Hyperbaric Oxygen Therapy in Traumatic Brain Injury: A Comprehensive Structure Review.

INTRODUCTION

Hyperbaric oxygen (HBO₂) treatment has sparked increasing attention as a potential therapeutic intervention for traumatic brain injury (TBI), but the variability in findings necessitates a comprehensive analysis of recent literature. This review aims to evaluate the latest empirical evidence on the effectiveness of HBO₂ treatment for TBI, focusing on its impact on neurological recovery, cognitive function, and physiological markers.

METHODS

To achieve this, we extensively searched scholarly articles in reputable databases such as Scopus and Web of Science (WoS), focusing on studies published between 2015 and 2024, and followed the PRISMA framework for study selection. The final dataset comprised 74 cases (n=74) and was analyzed using both quantitative methods (descriptive statistics) and qualitative techniques (thematic analysis). The findings were divided into three themes: (1) clinical efficacy of HBO₂ treatment for TBI, (2) mechanisms of action and biological pathways in HBO₂ treatment, and (3) evolving therapeutic applications of HBO₂ in TBI.

RESULTS

Mixed outcomes; while some studies reported significant cognitive, physiological, and clinical improvements, others raised concerns about methodological variability and limited reproducibility. Mechanistic studies highlighted HBO₂'s role in modulating pathways such as TLR4/NF-κB and VEGF/ERK, facilitating neuroprotection, angiogenesis, and synaptogenesis. Emerging therapies combining HBO₂ with regenerative approaches, such as stem cell treatments, showed promise in enhancing recovery.

DISCUSSION: In conclusion, HBO₂ treatment demonstrates clinical efficacy in improving memory, executive function, and neuroprotection, particularly in the treatment of post-concussive symptoms. Mechanistic studies highlight its role in reducing neuroinflammation and oxidative stress while promoting neurogenesis and angiogenesis. However, standardized protocols and long-term follow-up are needed to confirm its full therapeutic potential in TBI management.