0.003), Stroop Test (p < 0.001), TOVA Impulsivity (p = 0.041), TOVA Variability (p = 0.045), Grooved Pegboard (p = 0.028), Rivermead PCSQ (p = 0.0002), PCL-M PTSD score (p < 0.001), PHQ-9 depression (p < 0.001), GAD-7 anxiety (p = 0.007), MPQoL (p = 0.003), and self-report of percent of normal (p < 0.001). SPECT showed significant diffuse increases in regional cerebral blood flow.
Why it matters
This study provides preliminary safety and signal-finding data suggesting low-pressure HBOT protocols may affect chronic symptoms in blast-induced TBI and PTSD.
Limits
The study is an uncontrolled, unblinded phase I trial with a very small sample size (n = 16). Without a sham control group, improvements cannot be separated from placebo effects, natural history, or test-retest learning effects, and follow-up was limited to one week post-treatment.
Cited by
- supports Hyperbaric oxygen therapy significantly improves cerebral blood flow in military personnel who suffered blast injuries.