Oxygen Therapy Shows Promise for Adults Living With Childhood Brain Injuries

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Hyperbaric oxygen therapy (HBOT) may help repair long-term brain damage from childhood injuries — even decades later — according to a recent study published in Frontiers in Neurology.

Approximately 10% to 30% of children who suffer a traumatic brain injury (TBI) continue to experience long-lasting effects, called post-concussion syndrome (PCS), well into adulthood. These can include problems with memory, focus, processing information and decision-making. Unfortunately, PCS is often missed by doctors and left untreated.

“HBOT has recently gained attention as a potential treatment for chronic PCS,” wrote a team of investigators including Shai Efrati, M.D., associate professor at the Sagol School of Neuroscience, Tel Aviv University. “By increasing oxygen delivery under elevated pressure, dedicated protocols of HBOT may induce neuroplasticity and recovery of dysfunctional brain regions even at the late chronic phase.”

Previous research has backed this up, with studies showing improvements in behavioral outcomes among both pediatric and adult patients. However, no study had yet investigated the impact of HBOT on adults suffering from chronic PCS that occurred from childhood TBI. Therefore, the current study evaluated whether HBOT could help adults years after their injury.

HBOT involves breathing 100% oxygen in a pressurized chamber, which can stimulate healing processes in the brain.

The team of investigators reviewed data from patients treated at the Sagol Center for Hyperbaric Medicine and Research, Shamir Medical Center, Israel, between 2017 and 2024. To be included, patients had to have done the following:

• Experienced a TBI before age 17
• Started HBOT as an adult (after age 20)
• Completed computerized thinking and memory tests before and after treatment
• Received at least 40 HBOT sessions, each lasting 90 minutes

In total, 26 adults, with an average age of 32 years, were included in the study. Patients were injured at an average age of 8, and HBOT was started 24 years after injury.

After treatment with HBOT, patients showed significant improvements in the following:

• Overall thinking abilities
• Memory
• Executive function (planning, decision-making, problem-solving)
• Attention
• Information processing speed

The only area that did not improve was motor skills. Importantly, improvements were seen regardless of how severe the original injury was — even those with a mild TBI responded well.

Investigators noted that the small, select group of patients may have limited the study. As all of them were able to complete at least 40 HBOT sessions and had no other neurological conditions, the results may not apply to everyone living with PCS. Additionally, as there wasn’t a comparison group, it’s difficult to say for sure that the improvements were due to HBOT alone. The study measured results right after treatment, so researchers don’t yet know whether the benefits last for months or years. Lastly, the study mainly examined memory, attention and thinking skills. Patients also reported feeling better in areas like mood, sleep and daily functioning, but these improvements weren’t formally measured.

While more research is needed, the team believes these findings give hope to adults living with PCS that treatment options may exist long after the original injury.

Future research efforts should include prospective, controlled trials to confirm these findings, better understand optimal dosing protocols and explore the long-term durability of treatments.

“Given that treatment effects were not dependent on time since injury or injury severity, HBOT may represent a valuable therapeutic option even for those with long-standing symptoms,” investigators concluded. “These results also highlight the need for early recognition, long-term follow-up and access to rehabilitation for pediatric TBI survivors, especially those with mild injuries who are often misclassified and undertreated.”