Hyperbaric oxygen for blast‐related postconcussion syndrome: Three‐month outcomes. Issue 2 (20th February 2014)

• Record Type: Journal Article
• Authors: Cifu, David X.; Walker, William C.; West, Steven L.; Hart, Brett B.; Franke, Laura Manning; Sima, Adam; Graham, Carolyn W.; Carne, William
• Is Part Of: Annals of neurology. Volume 75:Issue 2(2014:Feb.)
• Page Start: 277
• Page End: 286
• Publication Date: 2014-02-20
• Subjects: Neurology -- Periodicals; Pediatric neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; 616.8
• DOI: 10.1002/ana.24067
• Languages: English
• ISSNs: 0364-5134

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ana24067-sec-0001" sec-type="section"> <title>Objective</title> <p>Mild traumatic brain injury (mTBI) and postconcussion syndrome (PCS) are common among military combatants. Hyperbaric oxygen (HBO<sub>2</sub>) is a proposed treatment for these conditions, but it has not been rigorously studied. The objective of this study was to determine the effects of HBO2 by 3 months post compression at 2 commonly employed dosing levels to treat PCS; whether specific subgroups may have benefited; and if no overall effect was found, whether benefit is masked by other conditions.</p> </sec> <sec id="ana24067-sec-0002" sec-type="section"> <title>Methods</title> <p>This randomized, double‐blind, sham‐controlled study was conducted at the Naval Air Station in Pensacola, Florida on 61 male Marines with a history of mTBI and PCS. Intervention consisted of 40 once daily 60‐minute hyperbaric chamber compressions at 2.0 atmospheres absolute (ATA) at 1 of 3 randomly preassigned oxygen fractions, resulting in respective blinded groups with an oxygen‐breathing exposure equivalent to (1) surface air (sham), (2) 100% oxygen at 1.5ATA, or (3) 100% oxygen at 2.0ATA. The main outcome measure was the Rivermead Post‐Concussion Questionnaire‐16 (RPQ‐16) collected before compressions and at 2 later points.</p> </sec> <sec id="ana24067-sec-0003" sec-type="section"> <title>Results</title> <p>The interaction of time by intervention group was not significant for improvement on the RPQ‐16. Nor was there evidence of efficacy on the RPQ‐16 for any subgroup. No significant time by intervention interaction was found for any functional, cognitive, or psychomotor secondary outcome measure at an unadjusted 0.05 significance level.</p> </sec> <sec id="ana24067-sec-0004" sec-type="section"> <title>Interpretation</title> <p>Using a randomized control trial design and analysis including a sham, results showed no evidence of efficacy by 3 months post‐compression to treat the symptomatic, cognitive, or behavioral sequelae of PCS after combat‐related mTBI. ANN NEUROL 2014;75:277–286</p> </sec> </abstract>