Resting state function magnetic resonance imaging study on the effect of hyperbaric oxygen on the improvement of executive function of the patients with traumatic brain injury

Abstract

Objective To observe the effect of hyperbaric oxygen therapy (HBOT) on the improvement of executive function of the patients with traumatic brain injury (TBI) by using resting state functional magnetic resonance (rs-fMRI). Methods Fifty patients with executive disorder after traumatic brain injury were rando mly divided into the HBO group (n=25) and the control group (n=25). The patients of the control group received routine treatment and executive function rehabilitation training, while the patients of the HBO group were supplemented with HBOT in addition to the treatment received by the control group. The applied HBO pressure was 2.0 MPa, one session a day with a duration of 105 minutes, five days a week, for a total of 20 sessions. Both before and after treatment, all the subjects received executive function assessment and rs-fMRI examination by using the drawing of clock test, the Chinese version Stroop color word test and the Wechsler adult intelligence scale similarity subtest. In the study, we closely observed the effects of HBOT on the intensity of metabolic activities in the brain, changes in neuron cell synchronization and coordination in TBI patients through the approach of rs-fMRI technique combined with ReHo and ALFF analysis methods. At the same time, the correlation between imaging data and neuropsychological assessment results was also analyzed in the study. Results (1) After intervention, Stroop-A time-consumption and Stroop-C time-consumption, correct reading scores, as well as interference scores of the HBO group were all significantly better than those of the control group, and statistical significance could be found when comparisons were made between the 2 groups (P<0.05). (2) Following intervention with different methods, obvious differences in the ALFF value of superior parietal lobe in the common brain regions of the TBI patients in the 2 groups could be seen, with statistical significance (P<0.05). Correlation analysis revealed that there was a positive correlation between the superior parietal lobe and interference time in the HBO group (P<0.05). (3) There was also a positive correlation between correct readings of Stroop-A in the middle frontal gyrus of the HBO group (P<0.05). Conclusion Executive function rehabilitation training, HBO therapy combined with executive function rehabilitation training could improve the executive function of TBI patients to various degrees. HBO therapy combined with executive function rehabilitation training was more beneficial to further improvement of executive function in patients with TBI. The improvement of executive function in TBI patients by HBO therapy might be achieved through the regulation of spontaneous activity and regional homogeneity of neurons in the middle frontal gyrus, and superior parietal lobe. Key words: Hyperbaric oxygen therapy(HBOT); Traumatic brain injury(TBI); Executive function(EF); Resting state function magnetic resonance imaging; Superior parietal lobule