Hyperbaric Oxygen Therapy (HBOT) for Treating Neurocognitive Deficits in Traumatic Brain Injury Patients: A Systematic Review and Meta-analysis
Humza Saeed1, Sufyan Shahid2, Ayesha Batool3, Abdullah Farooq4, Megha Joshi5, Japleen Kaur6
1Rawalpindi Medical University, Rawalpindi, Pakistan, 2Khawaja Muhammad Safdar Medical College, Sialkot, Pakistan, 3Allama Iqbal Medical College, Lahore, Pakistan, 4Lahore Medical and Dental College, Lahore, 5Essen Health Care, New York, 6University of California, San Diego
Objective:
We performed a Systematic Review and Meta-Analysis to evaluate the efficacy of Hyperbaric Oxygen Therapy (HBOT) in improving neurocognitive outcomes for Traumatic Brain Injury (TBI) patients.
Background:
Traumatic brain injury (TBI) is a leading cause of disability worldwide, often resulting in long-term neurocognitive impairments that significantly affect survivors' quality of life. However, despite their clinical significance, effective treatment options for these deficits remain limited.
Design/Methods:
PubMed, Embase, and Cochrane Central databases were systematically searched to identify studies investigating HBOT for treating neurocognitive deficits in traumatic brain injury patients. The primary outcomes comprised of cognitive function, memory, attention, executive function, information processing speed (IPS), and motor skills. We applied a random effects model and pooled mean differences (MDs), along with 95% confidence intervals (CI) using RevMan 5.4.
The RoB 2 tool and the ROBINS-E tool were used to assess the quality of randomized controlled trials and observational studies, respectively.
Results:
A total of four studies, comprising 250 patients (mean age = 25 years, 43% female), were included. The results demonstrated that after receiving HBOT, TBI patients showed significantly improved general cognitive scores (MD 7.47; p = 0.003), memory (MD 10.13; p < 0.00001), attention (MD 7.99; p < 0.00001), executive function (MD 7.16; p = 0.002), information processing speed (IPS) (MD 7.48; p = 0.01), and motor skills (MD 5.19; p < 0.00001) compared to baseline. Both RCTs were rated as having a low risk of bias, while the two observational studies had a moderate risk of bias due to confounding and selective reporting.
Conclusions:
HBOT significantly improves neurocognitive deficits in traumatic brain injury patients compared to baseline. However, larger trials with standardized protocols are needed to establish the optimal therapeutic role of HBOT in TBI management.
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