Sixteen active duty and retired U.S. veterans were treated with hyperbaric oxygen therapy nearly three years after brain injuries and PTSD caused by improvised explosive device (IED) and rocket-propelled grenade explosions.
New Orleans, LA (PRWEB) December 05, 2011
Interpretation of Harch, et al Journal of Neurotrauma study published online 11/22/2011
On November 22, 2011 the long-awaited preliminary results of the LSU Pilot Trial of hyperbaric oxygen therapy (HBOT) in chronic blast-induced mild-moderate traumatic brain injury (TBI)/post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD) were published online. And, the results were stunning. The article appears in the prestigious peer-reviewed Journal of Neurotrauma as a Fast Track Article, Open Access Option, at: http://www.liebertonline.com/toc/neu/0/0. The study reinforced the historical safety and feasibility of the HBOT 1.5 ATA (atmospheres absolute) protocol, while significantly improving the symptoms, cognition, and quality of life of the injured veterans.
The study was conducted by Dr. Paul G. Harch and colleagues at LSU School of Medicine New Orleans, the University of North Dakota School of Medicine, and the University of California, Irvine, School of Medicine and Amen Clinics. Sixteen symptomatic active duty and retired U.S. veterans were treated with hyperbaric oxygen therapy nearly three years after TBI and PTSD caused by improvised explosive device (IED) and rocket-propelled grenade explosions. All of the veterans had been diagnosed by military and/or civilian specialists with PCS and PTSD before coming to New Orleans to enter the study.
After forty low pressure hyperbaric oxygen treatments in one month the veterans achieved substantial improvements in post-concussion symptoms, physical exams, cognitive testing, quality of life, and brain blood flow. The veterans achieved a nearly 15 point increase in IQ which is equivalent to the change from the average IQ of a clerical worker or construction worker to the average IQ of a college instructor or engineer. The magnitude of this increase, along with the significant improvements in short term memory, attention/concentration, and executive function was far greater than has been demonstrated in placebo controlled studies or in studies that documented improvements due to short-interval test/retest effects. These cognitive gains strongly suggested the ability of these and similarly treated veterans to seek or return to college level education or achieve higher salary employment.
The veterans experienced a marked reduction in headaches, the primary marker of blast-induced TBI, and a 30 % reduction in PTSD symptoms. The reduction in headaches and PTSD contributed to a significant improvement in quality of life that was augmented by an average 50% reduction in depression symptoms and secondary reduction in suicidal thoughts. Simultaneously, nearly two-thirds of the veterans on psychoactive medications were able to reduce or discontinue their doses of these medications. The off-label use of FDA blackbox labeled psychoactive medications in veterans with PCS and PTSD has been implicated by NPR/ProPublica in the record suicide rate in veterans. Total deaths from suicides have now exceeded combat deaths. The reduction in PTSD, depression, and suicidality in the Harch study has major implications for this suicide epidemic.
The effectiveness of HBOT in treating chronic TBI and PTSD was proven in the study by the addition of striking imaging findings. Using two different methods of analysis of high resolution SPECT brain blood flow imaging Dr. Harch and colleagues were able to demonstrate highly significant improvements in blood flow after one and 40 HBOTs. Specifically, after the first HBOT the researchers demonstrated 85 areas of injured brain tissue with increased brain blood flow. A greater number of areas showed improvement after 40 HBOTs. In contrast imaging studies on placebo effects have demonstrated at most five areas of the brain with increased blood flow.
The ultimate proof of HBOTs causal effect on improvement in the veterans was achieved when the researchers attempted to match the significant improvements in short term memory to blood flow changes. The research team was able to show that the significant improvements in memory and the veterans’ self reports of improved cognition were matched to improvements in blood flow in the brain’s short term memory region, the hippocampus. These findings were nearly identical to the results achieved by Dr. Harch and colleagues in a rat model of chronic traumatic brain injury in 2007 (Brain Research, 2007, http://www.sciencedirect.com/science/article/pii/S0006899307015612). After 80 HBOTs rats showed increased blood vessel density in the injured hippocampus and highly correlated improvements in memory, the first demonstration of improvement of chronic animal brain injury in science.
In summary, Dr. Harch and colleagues have demonstrated a remarkable effectiveness of 1.5 ATA HBOT in treating the chronic effects of mild blast-induced TBI and PTSD. Headaches, post-concussion symptoms, abnormal neurological exam findings, cognition, PTSD, depression, suicidal ideation, quality of life, and brain blood flow were significantly improved after a one month course of HBOT. At six month phone followup the great majority of veterans sustained their symptomatic improvements. In comparison to standard of care treatments the Harch study argues strongly for the immediate application of HBOT 1.5 to the hundreds of thousands of veterans with persistent post-concussion syndrome with or without post-traumatic stress disorder.