Effect of hyperbaric oxygen combined with folic acid on clinical efficacy and cognitive function in patients with cerebral small vessel disease

Objective: To identify the effect of hyperbaric oxygen combined with folic acid on clinical efficacy and cognitive function in patients with cerebral small vessel disease (CSVD), and to analyze the risk factors affecting efficacy. Methods: Data from 108 elderly patients with CSVD (homocysteine (Hcy) > 10 mu mol/L) treated in The First Hospital of Yulin from February 2019 to February 2022 were retrospectively analyzed. Among them, 50 patients treated with folic acid were set as the control group (CG), and the remaining 58 patients treated with additional hyperbaric oxygen therapy were in the study group (SG). Clinical efficacy was compared between the two groups after treatment, and changes in Hcy level before and after treatment were observed. Montreal Cognitive Assessment (MoCA) was used to compare the improvement of cognitive function between two groups. According to the efficacy after treatment, patients with markedly effective and effective responses were set as the improved group, and patients with ineffective response as the unimproved group. Risk factors affecting the efficacy of the patients were analyzed by logistic regression. Also, changes in quality of life (assessed by activities of daily living (ADL) scale) before and after treatment as well as the incidence of adverse reactions after treatment were and compared between groups. Results: Before treatment, there was no significant difference identified in MoCA scores, plasma Hcy levels, or ADL scores between the two groups (P > 0.05). After treatment, scores of MoCA and ADL increased and plasma Hcy level decreased in both groups, and the changes in the SG were more significant than those in the CG (P < 0.05). Additionally, no notable difference was observed in the incidence of adverse reactions between the two groups (P > 0.05). Logistic regression analysis revealed that hypertension, hyperlipidemia, and diabetes were risk factors affecting the efficacy. Conclusion: Hyperbaric oxygen combined with folic acid can effectively improve cognitive function and quality of life, and reduce Hcy level in patients with CSVD. In addition, hypertension, hyperlipidemia, and diabetes are risk factors affecting efficacy.