| Objective:In this study,we investigated the clinical efficacy of Hyperbaric oxygen therapy(HBOT)in improving the executive function of patients with traumatic brain injury(TBI),using resting state functional magnetic resonance imaging to analyze the change of brain Amplitude of Low Frequency Fluctuation and Regional Homogeneity in patients with traumatic brain injury.To explore HBOT on improving executive dysfunction after traumatic brain injury patients with brain changes the possible mechanism.Methods:This topic using randomized controlled trials,38 patients with executive dysfunction after traumatic brain injury admitted to Fuzhou General Hospital,randomly divided into the hyperbaric oxygen group(n=20)and the control group(n=18)and the control group accepted routine treatment and executive function rehabilitation,hyperbaric oxygen group on the basis of hyperbaric oxygen therapy(HBOT).The concrete proposal of hyperbaric oxygen therapy was 2.0 absolutely atmosphere,105minutes,once a day,five times per week,ten times for a period of treatment,and a total of 20 times.All of the subjects were accepted the executive founction assessment of Draw the clock test,Chinese Stroop color word test and Wechsler’s adult intelligence scale similarity subtest score and rs-fMRI examination before and after treatment.Explore the rs-fMRI technique combined with ReHo and ALFF analysis methods to investigate the effects of HBOT on the intensity of metabolic activity of brain regions,neurons cell synchronization and coordination changes in TBI patients from the perspective of spontaneous activity of whole brain neurons and abnormal signals of local brain activity.To further analysis of the correlation between imaging data and neuropsychological assessment results.Results:(1)Before the treatment,two groups of participants’ demographic data,Draw the clock test,Chinese Stroop color word test and Wechsler’s adult intelligence scale similarity subtest score differences had no statistical significance(P>0.05).(2)Compared with pre-intervention,the intervention of the two groups after Draw the clock test、Wechsler’s adult intelligence scale similarity subtest score and the Chinese version of Stroop test of color words were significantly improved,and the differences are significant(P<0.01).After the intervention,the Stroop-A time-consuming,Stroop-C time-consuming,correct readings,and interference effect scores of the hyperbaric oxygen group were significantly better than those of the control group.The difference was statistically significant(P<0.05).After the intervention,the difference between the two groups,Wechsler’s adult intelligence scale similarity subtest score in the hyperbaric oxygen group was higher than that of the control group,and the difference was statistically significant(P<0.05),but there was no significant difference on Draw the clock test between the two groups,the difference was not statistically significant(P>0.05).The time-consuming and correct readings of Stroop’s color words test A and C cards were significantly improved,the difference was statistically significant(P<0.05),and the improvement of interference effect was significant(P<0.01).Stroop-B reaction time was significantly shortened,and the difference was statistically significant(P<0.05),but the correct reading number did not improve significantly,or the difference was not statistically significant(P>0.05).The results suggest that hyperbaricoxygen therapy is superior to the control group in improving the ability of abstract summary,information processing speed,and interference suppression ability.(3)Compared with pre-intervention.the brain regions with significantly increased ALFF in the hyperbaric oxygen group included Medial Frontal Gyrus,left Middle Frontal Gyrus,Lentiform Nucleu,Anterior Cingulate Gyrus.The brain regions with significant decreased ALFF values including Cerebellum Posterior Lobe,Superior Temporal Gyrus,Superior Parietal Lobule,Superior Frontal Gyrus,the difference was statistically significant(P<0.05).The brain regions with significantly decreased ALFF values in the control group included Cerebellum Posterior Lobe,Posterior Cingulate Gyrus,Precuneus_R,Superior Parietal Lobe and Inferior Parietal Lobe.The differences were statistically significant(P<0.05).After different interventions,in the common brain regions of two groups of TBI patients,the difference of the Superior Parietal Lobe was statistically significant(P<0.05).The correlation analysis found that there was a positive correlation between the Superior Parietal Lobe and the interference time in the hyperbaric oxygen group(interference time:r=0.551,P=0.012),and there was no significant correlation with other clinical indicators(P>O.05).(4)Compared with pre-intervention,the brain regions with significantly increased ReHo after hyperbaric oxygen group included Lingual Gyrus,Middle Frontal Gyrus and Anterior Cingulate Gyrus.The brain regions with significant decreased ReHo values included Cerebellum Posterior Lobe,Superior Temporal Gyrus,and Middle Temporal Gyrus.The difference was statistically significant(P>0.05).The brain regions with significantly increased ReHo values in the control group included the Inferior Frontal Gyrus,Middle Frontal Gyrus,Superior Temporal Gyrus,and Middle Temporal Gyrus.The differences were statistically significant(P<0.05).After different interventions,the common brain regions of the two groups of patients with TBI had Superior Temporal Gyrus,Middle Temporal Gyrus and Middle Frontal Gyrus.The difference was statistically significant(P<0.05).The correlation analysis found that there was a positive correlation between correct readings of Stroop-A in the Middle Frontal Gyrus of the hyperbaric oxygen group(correct reading of card A:r=0.527,P=0.017),and there was no significant correlation between ReHo and clinical indicators in other brain regions(P>0.05).Conclusions:1.The executive function rehabilitation training,hyperbaric oxygen combined with executive function rehabilitation training can improve the executive function of TBI patients in different degrees.2.Hyperbaric oxygen treatment combined with executive function rehabilitation training is more beneficial to improve the executive dysfunction after traumatic brain injury.3.One of the mechanisms,hyperbaric oxygen therapy improve executive function after traumatic brain injury,is probably caused by adjusting the neurons spontaneous activity and regional homogeneity of the Middle Frontal Gyrus,and Superior Parietal Lobe. |
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