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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Neurotrauma
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1360311
This article is part of the Research Topic Review of Hyperbaric Therapy & Hyperbaric Oxygen Therapy in the Treatment of Neurological Disorders According to Dose of Pressure and Hyperoxia View all 12 articles

Systematic Review and Dosage Analysis: Hyperbaric Oxygen Therapy Efficacy in Treatment of Posttraumatic Stress Disorder

Provisionally accepted
Susan R. Andrews Susan R. Andrews 1*Paul G. Harch Paul G. Harch 2*
  • 1 Neuropsychology Services for Children and Adults, Metairie, Louisiana, United States
  • 2 Emergency and Hyperbaric Medicine, LSU Health Sciences Center, New Orleans, LA, United States

The final, formatted version of the article will be published soon.

    Background: Posttraumatic Stress Disorder (PTSD) is a frequently comorbid diagnosis (37%) with mild Traumatic Brain Injury (mTBI) Persistent Postconcussion Syndrome (PPCS) in military veterans. Studies of hyperbaric oxygen therapy (HBOT) treatment of mTBI PPCS in military subjects revealed simultaneous improvement of PTSD and PTSD symptoms that have been replicated in civilian PTSD patients, suggesting that HBOT may be an effective treatment for PTSD. This is a systematic review and dosage analysis of the evidence of HBOT treatment of patients with PTSD symptoms. Methods: PubMed, CINAHL, and the Cochrane Systematic Review Database were searched from September 18 to November 23, 2023, for all adult clinical studies published in English on HBOT and PTSD. Randomized trials and studies with symptomatic outcomes were selected for final analysis. Studies and outcomes were analyzed according to the total dose of oxygen on immediate post-treatment symptom outcomes in HBOT-treated versus control groups. Results: Eight studies were included, all with < 75 subjects/study, total 393 subjects: seven randomized trials (four with true control groups, 3 with comparative dose groups) and one imaging case-controlled study. Whether analyzed by oxygen, pressure, or composite oxygen and pressure dose of hyperbaric therapy statistically significant within and between group symptomatic improvements with or without imaging changes, as well as Reliable Change or Clinically Significant changes were achieved for patients treated with 40-60 HBOTS over a wide range of pressures from 1.3 to 2.0 ATA. Discussion: In multiple randomized and randomized controlled clinical trials HBOT over a pressure range from 1.3 to 2.4 ATA demonstrated either statistically significant symptomatic improvements, Reliable Changes, or Clinically Significant Changes in patients with PTSD symptoms or PTSD. The imaging findings and hyperbaric oxygen therapy effects indicate that PTSD can no longer be considered strictly a psychiatric disease.

    Keywords: Post Traumatic Stress Disorder, PTSD, hyperbaric oxygen therapy Post traumatic stress disorder, hyperbaric oxygen therapy, Treatment, chronic

    Received: 22 Dec 2023; Accepted: 08 May 2024.

    Copyright: © 2024 Andrews and Harch. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Susan R. Andrews, Neuropsychology Services for Children and Adults, Metairie, Louisiana, United States
    Paul G. Harch, Emergency and Hyperbaric Medicine, LSU Health Sciences Center, New Orleans, LA, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.