Case control study: Hyperbaric oxygen treatment of mild traumatic brain injury persistent post-concussion syndrome and post-traumatic stress disorder

Harch, Paul G.; Andrews, Susan R.; Fogarty, Edward F; Lucarini, Juliette; Meter, Keith W. Van

doi:10.4103/2045-9912.215745

Cited by 33 publications

(88 citation statements)

References 75 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specifically, critical information regarding the optimal therapeutic time frame of NBO and its long-term effects are still unclear Therefore, it does not serve the same effectiveness as the HBOT for post- and pre-stroke conditions and is less of an intriguing option for preconditioning [ 16 , 24 , 25 ]. Nevertheless, the synergistic use of normobaric oxygen treatment accompanied by HBOT shows promise in reducing stroke mortality [ 2 , 29 ]. Recent in vivo investigations have shown that HBOT and normobaric oxygen treatment may widen the limited window for thrombolytic therapy, and various neuroprotective medications [ 29 , 30 ].…”

Section: Hbot In Ischemic Stroke: Potential Benefits and Limitatiomentioning

confidence: 99%

“…In light of the current COVID-19 pandemic, clinical trials have explored HBOT in infected patients experiencing extreme respiratory distress. COVID-19 infection generates a potent cytokine storm that spurs the onset of progressive hypoxia, leading to severe respiratory illness [ 2 , 87 ]. Furthermore, HBOT’s capacity to enhance oxygen flow and attenuate inflammation may bear curative effects in COVID-19 patients [ 87 ].…”

Section: Implications Of Hbot In Other Neurological and Non-neurolmentioning

confidence: 99%

“…In Wuhan, HBOT was administered to critically ill COVID-19 patients and resulted in ameliorated hypoxia, increased blood flow, and mitigated immune system deficits. Remarkably, these patients demonstrated substantial recovery and were released from hospital care after 3–8 HBOT sessions [ 2 ]. In another clinical trial, COVID-19 patients demonstrated alleviated shortness of breath [ 87 ], though a significant reduction in mortality rate was not observed.…”

Section: Implications Of Hbot In Other Neurological and Non-neurolmentioning

confidence: 99%

“…When tPA is administered intravenously up to 4.5 h after stroke onset in patients with acute ischemic stroke, it reduces mortality and increases rates of independent ambulation when thrombolytic treatment is given early. If tPA is not delivered within the given time frame, it becomes associated with increased occurrences of severe hemorrhagic transformation, thereby limiting the therapeutic opportunity [ 2 ]. Since stroke is currently the fifth leading cause of death in the U.S., and someone dies of one approximately every 4 min, the discovery of new and effective stroke treatments is of high necessity moving forward.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

An Extra Breath of Fresh Air: Hyperbaric Oxygenation as a Stroke Therapeutic

et al. 2020

View full text Add to dashboard Cite

Stroke serves as a life-threatening disease and continues to face many challenges in the development of safe and effective therapeutic options. The use of hyperbaric oxygen therapy (HBOT) demonstrates pre-clinical effectiveness for the treatment of acute ischemic stroke and reports reductions in oxidative stress, inflammation, and neural apoptosis. These pathophysiological benefits contribute to improved functional recovery. Current pre-clinical and clinical studies are testing the applications of HBOT for stroke neuroprotection, including its use as a preconditioning regimen. Mild oxidative stress may be able to prime the brain to tolerate full extensive oxidative stress that occurs during a stroke, and HBOT preconditioning has displayed efficacy in establishing such ischemic tolerance. In this review, evidence on the use of HBOT following an ischemic stroke is examined, and the potential for HBOT preconditioning as a neuroprotective strategy. Additionally, HBOT as a stem cell preconditioning is also discussed as a promising strategy, thus maximizing the use of HBOT for ischemic stroke.

show abstract

Section: Hbot In Ischemic Stroke: Potential Benefits and Limitatiomentioning

confidence: 99%

Section: Implications Of Hbot In Other Neurological and Non-neurolmentioning

confidence: 99%

Section: Implications Of Hbot In Other Neurological and Non-neurolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An Extra Breath of Fresh Air: Hyperbaric Oxygenation as a Stroke Therapeutic

et al. 2020

View full text Add to dashboard Cite

show abstract

“…For example, in a few small military cohorts of 45 service members with chronic blast-induced mild to moderate TBI, PPCS, and PTSD, forty 60-minute sessions of HBOT 1.5 ATA resulted in 36% to 96% increases in perceived quality of life and percentage back to normal cognitive, physical, and emotional function reported. 28,31 There are also many testimonials and anecdotal reports of HBOT as a "miracle cure" for TBI and/or PTSD that is "giving people back their lives." 32,33 Based on such anecdotal reports, HBOT has gained some political advocacy, such as from Congressman Walter B. Jones in North Carolina and other lawmakers, which has resulted in Oklahoma, Texas, and Indiana passing legislation establishing funding to provide eligible Veterans with TBI and/or PTSD with access to HBOT.…”

Section: Debate On Hbot For Tbi/ptsdmentioning

confidence: 99%

Evidence brief: hyperbaric oxygen therapy (HBOT) for traumatic brain injury and/or post-traumatic stress disorder

Bennett

2018

Diving Hyperb Med

View full text Add to dashboard Cite

This report is a product of the VA Evidence-based Synthesis Program. The purpose is to provide "timely and accurate syntheses of targeted healthcare topics …. to improve the health and healthcare of Veterans". The authors have made a comprehensive search and analysis of the literature and make recommendations to assist clinicians in dealing with veterans suffering from either traumatic brain injury (TBI) or post-traumatic stress disorder (PTSD). The report is timely and of great potential impact given the vigorous and lengthy debate among hyperbaric physicians and lay people determined to find an answer for the large numbers of veterans deeply affected with some combination of PTSD and post-concussion dysfunction. The authors lament the evidence on using hyperbaric oxygen treatment (HBOT) for TBI/PTSD has been "controversial, widely debated, and potentially confusing." Unfortunately, this report will not improve that situation. The report is as much a political document as it is evidence-based. That politics are involved is apparent from the outset with the statement "The ESP Coordinating Center is responding to a request from the Center for Compassionate Innovation (CCI)…" The report fails to further illuminate the situation than the many thousands of words already spent on summarising the evidence. Let me save you some time and get to the quick of this report. The authors (rightly) highlight the fact that uncontrolled case series and a randomised, controlled trial (RCT) without blinding or a sham control all suggest HBOT may be of benefit for these Veterans. Somewhat disappointingly, well-controlled, blinded RCTs using a sham exposure to 1.2 or 1.3 ATA breathing air fail to confirm any such benefit. While the conventional interpretation of these data is that there is no reliable evidence of an effect of HBOT, proponents have responded by postulating these control exposures are not 'sham' because they are clinically active. Any putative mechanism remains unknown and unproven outside the context of this clinical area. These exposures just happen to be about equipotent with true HBOT. With this accurate summary, the authors conclude that any effect of HBOT is as yet unclear. They suggest that in Veterans who have not responded to other therapeutic options, the use of HBOT is "reasonable". This conclusion allows for a similar recommendation for any unproven therapeutic option where there is no clearly effective treatment available and is, to this reviewer, unacceptable. While any putative mechanism for low-pressure air exposure owes more to magical thinking than physics, physiology or therapeutics, this is an argument the authors of this report seem to have accepted at some level. The proponents of HBOT have an obligation to both show the greater effectiveness of HBOT than a functional sham and to demonstrate a plausible mechanism. Until then, the strongest recommendation that should be made is that the 'sham' therapy can be used until the case is proven. It is not clear why the proponents of HBOT do not advocate t...

show abstract