Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 09-03-2014, 08:02 PM #1
Laupala Laupala is offline
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Default Hyperbaric oxygen treatment - beneficial for PCS?

I'm seeing a psychologist who specializes in brain injury, and he suggested that if I'm interested in pursuing alternative treatments, that I look into HBOT. Back when I could read/spend more time on computers, I remember finding an article that suggested that HBOT could help TBI if treatment started relatively quickly after the injury, but I didn't find a lot (granted I wasn't really looking too hard) suggesting that it could help someone well after the initial injury.

Does anyone know more about this, or had experience with it? Has it been shown to be helpful for PCS, even well after the injury? I've found a place that's close to my house, and while it's obviously expensive, I'd be willing to dip into my savings if there's a reasonable chance it could be helpful.
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26 year-old PhD student in evolutionary biology, slipped on ice in Feb 2014 while clipping my fingernails and walking to save time (dumbest reason for PCS ever?). Initially just had headaches and didn't feel quite right, but a minor head bump 5 days later started a downward spiral of anxiety, depression, insomnia and fatigue. Had trouble concentrating on reading/looking at screens

April 2014 - did exertion test, passed, started exercising and doing more, but didn't feel much better.

May 2014 - Went on backpacking trip OK'd by doctor, trip itself went fine, but felt worse a few days after getting back, more difficulty concentrating, worse headaches.

June 2014 - Bumped head on ceiling walking slowly down stairs, no immediate symptoms, but caused worsening headahces, more difficulty concentrating and looking at screens. Have not felt as good as I did before this since this bump.

December 2014 - after feeling relatively better I went xc skiing and fell but didn't hit my head (something my psychologist who specializes in brain injuries told me he hoped would happen so I saw it was OK), felt worse

Feb 2015 - back in grad school, light teaching load and some research, nowhere close to operating at my full capacity. Still have constant headaches, difficulty reading/looking at screens, mild anxiety and depression, and just not feeling like my normal sharp self.

Trying, but struggling, to believe that I'll get back to my old self, or at least get close.
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Old 09-03-2014, 08:07 PM #2
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a lot of ongoing tests in the military right now. results mixed. we had a guy on the board who tried it in mexico and he wasn't too impressed with the results if I remember right but he was paying so little it was worth it. a few others will com along I'm sure with more info. we had another guy going for that shot in florida, I think, but we haven't heard back from him yet
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Old 09-03-2014, 08:30 PM #3
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I think that someone was going down to Mexico for this... but can't remember who.. sorry
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The Start: MVA, t-boned, on 1-12-14 (my sons 5th birthday) and did not think anything of it.. my back hurt on site but everything else seemed ok. Lost about 10-12 hours from about 3 hours after the accident to the next day...Experienced terrible brain fog for over a month, plus intense headaches, nausea, dizziness, cognitive difficulties, disorientation, no short term memory, depression and just an overall hangover feeling daily.

Current Situation: I'm about 7 months in and my local neurologist has waived her white flag and therefore I am headed to Dallas to be seen (I have family there). The headaches are still daily. I have nausea, dizziness as well.

Drugs I have been on- Vicodin (off), Naproxen (off), proanolol (off), topamax (off), cataflam (off), Midrin (off), Flexeril (off) and now Namenda XR (off), Nortrptylin (off), Verapamil (off)

Therapy- Osteopath, Vestibular and balance therapy, fuzion/soft tissue massage, acupuncture

Drs- ER (no help), GP, Chiropractor, Neurologist and Osteopath
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Old 09-03-2014, 08:52 PM #4
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The studies show that it takes 40 to 80 treatments to see a noticeable improvement if there is an improvement. The HBOT industry has been promoting HBOT for PCS due to anecdotal evidence. Some are trying to do valid clinical studies but a true double blind study would be a challenge.
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Old 09-03-2014, 09:01 PM #5
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Quote:
Originally Posted by Mark in Idaho View Post
The studies show that it takes 40 to 80 treatments to see a noticeable improvement if there is an improvement. The HBOT industry has been promoting HBOT for PCS due to anecdotal evidence. Some are trying to do valid clinical studies but a true double blind study would be a challenge.
Mark, the military is doing a number of hbot studies. Will these be double blind automatically or not necessarily so? I'm not even sure what double blind means.
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Old 09-03-2014, 09:10 PM #6
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Just found a nice review article (Hyperbaric oxygen therapy for chronic post-concussive syndrome) that talks about the challenges in doing a truly blind study (hard to fake a true hyperbaric chamber experience), but it did cite a recent study published in PloS One that attempted to do this via a crossover approach that allows intra and inter group comparisons between treatment and a sort of control that I don't quite understand. This study found significant improvement in all sorts of measures after treatment, and no significant improvement after their control.

The review article says this is a promising start, but it's still not a true blind clinical trial. I'm also wondering how sustainable or lasting any improvements are after the treatment. If it provides a temporary boost, great, but not really worth the money. If the treatment actually leads to lasting healing, then it might be worth it.

I'll have to do more research later, too much screen time!
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26 year-old PhD student in evolutionary biology, slipped on ice in Feb 2014 while clipping my fingernails and walking to save time (dumbest reason for PCS ever?). Initially just had headaches and didn't feel quite right, but a minor head bump 5 days later started a downward spiral of anxiety, depression, insomnia and fatigue. Had trouble concentrating on reading/looking at screens

April 2014 - did exertion test, passed, started exercising and doing more, but didn't feel much better.

May 2014 - Went on backpacking trip OK'd by doctor, trip itself went fine, but felt worse a few days after getting back, more difficulty concentrating, worse headaches.

June 2014 - Bumped head on ceiling walking slowly down stairs, no immediate symptoms, but caused worsening headahces, more difficulty concentrating and looking at screens. Have not felt as good as I did before this since this bump.

December 2014 - after feeling relatively better I went xc skiing and fell but didn't hit my head (something my psychologist who specializes in brain injuries told me he hoped would happen so I saw it was OK), felt worse

Feb 2015 - back in grad school, light teaching load and some research, nowhere close to operating at my full capacity. Still have constant headaches, difficulty reading/looking at screens, mild anxiety and depression, and just not feeling like my normal sharp self.

Trying, but struggling, to believe that I'll get back to my old self, or at least get close.
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Old 09-03-2014, 11:58 PM #7
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Double blind means neither the subject nor the assessor knows whether that subject had the control (placebo or such) treatment or the studied treatment. In HBOT, the subject would have to be put in the HBOT chamber with the pressure increased but the oxygen level left at a normal ratio for the control group. (even this would not be true double blind) Then, the subjects would be studied for any changes before the data is collated by whether or not the data is for a control group subject or a studied treatment group subject using random identifiers. This removes any bias or other influence that may skew the results.

The studies so far have focused on MRI images that show an increase in capillary growth in those who have had HBOT. They extrapolate this to say that capillary growth signifies neurogenesis or such.

What is not discussed is whether these 40 to 80 sessions have an impact on healing due to the need to lay relaxed for these scheduled period of times. Meditation claims to have similar effects on capillary growth. Or whether there is a placebo effect.
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Old 09-04-2014, 11:19 AM #8
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thanks for sharing...did it say how many sessions brought about the significant improvement? and how significant?

Quote:
Originally Posted by Laupala View Post
Just found a nice review article (Hyperbaric oxygen therapy for chronic post-concussive syndrome) that talks about the challenges in doing a truly blind study (hard to fake a true hyperbaric chamber experience), but it did cite a recent study published in PloS One that attempted to do this via a crossover approach that allows intra and inter group comparisons between treatment and a sort of control that I don't quite understand. This study found significant improvement in all sorts of measures after treatment, and no significant improvement after their control.

The review article says this is a promising start, but it's still not a true blind clinical trial. I'm also wondering how sustainable or lasting any improvements are after the treatment. If it provides a temporary boost, great, but not really worth the money. If the treatment actually leads to lasting healing, then it might be worth it.

I'll have to do more research later, too much screen time!
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April 11, 2014 Flipped in class 2 white water while kayaking, hit my forehead (was wearing a helmet). Lots of symptoms to begin with. Those remaining are fatigue, brain freezes/overstimulation, headaches, sensitivity to light and sound. Insomnia is getting better but still an issue, and appetite is ba-ack! Depression and anxiety are largely under control thanks to Lexapro, exercise, and a very distant light at the end of the tunnel.

Drugs: Lexapro, occasional 2-5mgs ambien. Off amatryptaline. Taking about 453 supplements.

Just started vision therapy, waiting on some blue-tinted prism glasses.

"You will encounter many defeats, but you must not be defeated. In fact, it may be necessary to encounter the defeats, so you can know who you are, what you can rise from, how you can still come out of it." Maya Angelou
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Old 09-04-2014, 01:18 PM #9
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I think this is the article Laupala is referring to.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984490/

If you read the whole article, including the part about placebo effect and attempts at double blind study, the result is not as rosy as first presented.

The study with the rosy results is abstracted here.
http://www.ncbi.nlm.nih.gov/pubmed/24260334
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Old 09-04-2014, 05:09 PM #10
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The full article is available to everyone here (hooray open access publishing!)

http://www.plosone.org/article/info%...l.pone.0079995

The review article mark posted does a good job of tempering the conclusions about the PLoS One article, while maintaining that it's a promising avenue for future research. I still haven't gotten around to closely reading the PLoS One article, a busy day!
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26 year-old PhD student in evolutionary biology, slipped on ice in Feb 2014 while clipping my fingernails and walking to save time (dumbest reason for PCS ever?). Initially just had headaches and didn't feel quite right, but a minor head bump 5 days later started a downward spiral of anxiety, depression, insomnia and fatigue. Had trouble concentrating on reading/looking at screens

April 2014 - did exertion test, passed, started exercising and doing more, but didn't feel much better.

May 2014 - Went on backpacking trip OK'd by doctor, trip itself went fine, but felt worse a few days after getting back, more difficulty concentrating, worse headaches.

June 2014 - Bumped head on ceiling walking slowly down stairs, no immediate symptoms, but caused worsening headahces, more difficulty concentrating and looking at screens. Have not felt as good as I did before this since this bump.

December 2014 - after feeling relatively better I went xc skiing and fell but didn't hit my head (something my psychologist who specializes in brain injuries told me he hoped would happen so I saw it was OK), felt worse

Feb 2015 - back in grad school, light teaching load and some research, nowhere close to operating at my full capacity. Still have constant headaches, difficulty reading/looking at screens, mild anxiety and depression, and just not feeling like my normal sharp self.

Trying, but struggling, to believe that I'll get back to my old self, or at least get close.
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