The Application Of ALFF Analysis Of Rs-fMRI To Explore The Neurological Rehabilitation Mechanisms Of Hyperbaric Oxygen Therapy For Memory Dysfunction After Traumatic Brain Injury

Objective:To evaluate the clinical efficacy of hyperbaric oxygen(HBO)therapy for memory dysfunction after traumatic brain injury(TBI)and to explore the neurological rehabilitation mechanisms of HBO treating patients with memory dysfunction after TBI by using amplitude of low-frequency fluctuation(ALFF)in resting-state functional magnetic resonance imaging(rs-fMRI),which aids to provide the visible evidences for the wide application of HBO in clinical practice.Methods:70 patients with memory dysfunction after TBI meeting the inclusion criteria were randomly divided into hyperbaric oxygen group(HBO group)and non-hyperbaric oxygen group(NHBO group)with 35 cases in each group.The HBO group received HBO,cognitive rehabilitation and basic therapy,and the NHBO group just received cognitive rehabilitation and basic therapy for 4 weeks.All participants received assessment of Montreal Cognitive Assessment(MoCA)(only analysing delayed memory),Wechsler Memory Scale(WMS),and fMRI scaning before and after treatment.DPABI software was used to perform one-sample paired t-tests before and after treatment for the two groups,and the different brain regions of ALFF before and after treatment was obtained.The SPSS 22.0 software package was used for statistical analysis.After removing the influence of age,gender and education level,partial correlation between scale scores and ALFF was analyzed.Based on the experimental results,we exlpored the neurological rehabilitation mechanisms of HBO therapy for memory dysfunction after TBI.Results:1.Compared with before treatment,the delayed memory score and WMS score of both groups all increased,and there was a significant difference(P<0.05).2.From the analysis between groups,the delayed memory scores and WMS scores in the HBO group were better than that of the NHBO group with a statistically significant difference(P<0.05).3.After treatment,in the HBO group,the areas of decreasing ALFF values included middle frontal gyrus in the left iliac region,the inferior frontal gyrus in the left iliac region and the inferior frontal gyrus in the left deltoid region.The enhanced areas included bilateral inferior apical marginal gyri,left middle temporal gyrus,left occipital middle gyrus,left postcentral gyrus,bilateral superior parietal gyrus and right anterior precuneus.4.After treatment,in the NHBO group,the areas of decreasing ALFF values included bilateral skeletal nucleus,parahippocampal gyrus,left medial frontal gyrus,left middle frontal gyrus and left posterior cingulate cortex.The enchanced areas included Bilateral cerebellar lobe,bilateral middle temporal gryus,right anterior precuneus,left superior temporal gyrus and right superior parietal gyrus.5.After treatment,the common difference brain areas in the two groups were right anterior precuneus,right superior parietal gyrus and left middle temporal gyrus.Among them,ALFF difference of only right anterior precuneus between the two groups had a statistically significant difference before and after treatment(P<0.05),and there was no significant difference in other common difference brain areas(P>0.05).6.After removing the effects of age,sex,and education on memory function,partial correlation analysis showed that the dALFF of right inferior apical marginal gyri of the HBO group was positively correlated with dMQ(r=0.524,P=0.026);There was a positive correlation between dALFF and dMQ in the right anterior precuneus(r=0.497,P=0.036).There was no correlation between the difference in brain area and the WMS score in the NHBO group(P>0.05).Conclusion:1.Hyperbaric oxygen combined with cognitive rehabilitation training can effectively improve memory dysfuction after TBI.It can be used as one of the means of clinical treatment to treat parients with TBI.2.The neurological rehabilitation mechanisms of hyperbaric oxygen therapy for memory dysfunction after traumatic brain injury may be through invoking alterations of regional spontaneous neuronal activity,including the key node of the right anterior precuneus,left postcentral gyrus,left middle occipital gyrus,bilateral inferior apical marginal gyri and other memory-related brain regions,which can be an aid to promote the compensation and integration of the structure and function of the central nervous system.This is the reason for improving the memory function.