1.The effect of hyperbaric oxygen therapy on cognitive dysfunction caused by traumatic brain injury : A diffusion tensor imaging study
Zheng DING ; Sujian ZHOU ; Huiping PENG ; Xiaoxin LU ; Hui XIAO ; Yang LIU ; Chunshan TAN
Chinese Journal of Physical Medicine and Rehabilitation 2019;41(3):189-194
Objective To observe any effect of hyperbaric oxygen therapy on cognitive dysfunction caused by traumatic brain injury,and to explore possible neural mechanisms.Methods Sixty-four patients with cognitive impairment after a traumatic brain injury were randomly divided into a hyperbaric oxygen group (n =32) and a control group (n=32) using a random number table.Both groups accepted routine medical therapy and cognitive rehabilitation training,but the hyperbaric oxygen group additionally received hyperbaric oxygen treatment.Both groups' cognitive functioning was assessed using the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) before and after the treatment.Fifteen patients were randomly selected from both groups to receive T1WI and diffusion tensor imaging scans.The correlation between the two evaluation resuhs was analyzed.Results After the intervention,improvement was observed in the average MMSE and MoCA scores of both groups,with the improvement in both average scores in the hyperbaric oxygen group significantly greater than among the control group.There was no significant correlation between the fractional anisotropy (FA) values of damaged white matter and the average MMSE or MoCA score in the controi group,but in the hyperbaric oxygen group there were significant positive correlations between the FA values of the corpus callosum,the anterior limb of the internal capsule and the left superior longitudinal fasciculus and the average MMSE and MoCA scores.Conclusions Hyperbaric oxygen therapy combined with rehabilitation training can further improve cognition after a traumatic brain injury.This is probably due to its adjusting the structure and function of the corpus callosum,of the anterior limb of the internal capsule and of the left superior longitudinal fasciculus.
2.Resting state function magnetic resonance imaging study on the effect of hyperbaric oxygen on the improvement of executive function of the patients with traumatic brain injury
Jiayu WU ; Qingyan SU ; Huiping PENG ; Xiaoyang WANG ; Jian GAN ; Sujian ZHOU ; Xiaoxin LU ; Chunshan TAN
Chinese journal of nautical medicine and hyperbaric medicine 2018;25(6):346-353,358
Objective To observe the effect of hyperbaric oxygen therapy (HBOT) on the improvement of executive function of the patients with traumatic brain injury (TBI) by using resting state functional magnetic resonance (rs-fMRI).Methods Fifty patients with executive disorder after traumatic brain injury were randomly divided into the HBO group (n =25) and the control group (n =25).The patients of the control group received routine treatment and executive function rehabilitation training,while the patients of the HBO group were supplemented with HBOT in addition to the treatment received by the control group.The applied HBO pressure was 2.0 MPa,one session a day with a duration of 105 minutes,five days a week,for a total of 20 sessions.Both before and after treatment,all the subjects received executive function assessment and rs-fMRI examination by using the drawing of clock test,the Chinese version Stroop color word test and the Wechsler adult intelligence scale similarity subtest.In the study,we closely observed the effects of HBOT on the intensity of metabolic activities in the brain,changes in neuron cell synchronization and coordination in TBI patients through the approach of rs-fMRI technique combined with ReHo and ALFF analysis methods.At the same time,the correlation between imaging data and neuropsychological assessment results was also analyzed in the study.Results (1) After intervention,Stroop-A time-consumption and Stroop-C time-consumption,correct reading scores,as well as interference scores of the HBO group were all significantly better than those of the control group,and statistical significance could be found when comparisons were made between the 2 groups (P < 0.05).(2) Following intervention with different methods,obvious differences in the ALFF value of superior parietal lobe in the common brain regions of the TBI patients in the 2 groups could be seen,with statistical significance (P < 0.05).Correlation analysis revealed that there was a positive correlation between the superior parietal lobe and interference time in the HBO group (P < 0.05).(3) There was also a positive correlation between correct readings of Stroop-A in the middle frontal gyrus of the HBO group (P < 0.05).Conclusion Executive function rehabilitation training,HBO therapy combined with executive function rehabilitation training could improve the executive function of TBI patients to various degrees.HBO therapy combined with executive function rehabilitation training was more beneficial to further improvement of executive function in patients with TBI.The improvement of executive function in TBI patients by HBO therapy might be achieved through the regulation of spontaneous activity and regional homogeneity of neurons in the middle frontal gyms,and superior parietal lobe.
3.Resting state function magnetic resonance imaging study on the effect of hyperbaric oxygen on the improvement of executive function of the patients with traumatic brain injury
Jiayu WU ; Qingyan SU ; Huiping PENG ; Xiaoyang WANG ; Jian GAN ; Sujian ZHOU ; Xiaoxin LU ; Chunshan TAN
Chinese journal of nautical medicine and hyperbaric medicine 2018;25(6):346-353,358
Objective To observe the effect of hyperbaric oxygen therapy (HBOT) on the improvement of executive function of the patients with traumatic brain injury (TBI) by using resting state functional magnetic resonance (rs-fMRI).Methods Fifty patients with executive disorder after traumatic brain injury were randomly divided into the HBO group (n =25) and the control group (n =25).The patients of the control group received routine treatment and executive function rehabilitation training,while the patients of the HBO group were supplemented with HBOT in addition to the treatment received by the control group.The applied HBO pressure was 2.0 MPa,one session a day with a duration of 105 minutes,five days a week,for a total of 20 sessions.Both before and after treatment,all the subjects received executive function assessment and rs-fMRI examination by using the drawing of clock test,the Chinese version Stroop color word test and the Wechsler adult intelligence scale similarity subtest.In the study,we closely observed the effects of HBOT on the intensity of metabolic activities in the brain,changes in neuron cell synchronization and coordination in TBI patients through the approach of rs-fMRI technique combined with ReHo and ALFF analysis methods.At the same time,the correlation between imaging data and neuropsychological assessment results was also analyzed in the study.Results (1) After intervention,Stroop-A time-consumption and Stroop-C time-consumption,correct reading scores,as well as interference scores of the HBO group were all significantly better than those of the control group,and statistical significance could be found when comparisons were made between the 2 groups (P < 0.05).(2) Following intervention with different methods,obvious differences in the ALFF value of superior parietal lobe in the common brain regions of the TBI patients in the 2 groups could be seen,with statistical significance (P < 0.05).Correlation analysis revealed that there was a positive correlation between the superior parietal lobe and interference time in the HBO group (P < 0.05).(3) There was also a positive correlation between correct readings of Stroop-A in the middle frontal gyrus of the HBO group (P < 0.05).Conclusion Executive function rehabilitation training,HBO therapy combined with executive function rehabilitation training could improve the executive function of TBI patients to various degrees.HBO therapy combined with executive function rehabilitation training was more beneficial to further improvement of executive function in patients with TBI.The improvement of executive function in TBI patients by HBO therapy might be achieved through the regulation of spontaneous activity and regional homogeneity of neurons in the middle frontal gyms,and superior parietal lobe.

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