UHM Journal Publishes Second Special Edition on Traumatic Brain Injury

The Undersea and Hyperbaric Medical Society has published a supplemental issue of its member publication, the Undersea and Hyperbaric Medicine Journal, to summarize results in studies on traumatic brain injury (TBI). The issue, consisting of 11 papers plus an executive summary reports new data from two interventional studies sponsored by the United States Army, as well as from a companion study of normal volunteers, and includes a pooled data analysis of all military-sponsored investigations of hyperbaric oxygen for persistent post-concussive symptoms to date. 

This special issue of the UHM Journal is available to the public at www.uhms.org. Cost for the electronic copy is $25. UHMS members have free access to the PDF files. As with all papers that appear in the UHM Journal, these TBI-related texts received peer review.

Drawing on the robust data set from the completed studies, in particular BIMA (brain injury and mechanisms of action) of hyperbaric oxygen for persistent post-concussive symptoms after mild traumatic brain injury and the normative study, the authors of the papers in this second special issue present new analyses that complement the primary publications and add to the general knowledge about tools for diagnosing and measuring deficits after mild TBI, the safety of hyperbaric oxygen in this population, and the possible role of hyperbaric oxygen in ameliorating post-concussive symptoms and symptoms of post-traumatic stress disorder (PTSD). 

“Over the last several years, the scientific community has learned that the long-term consequences of mild TBI occur much more often than previously thought. We’re learning more about how mild TBI disrupts the brain. But we haven’t made huge strides in learning how to help patients who have those long-term consequences become healthy again,” notes Dr. Lindell K. Weaver, study director and lead principal investigator of the BIMA and healthy volunteer studies. “One limiting factor in conducting studies in mild TBI is that we haven’t really known what tools to use to measure improvement. With BIMA and the companion normal study, we hoped to gather good data about outcome measures that are sensitive to change in mild TBI and differentiate from ‘normal’ brain function.” 

The studies reported in this special issue are of particular importance to the hyperbaric medicine community. Hyperbaric oxygen has been proposed as a treatment for brain injury, and the studies sponsored by the United States military help to establish a safety profile for hyperbaric oxygen in the mild TBI population. In addition, the information in these papers can guide future research in this area. “While we found significant improvement in post-concussive symptoms with 40 hyperbaric oxygen sessions in BIMA, the effect was not durable to one year and beyond. This might mean that more than 40 sessions are required for long-term improvement, but other research studies will have to answer that question,” says Dr. Weaver.

The special issue also highlights other exciting directions for research. “The improvements we saw after chamber sessions in eye tracking and the possible relationship between oxygen dosing and improved PTSD symptoms are particularly intriguing,” adds Dr. Weaver.

Here’s a listing of papers and authors in this issue:

Executive summary: Secondary analyses of DoD-sponsored studies examining hyperbaric oxygen for persistent post-concussive symptoms after mild traumatic brain injury. BB Hart, LK Weaver, SH Wilson, AS Lindblad, S Churchill, K Deru.

Reference ranges and stability of auditory and vestibular measures in a comprehensive assessment battery for traumatic brain injury. A Meehan, A Lewandowski, K Deru , D Hebert, LK Weaver.

Quantitative analysis tool for clinical functional MRI in mild traumatic brain injury. PE Cartwright, TG Perkins, P Santhanam, LK Weaver, K Deru, WW Orrison. 

Hidden hearing deficits in military service members with persistent post-concussive symptoms. A Meehan, D Hebert, K Deru, LK Weaver.

Central auditory processing disorders after mild traumatic brain injury. P Santhanam, A Meehan, WW Orrison, SH Wilson, TR Oakes, LK Weaver.

Prospective study of anxiety, post-traumatic stress and depression on postural control, gait, otolith and visuospatial function in military service members with persistent post-concussive symptoms. A Meehan, A Lewandowski, LK Weaver, D Hebert, K Deru.

Analysis of magnetic resonance spectroscopy relative metabolite ratios in mild traumatic brain injury and normative controls. PE Cartwright, TG Perkins, SH Wilson, LK Weaver, WW Orrison.

Eye tracker outcomes in a randomized trial of 40 sessions of hyperbaric oxygen or sham in participants with persistent post-concussive symptoms. PA Wetzel, AS Lindblad, C Mulatya, MA Kannan, Z Villamar, GT Gitchel, LK Weaver.

Extended follow-up in a randomized trial of hyperbaric oxygen for persistent post-concussive symptoms. BB Hart, SH Wilson, S Churchill, K Deru, LK Weaver, M Minnakanti, AS Lindblad.

Adverse events and blinding in two randomized trials of hyperbaric oxygen for persistent post-concussive symptoms. S Churchill, K Deru, LK Weaver, SH Wilson, D Hebert, RS Miller, AS Lindblad.

A composite outcome for mild traumatic brain injury in trials of hyperbaric oxygen. LK Weaver, S Churchill, SH Wilson, D Hebert, K Deru, AS Lindblad. 

Hyperbaric oxygen for mTBI-associated PCS and PTSD: Pooled analysis of results from Department of Defense and other published studies. BB Hart, LK Weaver, A Gupta, SH Wilson, A Vijayarangan, K Deru, D Hebert.

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~ Kayla Deru, LDS Hospital, Salt Lake City, Utah.

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