Early Intervention of Hyperbaric Oxygen Therapy is important in reducing long-term effects of neuronal stress or damage sustained during mild traumatic brain injury, otherwise known as concussion.
November 28, 2020
After a concussion we are providing decreased oxygen to our brain because we cannot deliver as much blood flow to it as usual. Concussive Injury leads to a period of decreased cerebral blood flow, rendering the brain ill-equipped to meet the energy demands required for restoring homeostasis. This so-called "energy crisis" creates a potential window of vulnerability within which the brain is susceptible to compounded injury effects if further neuronal stress or damage is sustained (2,3). This is really important to understand as it can have a great effect on our recovery unless we can combat it. In order to heal we need oxygen to make energy, or ATP that is essential for healing damaged regions of our brain, especially within our white matter tracts, or axons, causing "diffuse axonal injury" as a result of our brains becoming concussed.
The results compound and can increase in complexity and severity as patients do not always notice symptoms early on during their injury, but as time passes they may increase as seen in postconcussion syndrome. The symptoms associated with concussions are a result of complex pathophysiological processes and is described as a "neurometabolic cascade of concussion" (3). Hyperbaric Oxgyen Therapy can stop this cascade and increase oxygen(O2) to the brain by increasing O2 concentration in the plasma and cerebrospinal fluid to bathe, or saturate the brain with oxygen to allow our cells to make energy and heal. That's how hyperbaric oxygen therapy works, oxygen while under pressure is dissolved into fluids that can travel much easier and readily into areas of damage and inflammation that are restricted by larger red blood cells. This miraculous law of physics is allowing us to understand how we can improve treatment protocols and strategies in individuals who have sustained brain injuries and in the prevention of retrograde chromotological changes that occur and weaken areas of our brain, deriving the symptoms experienced.
A concussion is a transient alteration of brain function induced by traumatic forces transmited to the brain that lead to complex, pathophysiological changes with or without the loss of consciousness (1,4,5)
We utlilize mild hyperbaric oxygen therapy for neurocognitive conditions such as concussion to increase fuel to the brain, providing a decrease in inflammation and creating healing through increased oxygen bioavailability. This gives us to the fuel to create neuroplasticity, or healing within our brain. Trauma changes our brain, but we can change it back through the proper treatments as seen with hyperbaric oxygen therapy. Whether chronic or acute, it should be considered as an extremely important part of concussion rehabilitation.
(1) Harmon, K. G. et al. 2013. American Medical Society for Sports Medicine position statement: concussion in sport. British Journal of Medicine. 47(1), 15-26.
(2) Lazzarino, G. et al. 2012. The importance of restriction from physical activity in the metaoblic recovery of concussed brain. Brain Injury: Pathogenesis, Monitoring, Recovery, and Management. Reijika, Croatia: Intech, 501-522.
(3) Asken, B. M. et al. 2016b "Playing it through" : Delayed reporting and removal from athletic activity after concussion predicts prolonged recovery. Journal of Athletic Training. 51(4), 329-335.
(4) McCrory, P. et al. 2013. Consensus statement on concussion in sport: the 4th international conference on concussion in sport, Zurich, November 2012. Journal of Athletic Training, 48(4), 554-575
(5) Brain Injury Association of America (2015). Mild brain injury and concussion. Retrieved from http://www.biausa.org/mild-brain-injury.htm
(6) Asken et al. 2018. Diffusion tensor Imaging (DTI) findings in adult civilian, military, and sport-related mild traumatic brain injury (mTBI): a systematic critical review. Brain Imaging and Behavior. 12:585-612