Treating vascular cognitive impairment using hyperbaric oxygen combined with repeated transcranial magnetic stimulation

Abstract

Objective To observe the clinical effect of combining hyperbaric oxygen (HBO) with repeated transcranial magnetic stimulation (rTMS) in the treatment of vascular cognitive impairment (VCI). Methods A total of 56 hospitalized VCI patients were randomly divided into an HBO+ rTMS group (n=25) and an rTMS group (n=27). The patients of both groups were given routine medication, rehabilitation and rTMS treatment, while the HBO+ rTMS group was additionally provided with HBO. The mini mental state examination (MMSE), the Montreal cognitive assessment (MoCA), the Lo Winston occupational therapy cognitive assessment (LOTCA) and the modified Barthel index (MBI) were used to evaluate the cognitive function of both groups before and after 4 weeks of treatment. Results Before the treatment there were no significant differences between the two groups in any of the average measurements. After the treatment, significant improvement was observed in the average MMSE and MBI scores in both groups, with significantly greater improvement in the HBO+ rTMS group. After the treatment, all the average sub-scores except that of naming and the total MMSE score of the rTMS group had improved significantly, together with all the average sub-scores and total scores of the HBO+ rTMS group. After the treatment the average visual space and execution, abstraction, delayed recall, orientation and the total MoCA score of the HBO+ rTMS group were all significantly higher than those of the control group. Conclusion HBO combined with rTMS can improve cognitive function and the life quality of VCI patients. Key words: Hyperbaric oxygen; Repetitive transcranial magnetic stimulation; Cognitive impairment