Normobaric Oxygen May Ameliorate Cerebral Venous Outflow Disturbance-Related Neurological Symptoms

Jiayue Ding, Yu Liu, Xiangyu Li, Zhiying Chen, Jingwei Guan, Kexin Jin, Zhongao Wang, Yuchuan Ding, Xunming Ji, Ran Meng, Jiayue Ding, Yu Liu, Xiangyu Li, Zhiying Chen, Jingwei Guan, Kexin Jin, Zhongao Wang, Yuchuan Ding, Xunming Ji, Ran Meng

Abstract

Cerebral venous outflow disturbance (CVOD) has begun to garner the attention of researches owing to a series of clinical symptoms that impose a significant impact on people's quality of life. Herein, we aimed to investigate whether normobaric oxygen (NBO) can ameliorate CVOD-induced neurological symptoms. This was one part of the prospective trial registered in ClinicalTrials.gov (NCT03373292). A total of 37 CVOD patients were divided into the NBO group (5-8 L/min of oxygen inhalation, 1 h per time, 3 times daily, n = 19) and the control group (without oxygen inhalation, n = 18) randomly. The assessments were performed at admission, 1-week hospitalization, and 6-month follow-up. Quantitative electroencephalogram (qEEG) data were recorded prior to and post 1 h of NBO in some patients. R software was used for data analysis. No NBO-related adverse events were observed during the whole NBO intervention process. The 1-week Patient Global Impression of Change (PGIC) scale showed that the symptom improvement occurred in nine patients in the NBO group (47.4%) while none in the control group (p = 0.001). NBO could improve headache evaluated with visual analog scale (pre-NBO vs. post-NBO: 4.70 ± 2.16 vs. 2.90 ± 2.03, p = 0.024) and Headache Impact Test-6 (53.40 ± 12.15 vs. 50.30 ± 13.04, p = 0.041). As for 6-month PGIC follow-up, eight out of 14 cases (57.1%) in the NBO group reported improvement, while only one out of 12 patients in the control group replied mild improvement (p = 0.014). The qEEG revealed that NBO reduced the ratio of theta to alpha power (0.65 ± 0.38 vs. 0.56 ± 0.35, p = 0.030) over the fronto-central electrodes. To sum up, NBO may be a safe and effective approach to attenuate CVOD-related symptoms (especially for headache) by brain functional improvement resulting from increasing oxygen supply to the brain tissues.

Keywords: EEG; brain dysfunction; cerebral venous outflow disturbance; neurological impairment; normobaric oxygen.

Copyright © 2020 Ding, Liu, Li, Chen, Guan, Jin, Wang, Ding, Ji and Meng.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
The symptom scales in normobaric oxygen (NBO) and control groups. Visual analog scale (VAS) and Headache Impact Test-6 (HIT-6) scale declined after 1-week NBO performance but remained unchanged after routine medical management. Compared with baseline, 1-week hospital anxiety and depression scale (HADS), Athens insomnia scale (AIS), insomnia severity index (ISI), and tinnitus handicap inventory (THI) improved in the NBO group; however, this change did not reach a statistical significance. *p < 0.05.
Figure 3
Figure 3
Immediate electroencephalogram (EEG) analysis before and after normobaric oxygen (NBO) intervention.

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