Cognitive Effects of Hyperbaric Oxygen Therapy (HBOT) After a Traumatic Brain Injury

This is a retrospective, single-center observational study evaluating the cognitive effects of hyperbaric oxygen therapy (HBOT) in adults who sustained a traumatic brain injury (TBI). Earlier randomized controlled work at this center demonstrated cognitive improvement after HBOT in patients with chronic deficits following mild TBI. This study evaluates a large sample size and operationalizes HBOT treatment as a continuous variable in the form of a cumulative oxygen dose, something has not been done before. Using the medical records of patients treated at the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center between 2008 and 2026, the investigators compare computerized NeuroTrax cognitive assessments obtained before and after HBOT. The investigators quantify within-patient change across the cognitive domains and the Global Cognitive Score, and test whether the magnitude of cognitive change is associated with cumulative oxygen dose, expressed as the area under the pressure-time curve (ATA-minutes). The study includes patients across all TBI severity grades and adjusts for baseline performance, age, sex, and injury severity.