Wednesday, December 28, 2011

Hyperbaric Oxygen for TBI: Some Clinical Evidence New and Forthcoming

In quick follow-up to yesterday's post ("Former NFL Player Battles Chronic Traumatic Encephalopathy") we refer readers to the latest findings from ongoing clinical trials on hyperbaric oxygen for traumatic brain injury (TBI).

Publishing in the Journal of Neurotrauma in November, Harch, et al, treated 16 military subjects with TBI, postconcussion syndrome, and posttraumatic stress disorder (PTSD) and found "significant improvements occurred in symptoms, abnormal physical exam findings, cognitive testing, and quality-of-life measurements, with concomitant significant improvements in SPECT." Subjects received 40 one-hour sessions of hyperbaric oxygen therapy at 1.5 ATA over 30 days. Treatment commenced nearly three years after injuries caused by improvised explosive device (IED) and rocket-propelled grenade explosions.

This is important scientific work. These are noteworthy clinical findings. But once again these investigators get carried away with the publicity. Note the adjectives in their December 5 news release: "groundbreaking," "prestigious," "stunning," "major," "remarkable." And they conclude that their "study argues strongly for the immediate application of HBOT 1.5 to hundreds of thousands of veterans"—a mighty bold claim for a preliminary report on a pilot trial in 16 patients. Harch is study chair of the ongoing National Brain Injury Rescue and Rehabilitation Project (NBIRR), an observational study of 1,000 patients begun in April 2010 and scheduled for completion in April 2014. We eagerly await the published results.

Other government-funded studies of HBOT for TBI now face serious political opposition. Read our 13 July 2011 post, "DCoE Faces Tough GAO Scrutiny." CLICK HERE to review all our previous coverage of hyperbaric oxygen for traumatic brain injury.

For a sobering perspective on the breadth of the clinical and political challenges surrounding TBI and PTSD, we also direct your attention to yesterday's year-end review of the excellent Brain Wars series. Read "Military Still Struggling to Treat Troops with Brain Injuries" on the ProPublica website.

[Illustration: Al Granberg, ProPublica]

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