# Evaluating the Impact of Hyperbaric Oxygen Therapy and Neurofeedback on Mild Traumatic Brain Injury: A Case Report

## TL;DR

A patient with recurrent mild traumatic brain injury showed significant improvement through hyperbaric oxygen therapy and neurofeedback over six years.

## Contribution

This case report demonstrates the potential of combining HBOT and neurofeedback for long-term recovery in recurrent mTBI.

## Key findings

- The patient experienced a statistically significant reduction in neurobehavioral symptoms over six years.
- Hyperbaric oxygen therapy and neurofeedback were associated with improved cognition, emotional regulation, and quality of life.
- Ongoing HBOT and neurofeedback helped maintain improvements and address persistent symptoms.

## Abstract

A 38-year-old male patient sustained a concussion in May 2017 while playing hockey. Despite initially following standard treatments and rest, he continued to experience post-concussive symptoms. Approximately two weeks later, he sought alternative therapy at The Oxford Center in Brighton, Michigan, where he was introduced to hyperbaric oxygen therapy (HBOT). Although a 40-session protocol was recommended, he ended treatment after 11 sessions, noting subjective improvements but later recognizing that discontinuing early may have hindered full recovery.

Over time, the patient’s medical history, encompassing ocular migraines, chronic and adrenal fatigue, and recurrent infections, contributed to ongoing stressors. Seasonal variations and occupational demands further exacerbated his symptoms. In July 2018, a second head injury occurred during a jet-ski accident, leading to more pronounced cognitive and functional impairments. A renewed course of 40 HBOT sessions, followed by an additional 40, produced substantial improvement and subsequent neurofeedback interventions further enhanced cognitive function, emotional regulation, and overall quality of life. By early 2019, after roughly 100 HBOT sessions, the patient reported a near-complete return to baseline. He continued periodic HBOT for maintenance, describing it as a “breath of life.”

From 2018 to mid-2024, successive neurofeedback sessions, guided by quantitative electroencephalography (qEEG) assessments, yielded marked gains in decision-making, attentional focus, and mental flexibility. The patient also employed intravenous micronutrient therapies, particularly high-dose vitamin C, to bolster immune resilience following pneumonia. Integrating HBOT, neurofeedback, and targeted physiological support, this comprehensive approach underscores the potential for synergistic benefits in recurrent mild traumatic brain injury (mTBI).

The Neurobehavioral Symptoms Inventory (NSI) data reveal a statistically significant reduction in overall neurobehavioral symptoms from 2018 to 2024 (z = -2.754, p = .006, d = 0.692), with prominent declines in anxiety, poor concentration, and depressed mood, as well as smaller but meaningful improvements in dizziness, balance, coordination, decision-making, slowed thinking, and fatigue. Some symptoms - such as headaches, nausea, and sensitivity to noise - remained unchanged, indicating areas for continued monitoring and targeted strategies. These results suggest the beneficial effects of interventions or changes implemented during the six-year span, highlighting the potential for sustained improvement with ongoing support.

The patient remains engaged in both HBOT and neurofeedback, reporting sustained improvements in cognition, emotional balance, and stress management. This case highlights the importance of adhering to recommended HBOT protocols, using neurofeedback to address persistent neurocognitive deficits, and incorporating ongoing evaluations to refine therapeutic strategies. These findings suggest that a multifaceted, long-term treatment plan may optimize recovery in individuals with recurrent mTBI, offering insights for clinicians seeking integrative methods to promote durable neurological and functional outcomes.