Hyperbaric Oxygen Therapy Improves Cognition in Patients Severe TBI; A Prospective Study

Abstract

Traumatic brain injury (TBI) is a significant cause of morbidity. In the USA the average lifetime cost of care for a severe TBI patient ranges from $600,000 to $1,875,000 [1]. In India 1.6 million persons sustain TBI annually. Of those 200,000 will die [2]. The survivors face a spectrum of challenges most commonly related to cognitive or corticospinal tract dysfunction. Brain injury related neuropsychological impairment affects quality of life (QoL) [3]. The common presentations of this are: impaired concentration, decreased attention, easy distractibility, impaired visuo-spatial conceptualization, slow verbal/ visual stimulus processing, impaired memory, communication disorder, poor judgment, poor executive function [4]. Participation is a strong predictor of life satisfaction in the differently-abled. These issues lead to ADL dependence when they result in depersonalization [5]. The standard treatment consists of pharmacological agents and therapeutic exercises. Pharmacological agents used vary from agents like Citocholine to Amantadine [6]. Psychological intervention is: Attention process training and tasks for attention deficits, compensatory strategies and errorless learning training for memory deficits, pragmatic language skills and social behavior guidance for cognitive-communication disorder, meta-cognitive strategy, and problem-solving training for executive disorder are the mainstay of therapy for cognitive deficits in persons with TBI [7]. None of these directly address the cortical infrastructure damage. Often, they work with what is preserved. Abstract