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Hyperbaric Oxygen Therapy Following Mild Traumatic Brain Injury May Not Minimize Concussion Symptoms

The use of hyperbaric oxygen therapy – exposure to a high oxygen environment – may not minimize concussion symptoms following a mild traumatic brain injury as experts had previously hoped, according to a research team from the Virginia Commonwealth University School of Medicine, the U.S. Air Force School of Aerospace Medicine and the Uniformed Services University of the Health Science Department of Neurology.

David Cifu, M.D., chair and Herman J. Flax M.D., Professor in the Department of Physical Medicine and Rehabilitation at VCU, served as corresponding author of the research. In addition, he is one of the guest editors and a research contributor for a special issue of the Journal of Rehabilitation Research & Development on “Sensory and Communication Disorders in Traumatic Brain Injury” published this week. Read that here: http://www.rehab.research.va.gov/jour/2012/497/contents497.html

Both of these publications come during Joining Forces Wellness Week. During this week-long event, Nov. 12-16, the VCU School of Medicine is one of more than 100 members of the Association of American Medical Colleges (AAMC) increasing awareness about the health needs of the nation’s veterans, service members and families, and elevating the role that medical schools and teaching hospitals play in serving this community.

In the past six years, the incidence of traumatic brain injury among deployed service members has increased by approximately 117 percent. Preliminary findings have shown that service members and veterans from the current Middle East conflicts may experience a higher incidence of post-concussion syndrome at three months and one year compared to civilians.

The specific injuries related to mild traumatic brain injury (mTBI) have been challenging to treat and researchers have been working to uncover potential therapies, including hyperbaric oxygen therapy (HBOT). When an individual is exposed to hyperbaric oxygen therapy, there is an increase in oxygenation of the blood and tissues, but what occurs in traumatic brain injury is still not fully proven or understood scientifically.

In a prospective study published online this week in the Journal of Neurotrauma, the team from the VCU School of Medicine, the U.S. Air Force School of Aerospace Medicine and the Uniformed Services University of the Health Science Department of Neurology examined 50 military service members with at least one combat-related, mild traumatic brain injury to determine the effects of 2.4 atmospheres absolute hyperbaric oxygen on their post-concussion symptoms. During an eight-week period, each subject received 30 sessions of either room air, or the high oxygen environment of the hyperbaric chamber.  Read the study: http://online.liebertpub.com/doi/pdf/10.1089/neu.2012.2549.

They found that the “hyperbaric oxygen at 2.4 atmospheres absolute had no effect on the post-concussive symptoms after mild TBI.”

“This is the first of three coordinated clinical trials that the Departments of Defense and Veterans Affairs have completed to explore whether HBOT may play a role in returning wounded warriors with brain injury to wellness and troop readiness, in response to political and public pressures to use these types of technologies,” Cifu said.

“This first controlled trial demonstrates that HBOT itself had no significant effect on symptoms of combat-related mTBI, but it's likely that some of the other factors associated with the intensive period of study (nurturing environment, health care professional’s attention, relatively low stress) did benefit the service members. It’s another piece to the puzzle of mTBI and combat injury that we need to optimize care for these heroes” said Cifu.

According to Cifu, a larger, multicenter, randomized clinical trial is needed to further explore this area.

The study was funded in part by a Defense Advanced Research Projects Agency grant (N66001-09-2-206) and a contract from the U.S. Army Medical Materiel Development Activity; the Air Force Medical Support Agency Medical Modernization Directorate, the 711th Human Performance Wing; and the U.S. Navy Bureau of Medicine and Surgery.

Earlier this year, First Lady Michelle Obama visited VCU to announce the country-wide “Joining Forces” initiative to mobilize all sectors of society to give service members and their families the opportunities and support they have earned.

The VCU School of Medicine is among more than100 members of the AAMC that signed a pledge to support “Joining Forces” with a commitment to pursue groundbreaking research in the areas of Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI), to enhance education and share research, information and best practices to better serve veterans and their families.

In January 2012, the White House said VCU was selected to host the announcement because it is a national leader in TBI research and a strong partner with the Hunter Holmes McGuire VA Medical Center Veterans Affairs Hospital. This partnership has earned VCU a national reputation as a comprehensive polytrauma center that treats seriously injured American service members, many with traumatic brain injuries or suffering from PTSD.

“Joining Forces” was established by First Lady Michelle Obama and Dr. Jill Biden to bring Americans together to recognize, honor and take action to support veterans and military families during their service and throughout their lives. The initiative aims to educate, challenge and spark action from all sectors of society to support veterans and active military.

About VCU and the VCU Medical Center

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 222 degree and certificate programs in the arts, sciences and humanities. Sixty-six of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University compose the VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.

Sathya Achia Abraham
VCU Office of Public Affairs
(804) 827-0890

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