Xu2019

The addition of hyperbaric oxygen to treatment with donepezil did not importantly improve cognitive outcomes in patients with vascular dementia.

Clinical bottom line:

  1. Hyperbaric resulted in improved Mini Mental State Examination (MMSE) scores
  2. Hyperbaric also resulted in increased serum humanin levels which may have a correlation with cognitive function

Citation/s:1. Xu Y, Wang Q, Qu Z, Yang J, Zhang X, Zhao Y. Protective effect of hyperbaric oxygen therapy on cognitive function in patients with vascular dementia. Cell Transplantation 2019; 28(8):1071-1075.

Lead author’s name and fax:Y. Zhao : zhao_yuwu2005@126.com

Three-part Clinical Question:In patients with vascular dementia, does treatment with hyperbaric oxygen and donepezil in comparison to donepezil alone result in an improvement in cognitive function?

Search Terms:Vascular dementia; cognitive function; humanin

The Study:Non-blinded non-concealed randomised controlled trial with intention-to-treat.

The Study Patients:Patients who met DSM-5 diagnostic criteria for vascular dementia. Patients with other forms of dementia, mental illness, brain trauma and severe systemic diseases were excluded.

Control group(N = 79; 79 analysed): Donepezil hydrochloride 5mg daily.

Experimental group(N = 79; 79 analysed): Donepezil hydrochloride 5mg daily and HBO 100% O2 at 2.0 ATA for 60 minutes 5 days per week for 12 weeks for a total of 60 sessions.

The Evidence:

Measure

Control group

HBOT group

Difference

95% CI

Mean value

SD

Mean value

SD

MMSE

20.1

2.8

21.7

2.4

1.6

-0.4 to 3.7

Humanin

143.1

8.6

146.5

9.4

3.4

-22.1 to 28.9

Comments:

  1. The authors’ treated MMSE scores as continuous and normally distributed – this is probably not appropriate. Their analysis suggests the difference between means is statistically significant (P<0.001), but we cannot confirm that on our analysis. Neither can we confirm the significant humanin analysis. The reason for the discrepancy is unclear.
  2. The authors identified a correlation between MMSE scores and humanin levels after adjusting for confounding factors. Humanin has no definitive clinical application currently.
  3. No blinding means there is a possibility of bias in this study through participation in the HBO arm.
  4. Donezepil is a cholinesterase inhibitor used to treat Alzheimer’s Disease (not vascular dementia).
  5. Outcomes are very short-term (2 days after treatment completion).

 

Appraised by:Hannah Rubinstein h.rubinstein@student.unsw.edu.au; Monday, 29 November 2021

Kill or Update By: November 2025

 

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