Hyperbaric oxygen therapy for cognitive disorders after irradiation of the brain.
OBJECTIVE
Analysis of the feasibility and effect of hyperbaric oxygen treatment (HBO) on cognitive functioning in patients with cognitive disorders after irradiation of the brain.


METHODS
Seven patients with cognitive impairment after brain irradiation, with an interval of at least 1.5 years after treatment, were treated with 30 sessions of HBO in a phase I-II study. A comprehensive neuropsychological test battery was performed before treatment, at 3 and 6 months thereafter. Patients were randomized into an immediate treatment group and a delayed treatment group. The delayed group had a second neuropsychological test at 3 months without treatment in that period and started HBO thereafter.


RESULTS
All eligible patients completed the HBO treatment and the extensive neuropsychological testing. One out of seven patients had a meaningful improvement in neuropsychological functioning. At 3 months there was a small, but not significant benefit in neuropsychological performance for the group with HBO compared to the group without HBO treatment. Six out of seven patients eventually showed improvement after HBO in one to nine (median 2.5) of the 31 tests, although without statistical significance.


CONCLUSIONS
HBO treatment was feasible and resulted in a meaningful improvement of cognitive functioning in one out of seven patients. Overall there was a small but not significant improvement.
Hulshof
Maarten C C M
MC
Department of Radiation Oncology, Academical Medical Center, University of Amsterdam, The Netherlands. m.c.hulshof@amc.uva.nl
Stark
Nienke M
NM
van der Kleij
Ad
A
Sminia
Peter
P
Smeding
Harriet M M
HM
Gonzalez Gonzalez
Dionisio
D
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000528:radiation effects*; D001932:Brain Neoplasms / Q000532:radiotherapy; D002528:Cerebellar Neoplasms / Q000532:radiotherapy; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004806:Ependymoma / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe; D005909:Glioblastoma / Q000532:radiotherapy; D005910:Glioma / Q000532:radiotherapy; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008527:Medulloblastoma / Q000532:radiotherapy; D008875:Middle Aged; D009447:Neuroblastoma / Q000532:radiotherapy; D009483:Neuropsychological Tests; D009837:Oligodendroglioma / Q000532:radiotherapy; D010296:Parietal Lobe; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D013702:Temporal Lobe; D013997:Time Factors