ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026
Electroencephalographic changes during hyperbaric oxygen therapy in patients with chronic disorders of consciousness.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundProlonged disorders of consciousness (PDOC) impose a substantial socioeconomic burden, and objective electrophysiological markers that can accompany hyperbaric oxygen therapy (HBOT) remain lacking.
methodsThis retrospective self-controlled study analyzed serial quantitative electroencephalographic (qEEG) changes during HBOT, with consciousness assessed by the Coma Recovery Scale-Revised (CRS-R), in patients with PDOC. Resting-state qEEG measures-power spectral density (PSD), permutation entropy (PE), and Lempel-Ziv complexity (LZC)-were obtained before HBOT (T1, baseline), during the first HBOT session (T2), and during the twentieth session (T3). CRS-R scores were assessed before and after the treatment course. Forty PDOC patients were stratified by baseline CRS-R into a higher-level group (CRS-R ≥ 8, n = 14) and a lower-level group (CRS-R < 8, n = 26).
resultsPE and LZC increased progressively and significantly from T1 to T3 in every brain region in both groups (all FDR-corrected p < 0.05); for example, frontal PE rose from 0.37 ± 0.01 to 0.66 ± 0.03 in the CRS-R ≥ 8 group and from 0.37 ± 0.03 to 0.62 ± 0.05 in the CRS-R < 8 group, with corresponding frontal LZC increases (0.14 ± 0.01 to 0.30 ± 0.03, and 0.15 ± 0.02 to 0.28 ± 0.04, respectively). PSD was otherwise stable, with a significant change confined to the occipital theta band in the CRS-R < 8 group (F = 6.047, FDR-corrected p = 0.022; T1 vs. T3, p = 0.028). Mean CRS-R improved over the course from 6.3 ± 2.8 to 8.7 ± 3.6 (p < 0.001; CRS-R < 8: 4.5 ± 1.4 to 6.7 ± 1.8; CRS-R ≥ 8: 9.6 ± 2.4 to 12.4 ± 3.2). The increases in EEG entropy and complexity occurred in parallel with the improvement in consciousness, but no formal correlation between qEEG and CRS-R changes was performed.
conclusionThese findings provide adjunctive electrophysiological measures for consciousness assessment and objective information accompanying HBOT as an adjuvant treatment for PDOC; causal or predictive inference awaits controlled studies.
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