Abstract
Objective: To investigate the effect of transcranial direct current stimulation (tDCS) combined with hyperbaric oxygen therapy (HBOT) in patients with delayed encephalopathy after carbon monoxide poisoning (DEACMP).Design: A parallel-group, open-label randomised controlled study.Setting: Hyperbaric Oxygen Therapy Room of the Second Hospital of Hebei Medical University.Subjects: A total of 40 patients were recruited for the current study. Patients were randomly divided into a treatment group and a control group (20 cases/group).Interventions: Control group: conventional, individualised rehabilitation therapy. Treatment group: conventional, individualised rehabilitation therapy and tDCS.Main Measures: cognitive function of patients, the Barthel Index (BI).Results: After treatment, significantly higher MMSE and BI scores, as well as a greater reduction in P300 latency and an increase in P300 amplitude, were observed in the treatment group compared to the control group (MMSE: 13 ± 7 vs. 9 ± 5; P300 latency: 342 ± 29 vs. 363 ± 17 ms; P300 amplitude: 7.0 ± 3.3 vs. 5.1 ± 2.7 μV; all P < 0.05). In both groups, however, MMSE and BI scores, in addition to P300 amplitude, were significantly improved; in contrast, there was a decrease in P300 latency in both groups after treatment compared to before treatment (all P < 0.05).Conclusion: Combined with HBOT, tDCS can help improve cognitive function and ADL in patients with DEACMP. This combination therapy might be a helpful method to enhance the recovery of patients with DEACMP.
Highlights
The incidence and mortality of acute carbon monoxide poisoning rank first among the occupational hazards in China [1]
From December 2016 to February 2018, forty patients with delayed encephalopathy after acute carbon monoxide poisoning who were admitted to the Second Department of Rehabilitation Medicine (Hyperbaric Oxygen Therapy Room) of the Second Hospital of Hebei Medical University were selected for this study (Figure 1)
Significantly higher Mini-Mental State Examination and Barthel Index scores were observed after treatment compared to those before treatment (P < 0.05); scores in the treatment group were significantly higher compared to the control group (P < 0.05) (Table 2)
Summary
The incidence and mortality of acute carbon monoxide poisoning rank first among the occupational hazards in China [1]. Delayed encephalopathy after carbon monoxide poisoning was a group of neuropsychiatric symptoms mainly acute dementia in patients with carbon monoxide poisoning after recovery from rescue. It usually occurs within 2 months after acute poisoning. Different types of medications, hyperbaric oxygen therapy and various rehabilitation methods have been applied in the treatment of delayed encephalopathy after acute carbon monoxide poisoning. These treatments are difficult to control the further progress of the disease. Exploring more effective treatments is the focus of current research
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