Lin Weaver and colleagues have published a fascinating report in Nature Scientific Reports “A double-blind randomized trial of hyperbaric oxygen for persistent symptoms after brain injury.” You should read the entire paper, but a brief summary is as follows:
- Adults with persistent (6 months to 10 years) mild, moderate, or severe symptoms of Traumatic Brain Injury (TBI) were enrolled.
- Subjects were randomly assigned to receive either 40 hyperbaric oxygen (HBO2) sessions (1.5 ATA oxygen) or 40 sham sessions (<0.1 psig 21% oxygen) over 12 weeks.
- Three months later, all were offered 40 unblinded HBO2 sessions.
- Participants completed the Neurobehavioral Symptom Inventory (NSI) at baseline, 13 weeks (after 40 chamber sessions), 6 months, 9 months (after the second chamber series), and 12 months with prime outcome at 13 weeks.
- 49 participants were enrolled; 47 analyzed due to drop-out/exclusion (26 males, 40 with traumatic brain injury).
- Baseline NSI was 35.9 ± 15.8 in the HBO2 group (n = 26) and 30.7 ± 16.9 in the sham group (n = 21) (p = 0.28).
- Mean 13-week change scores were 10.6 ± 10.6 (HBO2 group) and 3.6 ± 5.9 (sham group) (mean difference 7.0, 95% CI 1.7–12.3, p = 0.01).
“The HBO2 group improved on measures of olfaction, anxiety, sleep difficulties, and vestibular complaints. Both groups reported improvements in depression, headaches, PTSD symptoms, physical quality of life, and degree to which difficulties interfere with daily life. With an additional 40 HBO2 sessions, the original HBO2 group reported additional improvements on NSI at 12 months. Only 15 original sham participants completed the second chamber series, limiting conclusions from that data.”
HBO2 resulted in significant improvements in some symptoms compared to sham. (Some symptoms were improved with sham treatment, a fact reported previously. Since the control subjects did not receive more oxygen than room air or any additional nitrogen, we can assume that these improvements are a placebo effect.) Improvement of symptoms when the sham group was treated with HBO2 provides additional support for a benefit of HBO2. Congratulations to Dr. Weaver’s team for completing this important study, which has big implications on the use of HBO2 in TBI.
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
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