Posted on April 1, 2010 · Posted in Brain Injury

The Defense Department is doing an 18-month-long study to determine if hyperbaric chambers, typically used to treat carbon monoxide poisoning, can also help those with mild Traumatic Brain Injury (TBI). http://content.usatoday.com/communities/ondeadline/post/2010/03/defense-dept-to-study-effect-of-hyperbaric-chamber-on-traumatic-brain-injury/1

News of the study was first reported by the Army Times, which said that 100,000 troops have been diagnosed with mild TBI. http://www.armytimes.com/news/2010/03/army_TBI_033010w/

The new clinical trial will start in January next year. There have been studies that tried to gauge the impact that pressurized oxygen tanks have on those afflicted with TBI, but none definitely found out whether if hyperbaric oxygen reduces or ends TBI symptoms like headaches and memory loss.

That will be the goal of the new test, which will be done by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury in Virginia; and the Army Research and Materiel Command in Maryland.

There will be about 300 participants in the study, mainly Marines and soldiers.

The sites participating in the study are Fort Carson, Colo.; Camp Pendleton, Calif.; Camp Lejune, N.C.; Brooks City-Base, Texas; and perhaps Fort Hood, Texas.

Participants receiving the experimental treatment will breathe 100 percent oxygen while in the chamber at 1.5 atmospheres of pressure, according to the Army Times. It’s believed that the pressure from the chamber will cause oxygen in the blood to dissolve, so that more oxygen will flow in the body and heal injured tissue.

The control group will feel as if there were 1.3 atmospheres of pressure in the chamber, but they will be breathing normal air.

The hyperbaric chambers hold three to 16 participants, with each participant required to stay in the chamber for an hour a day, five days a week, for 40 sessions.

The test participants must have sustained a TBI four to six months ago.

Not to be skeptical, but the chances of this study leading to a new cure is very unlikely. First, the mechanism of carbon monoxide damage and traumatic injury are dramatically different. In carbon monoxide poisoning, the brain tissue is deprived of oxygen and the hyperbaric administration of oxygen can make up for this, done acutely. In mild traumatic brain injury, the mechanism of injury is the tearing and smashing of brain tissue. Almost no MTBI involves an anoxic/hypoxic brain injury, where the brain damage is caused by not enough oxygen.

Lastly, even if there is some curative value of super saturating with oxygen in the hours and days after an injury, to administer hyperbaric oxygen 4 to 6 months post, is absurd. Oxygen isn’t some magical curative substance that will fix something long broken. It is a necessarily element for real time brain function. Take it away and the brain dies. But flood a damaged brain with it six months after the fact and at best, you will do no harm. Adding oxygen to the brain 6 months after an injury makes as much sense as putting in twice the oil capacity of an engine, after it has already been blown.

The cost of this study could be used on far better projects. A comprehensive change in the protocol of testing for amnesia would do far more at less cost. If the Pentagon has money they want to throw at TBI research, then improve the MRI scanning that is done. Buy 3 Tesla scanners for all VA/Defense medical facilities. Implement DTI and SWI imaging techniques. Collate all that they learn from such studies. Even the implementation of something like the ImPact test would do far more than this study.

About the Author

Attorney Gordon S. Johnson, Jr.
Past Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447