**10. Conclusion**

It has been the experience of independent scientists over the last decade that peer-reviewed evidence from around the world attests to the safety and efficacy of HBOT in treating and helping to heal TBI and other neurological disorders. Yet the bulk of research on brain diseases and injury focuses on description and causes rather than treatments. Research into "treatments" is by design focused on treating symptoms. Clinical Practice Guidelines from the VA/DoD, for example, specifically focus on the "management" of concussion/mild traumatic brain injury [72]. Their CPG is a compendium of best practices for dealing with symptoms, not with healing or curing. No mention is made in the document of the wound to the brain, nor to healing that wound. And none of the treatments listed as standard of practice are approved by the FDA for treating TBI [73].

Unsurprisingly, huge sums are being poured into worldwide research, some coordinated, most in a competitive surge to devise better ways to understand the structure, function, aberrations and diseases, and treatments for the brain. The US (the Brain Initiative), Europe (Human Brain Project), Japan (Brain/MINDS Project), China (Brain Project), Israel, Australia and Canada have funded major projects [74]. Groups like One Mind and Paul Allen's Brain Institute are exploring how the brain works and what causes neurological disorders. While the projects vary slightly in their aims, the thrust is on knowledge rather than clinical medicine and healing. Longer-term goals of course include medicine to the patient. Yet precious little in all the efforts is being done to find immediate-use methods to intervene in areas of wide and profound importance to human mental health.

On a more mundane basis, federal, state, local, public and private efforts continue year-after-year to address in conferences and papers and legislation the perennial, interrelated issues of suicide, mental health, brain injury, addiction, and neurocognitive and neurological decline. It is hardly surprising that the expenditures promise phenomenal rewards for breakthroughs. Meanwhile, billions are expended treating symptoms of underlying brain damage that the science demonstrates is both treatable and potentially reversible, not later, but now.

Wright and Figueroa summarize for the majority of researchers on the use of HBOT to treat and help heal TBI: "There is sufficient evidence for the safety and preliminary efficacy data from clinical studies to support the use of HBOT in mild traumatic brain injury/persistent post concussive syndrome (mTBI/PPCS). The reported positive outcomes and the durability of those outcomes has been demonstrated at 6 months post HBOT treatment. Given the current policy by Tricare and the VA to allow physicians to prescribe drugs or therapies in an off-label manner for mTBI/PPCS management and reimburse for the treatment, it is past time that HBOT be given the same opportunity. This is now an issue of policy modification and reimbursement, not an issue of scientific proof or preliminary clinical efficacy." [75].

It is time to recognize the worldwide body of data, reduce healthcare costs, improve the lives of millions of brain-wounded and their families, and avoid lifetimes of lost earnings and the social impact of avoidable suffering. HBOT should be endorsed for the treatment of Traumatic Brain Injury. This can be achieved by extending CMS coverage to this diagnosis.
