Hyperbaric Oxygen Therapy’s Effects on Cognition and Narrative Discourse in Severe TBI: A Case Study
Discourse deficits following traumatic brain injury (TBI) have been found to negatively impact social reintegration and quality of life and are connected to underlying impairments in cognition. Hyperbaric oxygen therapy (HBOT) has been previously explored as a treatment for cognition in the TBI population, resulting in mixed outcomes. The present study examined the effect of HBOT on the cognitive and narrative discourse performance of an individual with chronic severe TBI. Multiple measurements of general cognition, receptive vocabulary, and discourse performance in the form of narrative storytelling were taken before and after HBOT. Hypotheses predicted that cognition would improve as a result of HBOT and facilitate enhanced narrative discourse performance; receptive vocabulary measures were not expected to improve on account of the participant’s lack of deficits in this area. Narratives were divided into T-units and assessed for organization, efficiency, and thoroughness. One-tailed t-tests indicated significant improvement in overall cognition but only in one aspect of the three narrative discourse measures. Further examination revealed that only improvements in attention explained the gains in cognition. For this study’s subject, HBOT likely increased attention but did not improve other areas of cognition measured, nor narrative discourse. Further studies incorporating more subjects and long-term outcome measurements are necessary for supporting these results and exploring HBOT’s effect on additional cognitive components and narrative discourse performance in a larger population of individuals with chronic, severe TBI.