PMID- 29152209
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 2045-9912 (Print)
IS  - 2045-9912 (Electronic)
IS  - 2045-9912 (Linking)
VI  - 7
IP  - 3
DP  - 2017 Jul-Sep
TI  - Case control study: hyperbaric oxygen treatment of mild traumatic brain injury 
      persistent post-concussion syndrome and post-traumatic stress disorder.
PG  - 156-174
LID - 10.4103/2045-9912.215745 [doi]
AB  - Mild traumatic brain injury (TBI) persistent post-concussion syndrome (PPCS) and 
      post-traumatic stress disorder (PTSD) are epidemic in United States Iraq and 
      Afghanistan War veterans. Treatment of the combined diagnoses is limited. The aim 
      of this study is to assess safety, feasibility, and effectiveness of hyperbaric 
      oxygen treatments (HBOT) for mild TBI PPCS and PTSD. Thirty military subjects 
      aged 18-65 with PPCS with or without PTSD and from one or more blast-induced 
      mild-moderate traumatic brain injuries that were a minimum of 1 year old and 
      occurred after 9/11/2001 were studied. The measures included symptom lists, 
      physical exam, neuropsychological and psychological testing on 29 subjects (1 
      dropout) and SPECT brain imaging pre and post HBOT. Comparison was made using 
      SPECT imaging on 29 matched Controls. Side effects (30 subjects) experienced due 
      to the HBOT: reversible middle ear barotrauma (n = 6), transient deterioration in 
      symptoms (n = 7), reversible bronchospasm (n = 1), and increased anxiety (n = 2; 
      not related to confinement); unrelated to HBOT: ureterolithiasis (n = 1), chest 
      pain (n = 2). Significant improvement (29 subjects) was seen in neurological 
      exam, symptoms, intelligence quotient, memory, measures of attention, dominant 
      hand motor speed and dexterity, quality of life, general anxiety, PTSD, 
      depression (including reduction in suicidal ideation), and reduced psychoactive 
      medication usage. At 6-month follow-up subjects reported further symptomatic 
      improvement. Compared to Controls the subjects' SPECT was significantly abnormal, 
      significantly improved after 1 and 40 treatments, and became statistically 
      indistinguishable from Controls in 75% of abnormal areas. HBOT was found to be 
      safe and significantly effective for veterans with mild to moderate TBI PPCS with 
      PTSD in all four outcome domains: clinical medicine, neuropsychology, psychology, 
      and SPECT imaging. Veterans also experienced a significant reduction in suicidal 
      ideation and reduction in psychoactive medication use.
FAU - Harch, Paul G
AU  - Harch PG
AUID- ORCID: 0000-0001-7329-0078
AD  - Louisiana State University School of Medicine, New Orleans, LA, USA.
FAU - Andrews, Susan R
AU  - Andrews SR
AD  - Louisiana State University School of Medicine, New Orleans, LA, USA.
FAU - Fogarty, Edward F
AU  - Fogarty EF
AD  - University of North Dakota School of Medicine, Bismarck, ND, USA.
FAU - Lucarini, Juliette
AU  - Lucarini J
AD  - Louisiana State University School of Medicine, New Orleans, LA, USA.
FAU - Van Meter, Keith W
AU  - Van Meter KW
AD  - Louisiana State University School of Medicine, New Orleans, LA, USA.
LA  - eng
PT  - Journal Article
DEP - 20171017
PL  - Australia
TA  - Med Gas Res
JT  - Medical gas research
JID - 101564536
PMC - PMC5674654
OTO - NOTNLM
OT  - brain injury treatment
OT  - cognitive assessment
OT  - combat veterans
OT  - hyperbaric oxygen
OT  - persistent post concussion syndrome
OT  - post traumatic stress disorder
OT  - single photon emission computed tomography
OT  - traumatic brain injury
COIS- Conflicts of interest Dr. Harch owns a small hyperbaric medicine consulting 
      company. He derives income from the treatment facility that is the primary 
      location of his medical practice. He is on the board of directors of the 
      International Hyperbaric Medical Association, a non-profit professional 
      organization, and derives no income from this organization. Dr. Fogarty is 
      president of the International Hyperbaric Medical Foundation (IHMF), a non-profit 
      corporation that promotes education, research, and teaching in hyperbaric 
      medicine. He also owns a holding company for a mobile hyperbaric clinic. Dr. 
      Andrews has no competing financial interests. Juliette Lucarini, is co-owner of 
      the hyperbaric consulting company with Paul G. Harch, M.D. Dr. Van Meter owns a 
      hyperbaric equipment leasing company and contracts with hospitals to provide 
      hyperbaric medicine physician staffing. Dr. Van Meter also owns the treatment 
      facility. Partial presentation of a small subset of data at HBOT 2014 (The 9th 
      International Symposium on Hyperbaric Oxygenation: Roadmap for the Future). 
      Presented two slides on P values for the cognitive and quality of life outcomes 
      for the first 24 subjects, compared to the first 15 subjects, in a lecture on 
      review of the science and literature of HBOT in persistent post-concussion 
      syndrome. None of the imaging, demographics, and content of the tables in this 
      manuscript were presented at that meeting.
EDAT- 2017/11/21 06:00
MHDA- 2017/11/21 06:01
PMCR- 2017/10/17
CRDT- 2017/11/21 06:00
PHST- 2017/11/21 06:00 [entrez]
PHST- 2017/11/21 06:00 [pubmed]
PHST- 2017/11/21 06:01 [medline]
PHST- 2017/10/17 00:00 [pmc-release]
AID - MGR-7-156 [pii]
AID - 10.4103/2045-9912.215745 [doi]
PST - epublish
SO  - Med Gas Res. 2017 Oct 17;7(3):156-174. doi: 10.4103/2045-9912.215745. eCollection 
      2017 Jul-Sep.