Clinical effect of hyperbaric oxygen combined with transcranial electrical stimulation and memantine hydrochloride on cognitive impairment in the patients with craniocerebral injury

Objective To investigate the clinical efficacy of hyperbaric oxygen (HBO) combined with transcranial electrical stimulation (tDCS) and memantine tablets on cognitive impairment in the patients with moderate to severe craniocerebral injury. Methods Forty-nine patients with moderate or severe cognitive impairment induced by trauma brain injury (TBI) who were admitted into the Rehabilitation Department and Neurosurgery Department of Shanxi University Hospital from May 2017 to May 2018 were enrolled for the study. The patients were divided into the HBO group (or group A, n= 16), the HBO + tDCS group (or group B, n=16) and the HBO + tDCS + memantine group (or group C, n= 17) in accordance with different treatment methods. The total scores of Montreal Cognitive Assessment Scale (MoCA) and the scores of each item before and 4 weeks after treatment, the Simple Mental State Examination Scale (MMSE) and Barthel Index (BI) were analyzed to determine improvement of cognitive impairment in the TBI patients. Results After 3 courses of treatment, MoCA comprehensive scores and sub-item scores were all significantly higher than those before treatment, with statistical significance (P<0.01). In sub-items, the comprehensive scores of VS-EF, ATT, LANG, D-MEM and MoCA in group B were significantly higher than those in group A after treatment, also with statistical significance (P<0.05). Following treatment, the scores of VS-EF, ATT, LANG and D-MEM in group C were all significantly higher than those in group B after treatment, also with statistical significance (P<0.05). The comprehensive scores of MMSE and ADL in group B and C after treatment were all significantly higher than those in group A, and statistical significance could be seen when comparisons were made between them (P<0.01). The comprehensive scores of MMSE(21.23±6.53) and ADL(64.38±12.80) in group C were all obviously higher than those in group B(17.61±6.35, 5.39±10.22), also with statistical significance (P<0.05). Conclusion Comprehensive treatment with HBO+ tDCS+ memantine could achieve obvious better therapeutic effects on cognitive impairment of the patients with severe TBI. For this reason, it is worth further clinical application. Key words: Hyperbaric oxygen; Craniocerebral injury; Cognitive impairment; Transcranial electrical stimulation; Hydrochloric acid memantine