The evaluation of the effects of hyperbaric oxygen therapy on cognitive performances in patients with diabetic neuropathy by event related brain potentials and neuropsychological tests

Objective: Many studies have shown that diabetes leads to cognitive impairment. However, there is no study investigating the effects of hyperbaric oxygen therapy (HBOT) on cognitive performances in diabetic patients. In our study, we aimed to investigate the effects of HBOT on cognitive performances in patients with diabetic neuropathy (DN) by event-related brain potentials (ERP) and neuropsychological tests (NPT). This study was the first to investigate the effects of HBOT on cognitive performances in diabetic patients. Materials and Methods: A total of 20 male DN patients between the ages of 50 and 60 who had been indicated for HBOT because of diabetic foot complications and who met all the inclusion criteria were included in our study. Cognitive performances of the patients were evaluated at baseline and after 30 sessions of HBOT by performing NPT and recording behavioral performances and ERP in auditory Oddball Test and visual Continuous Performance Test (CPT). The results obtained from the tests before and after HBOT were compared. Results: Statistically significant differences were found in Wechsler Memory Scale-Revised Digit Span Test, Trail Making Test, Verbal Fluency Test, Stroop Test, Boston Naming Test, Raven's Standard Progressive Matrices, London Tower Test, Benton Facial Recognition Test, Öktem Verbal Memory Processes Test, Addenbrooke's Cognitive Examination, Geriatric Depression Scale and Beck Anxiety Inventory in NPT batteries. Also, there were statistically significant differences in behavioral performance results and N100, N140, P200, N200, P300 of ERP in auditory Oddball Test and visual CPT. Conclusion: The results obtained from the tests performed in our study show that HBOT may have positive effects on cognitive performances in cognitive processes related to executive functions and high cortical functions in patients with DN. Significant findings reflecting an increase in cognitive performances within the results of our study are promising for future studies. However, more extensive studies are needed to investigate the effects of HBOT on the diabetic brain and cognitive performances of diabetic patients.