Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. May 19, 2023; 13(5): 226-233
Published online May 19, 2023. doi: 10.5498/wjp.v13.i5.226
Effect of hyperbaric oxygen on post-stroke depression
Hong Guo, Yi-Ran Ge, Yan-Bin Dong, Xiao-Chuan Zhao, Guan-Li Su, Jin-Cheng Wang
Hong Guo, Yan-Bin Dong, Department of Psychology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
Yi-Ran Ge, Department of Clinical Psychology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Xiao-Chuan Zhao, Guan-Li Su, Jin-Cheng Wang, Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Author contributions: Guo H and Ge YR concepted the study; Guo H, Dong YB and Zhao XC collected the data; Guo H, Zhao XC, Wang JC and Ge YR contributed to the formal analysis; Guo H and Zhao XC contributed to the investigation; Guo H, Zhao XC and Su GL contributed to the methodology; Guo H, Zhao XC, Su GL and Dong YB supervised the study; Zhao XC validated the study; Guo H and Ge YR contributed to the visualization of the study; Guo H and Wang JC originally drafted the manuscript; Guo H, Ge YR, Wang JC and Dong YB reviewed and edited the manuscript.
Institutional review board statement: The study was reviewed and approved by The First Medical Center, Chinese PLA General Hospital Institutional Review Board (Approval No. 20180068).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that there are no conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Cheng Wang, PhD, Chief Doctor, Department of Psychiatry, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang 050000, Hebei Province, China. 757451886@qq.com
Received: March 8, 2023
Peer-review started: March 8, 2023
First decision: March 28, 2023
Revised: April 8, 2023
Accepted: April 12, 2023
Article in press: April 12, 2023
Published online: May 19, 2023
Processing time: 72 Days and 7.2 Hours
ARTICLE HIGHLIGHTS
Research background

This study explores the clinical efficacy of such therapy for stroke complicated with depression and diabetes mellitus, and to provide reference and basis for clinical treatment and development through the application of relevant rating scales and laboratory test indicators.

Research motivation

Changes in ischemic hypoxia and brain cell damage are common mechanisms of stroke and post-stroke depression, so improving ischemic hypoxia may be an effective treatment. Diabetes is a chronic disease characterized by elevated blood sugar and other metabolic disorders. diabetes is associated with an increased risk of stroke and post-stroke depression.

Research objectives

This study explores the clinical efficacy of such therapy for stroke complicated with depression and diabetes mellitus, and to provide reference and basis for clinical treatment and development through the application of relevant rating scales and laboratory test indicators.

Research methods

Patients in both groups were given nutritional cerebrovascular application, once a day, three times a week, intramuscular or intravenous injection, which can be increased or decreased according to age and symptoms, anti-platelet, hypoglycemic and other conventional treatments. The control group received oral escitalopram oxalate, 10 mg, once a day for eight weeks., In addition to the oral drug regimen of the control group, the observation group received hyperbaric oxygen (HBO) therapy, once a day, five times a week, for eight weeks. The HBO treatment was as follows: an HBO chamber was pressurized for 20 min to reach 0.25 mpa. The patient then put on a mask and breathed pure oxygen for 40 min, breathing cabin air at 10-min intervals. Finally, patients decompressed for 30 min to normal pressure, and then left the cabin. Treatment was once a day, 10 times for a course of treatment, each course of intermittent 7-10 d, for a total of two months of observation.

Research results

There were no significant differences in age, sex, or depression course between the groups. After HBO treatment, Montgomery Depression Rating Scale scores in both groups decreased significantly, and were significantly lower in the control group. After HBO treatment, National Institutes of Health Stroke Scale scores in both groups decreased significantly, and scores in the observation group decreased more than in the control group, the difference was statistically significant. The levels of hypersensitive C-reactive protein and tumor necrosis factor (TNF)-α in both groups were significantly decreased, and the observation group was significantly lower than the control group. Fasting blood glucose levels in both groups decreased significantly, and those in the observation group decreased more than in the control group, with statistical significance.

Research conclusions

HBO therapy can significantly improve depressive symptoms and neurological dysfunction in patients with post-stroke depression, and reduce the levels of hypersensitive C-reactive protein, TNF-α and fasting blood glucose.

Research perspectives

The future research direction is mainly to study the influence of depression in diabetes patients.