Monday, January 6, 2014

Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury - Randomized Prospective Trial

I'm not sure I trust this. At least one of the authors, Dr. Shai Efrati, is directly associated with
Head of the Hyperbaric Unit at Assaf Harofeh Medical Center. Using SPECT scan to prove anything may be worthless.
From here:
http://neurobollocks.wordpress.com/2013/03/10/utterly-shameless-diagnostic-brain-imaging-neurobollocks/ 

Why use SPECT? The spatial resolution of the images is crap, and no-one uses it for clinical or research work that much anymore.
And the research here:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3829860/#
Rahav Boussi-Gross,#1 Haim Golan,#3,4 Gregori Fishlev,1 Yair Bechor,1 Olga Volkov,3,4 Jacob Bergan,1 Mony Friedman,1 Dan Hoofien,6,7 Nathan Shlamkovitch,8 Eshel Ben-Jacob,2,5,9,10,* and Shai Efrati1,2,3,10,*
Jinglu Ai, Editor
Author information ► Article notes ► Copyright and License information ►
Go to:

Abstract

Background

Traumatic brain injury (TBI) is the leading cause of death and disability in the US. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. The current study tested the effectiveness of Hyperbaric Oxygen Therapy (HBOT) in improving brain function and quality of life in mTBI patients suffering chronic neurocognitive impairments.

Methods and Findings

The trial population included 56 mTBI patients 1–5 years after injury with prolonged post-concussion syndrome (PCS). The HBOT effect was evaluated by means of prospective, randomized, crossover controlled trial: the patients were randomly assigned to treated or crossover groups. Patients in the treated group were evaluated at baseline and following 40 HBOT sessions; patients in the crossover group were evaluated three times: at baseline, following a 2-month control period of no treatment, and following subsequent 2-months of 40 HBOT sessions. The HBOT protocol included 40 treatment sessions (5 days/week), 60 minutes each, with 100% oxygen at 1.5 ATA. “Mindstreams” was used for cognitive evaluations, quality of life (QOL) was evaluated by the EQ-5D, and changes in brain activity were assessed by SPECT imaging. Significant improvements were demonstrated in cognitive function and QOL in both groups following HBOT but no significant improvement was observed following the control period. SPECT imaging revealed elevated brain activity in good agreement with the cognitive improvements.

Conclusions

HBOT can induce neuroplasticity leading to repair of chronically impaired brain functions and improved quality of life in mTBI patients with prolonged PCS at late chronic stage.

Trial Registration

ClinicalTrials.gov
NCT00715052
at

1 comment:

  1. oc1deanJanuary 7, 2014 at 11:41 AM

    Rather than putting comments here this person sent me an email directly.
    Ze'ev Cohen

    2:27 AM (9 hours ago)

    to me

    Hi,



    I personally know Dr.Efrati to be a serious researcher. He does use SPECT to assess potential usefulness of HBOT for patients, by comparing functional\metabolizing areas of the brain (seen in SPECT) to MRI scans of brain damaged areas. I'm a physical therapist, not an imaging expert, but using it this way, not to diagnose neurological conditions but to assess activity level of gross brain areas, seems like a reasonable way of doing screening (and research, by comparing an individual pre and post-treatment SPECTs). If you have a (clear) question regarding the use of SPECT in his studies or center I can forward it to him.

    ReplyDelete