Post Concussion Syndrome & TBI references
Dr Harch’s published research: March 2020

Harch PG, Andrews SR, Rowe CJ, Lischka JR, Townsend MH, Yu Q, Mercante DE. Hyperbaric oxygen therapy for mild traumatic brain injury persistent postconcussion syndrome: a randomized controlled trial. Med Gas Res. 2020;10(1):8-20. [See: https://medicalgasresearch.biomedcentral.com/articles/10.1186/s13618-015-0030-6 ]

This study concludes:
A course of 40 daily, 5 days/week, 150 kPa 60-minute HBOT treatments delivered to civilian and military subjects with the persistent postconcussion syndrome of mild TBI an average of 4.6 years after last TBI resulted in significant improvements in postconcussion symptoms, cognitive variables (memory, cognition/speed of information processing), and behavioral/ emotional problems (anxiety, depression, PTSD symptoms, sleep, and quality of life) compared to a randomly assigned Control Group. These improvements were duplicated in the Control Group after crossing over to HBOT. In both groups most of the improvements were sustained and even improved for some tests nearly 3 months after the last HBOT, suggesting HBOT as a disease-modifying therapy for mTBI PPCS

Let’s have a “CONCUSSION DISCUSSION.”
Dr Harch was the first to treat acute concussions with HBOT in 2001 w NFL player & chronic concussion (CTE) in world champion boxer in 1989 described in The Oxygen Revolution published in 2007.

In 1989
Drs. Van Meter, Gottlieb, and Harch in New Orleans launched the first formal study of boxers with CTE, using HBOT. Known as the Dementia Pugilistica Study they successfully treated a world champion boxer, now schizophrenic and requiring supervised care, 23 years after his last bout in which he was knocked unconscious for 4 minutes. Since that time Dr. Harch has treated hundreds of patients with TBI from acute concussion to chronic severe TBI. Dr. Harch understands acute concussion to post concussion syndrome to chronic severe TBI and CTE.

Dr. Harch’s first case and likely the first ever acute concussion case treated with HBOT was ex-NFL and All Pro linebacker Bill Romanowski of the Denver Broncos. The story of the salvage of Bill’s 2001 and 2002 seasons with Dr. Harch’s directed HBOT is told in the Oxygen Revolution, copyright 2007. Since that time Dr. Harch has treated numerous family members, relatives, athletes, and other patients with acute concussion. If acute concussion can be treated within the first few days to week after injury Dr. Harch has found that with proper HBOT dosing as little as 1-2 HBOTs can resolve the concussion and patent’s symptoms, preventing the post-concussion syndrome. With greater and greater delays more treatment is required. By the time six months has elapsed patients usually require the minimum 40 treatment protocol of HBOT that Dr. Harch, Van Meter, and Gottlieb developed in the Perfusion Metabolism Encephalopathy study that followed the boxer’s study in 1994. That protocol formed the basis for the protocol that has been used worldwide in multiple HBOT studies, including all of the DoD Veteran studies and the studies in Israel.

“Hyperbaric oxygen therapy is a treatment for wounds in the body in any location and of any duration. In the past three decades it has been increasingly successfully applied to patients with chronic traumatic brain injury of all severities, first by myself1-9 and then by others.10-16 The early human experience was duplicated in an animal model that constitutes the only improvement of chronic brain injury in animals in the history of science.17 The study was performed using the human protocol. In severe traumatic brain injury there are two controlled trials11,12 and in mild traumatic brain injury post-concussion syndrome there are two randomized controlled trials.14,16 All studies in chronic TBI done in this dosing range have shown positive results. This body of literature not only supports hyperbaric oxygen therapy for chronic neurocognitive residual of traumatic brain injury as a medical necessity, but also constitutes evidence-based medicine according to the definition of Sackett.18 In addition, there is no comparatively effective therapy.” Stated by Paul G. Harch, M.D.

References:
• Harch, P.G., Van Meter, K.W., Gottlieb, S.F., and Staab, P. (1994). HMPAO SPECT brain imaging and low pressure HBOT in the diagnosis and treatment of chronic traumatic, ischemic, hypoxic, and anoxic encephalopathies. Undersea Hyperb. Med. 21(Suppl), 30.
• Harch, P.G., Van Meter, K.W., Neubauer, R.A., and Gottlieb, S.F. (1996). Use of HMPAO SPECT for assessment of response to HBO in ischemic/hypoxic encephalopathies, in: Appendix, Textbook of Hyperbaric Medicine, 2nd ed. K.K. Jain (ed.), Hogrefe and Huber Publishers: Seattle (WA), pps. 480-491.
• Harch, P.G. and Neubauer, R.A. (1999). Hyperbaric Oxygen Therapy in Global Cerebral Ischemia/ Anoxia and Coma, in: Chapter 18, Textbook of Hyperbaric Medicine, 3rd Revised Edition. K.K. Jain (ed.), Hogrefe and Huber Publishers: Seattle (WA), pps. 319-345.
• Harch, P.G. (2002). The dosage of hyperbaric oxygen in chronic brain injury, in: The Proceedings of the 2nd International Symposium on Hyperbaric Oxygenation for Cerebral palsy and the Brain-Injured Child. J.T. Joiner (ed.). Best Publishing Co: Flagstaff (AZ), pps. 31-56.
• Harch, P.G. and Neubauer, R.A. (2004). Hyperbaric oxygen therapy in global cerebral ischemia/ anoxia and coma, in: Chapter 18, Textbook of Hyperbaric Medicine, 3rd Revised Edition. K.K. Jain (ed.). Hogrefe and Huber Publishers: Seattle (WA), pps. 223-261.
• Harch, P.G., and Neubauer, R.A. (2009). Hyperbaric oxygen therapy in global cerebral ischemia/anoxia and coma, in: Chapter 19, Textbook of Hyperbaric Medicine, 5th Revised Edition. K.K. Jain (ed.), Hogrefe and Huber Publishers: Seattle (WA), pps. 235-274.
• Harch, P.G., Neubauer, R.A., Uszler, J.M., and James, P.B. (2009). Appendix: Diagnostic Imaging and HBO Therapy, in: Chapter 44, Textbook of Hyperbaric Medicine, 5th Revised Edition. K.K. Jain (ed.), Hogrefe and Huber Publishers: Seattle (WA), pps. 505-519.
• Harch, P.G., Fogarty, E.F., Staab, P.K., and Van Meter, K. (2009). Low pressure hyperbaric oxygen therapy and SPECT brain imaging in the treatment of blast-induced chronic traumatic brain injury (post-concussion syndrome) and post-traumatic stress disorder: a case report. Cases Journal 2, 6538. http://casesjournal.com/casesjournal/article/view/6538.
• Harch, P.G., Andrews, S.R., Fogarty, E.F., Amen, D., Pezzullo, J.C., Lucarini, J., Aubrey, C., Taylor, D.V., Staab, P.K., and Van Meter, K.W.. (2012). A phase I study of low-pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and post-traumatic stress disorder. J Neurotrauma. 29, 168-185.
• Neubauer, R.A., Gottlieb, S.F., and Pevsner, N.H. (1994). Hyperbaric Oxygen for Treatment of Closed Head Injury. South. Med. J. 87, 933-936.
• Golden, Z.L., Neubauer, R., Golden, C.J., Greene, L., Marsh, J., and Mleko, A. (2002). Improvement in cerebral metabolism in chronic brain injury after hyperbaric oxygen therapy. Int. J. Neurosci. 112, 119-131.
• Golden, Z., Golden, C.J., Neubauer, R.A. (2006). Improving neuropsychological function after chronic brain injury with hyperbaric oxygen. Disability and Rehabilitation. 28(22), 1379-86.
• Wright, J.K., Zant, E., Groom, K., Schlegel, R.E., and Gilliland, K. (2009). Case report: Treatment of mild traumatic brain injury with hyperbaric oxygen. Undersea Hyperb. Med. 36, 391-99.
• Wolf, G., Cifu, D.X., Baugh, L, Carne, W., Profenna, L. (2012). The effect of hyperbaric oxygen on symptoms following mild traumatic brain injury. J Neurotrauma 29(17), 2606-12.
• Churchill, S., Weaver, L.K., Deru, K., Russo, A.A., Handrahan, D., Jr. Orrison, W.W., Foley, J.F., Elwell, H.A. (2013). A prospective trial of hyperbaric oxygen for chronic sequelae after brain injury (HYBOBI). Undersea Hyper. Med. 40(2), 165-193.
• Boussi-Gross, R., Golan, H., Fishlev, G., Bechor, Y., Volkov, O., Bergan, J., Friedman, M., Hoofien, D., Shlamkovitch, N., Ben-Jacob, E., Efrati, S. (2013) Hyperbaric Oxygen Therapy Can Improve Post Concussion syndrome Years after Mild Traumatic Brain Injury-Randomized Prospective Trial. PLOS ONE 8, 1-18.
• Harch, P.G., Kriedt, C., Van Meter, K.W., and Sutherland, R.J. (2007). Hyperbaric oxygen therapy improves spatial learning and memory in a rat model of chronic traumatic brain injury. Brain Res. 1174, 120-9. Epub 2007 Aug.
• Sackett, D., Rosenberg, M.C., Gray, J.A.M., Haynes, R.B., and Richardson, W.S. (1996). Evidence based medicine: what it is and what it isn’t. BMJ 312, 71-2.