A Phase I Study of Low-Pressure Hyperbaric Oxygen Therapy for Blast-Induced Post-Concussion Syndrome and Post-Traumatic Stress Disorder

AbstractThis is a preliminary report on the safety and efficacy of 1.5 ATA hyperbaric oxygen therapy (HBOT) in militarysubjects with chronic blast-induced mild to moderate traumatic brain injury (TBI)/post-concussion syndrome(PCS) and post-traumatic stress disorder (PTSD). Sixteen military subjects received 40 1.5 ATA/60 min HBOTsessions in 30 days. Symptoms, physical and neurological exams, SPECT brain imaging, and neuropsychologicaland psychological testing were completed before and within 1 week after treatment. Subjects experiencedreversible middle ear barotrauma (5), transient deterioration in symptoms (4), and reversible bronchospasm (1);one subject withdrew. Post-treatment testing demonstrated significant improvement in: symptoms, neurologicalexam, 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 Peg board ( p = 0.028), PCS symptoms (Rivermead PCSQ: p = 0.0002), PTSD symptoms (PCL-M: p < 0.001), depression (PHQ-9: p < 0.001), anxiety (GAD-7: p = 0.007), quality of life (MPQoL: p = 0.003), and self-report of percent of normal ( p < 0.001), SPECT coefficient of variation in all white matter and some gray matter ROIs after the first HBOT, and in half of white matter ROIs after 40 HBOT sessions, and SPECT statistical parametric mapping analysis (diffuse improvements in regional cerebral blood flow after 1 and 40 HBOT sessions). Forty 1.5 ATAHBOT sessions in 1 month was safe in a military cohort with chronic blast-induced PCS and PTSD. Significant improvements occurred in symptoms, abnormal physical exam findings, cognitive testing, and quality-of-life measurements, with concomitant significant improvements in SPECT.