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Neurological

Neurological

Brain and spinal cord are extremely sensitive to disruptions of oxygen supply and lack of oxygen due to impairment of circulation is a common cause of neurological problems. 

Hyperbaric oxygen therapy plays a major role in neuro-rehabilitation and restoration of motor, sensory, and cognitive function. Although earlier intervention with oxygen yields better results improvement is seen even if the injury was sustained months or years ago. 

Hyperbaric oxygen therapy is based on supplying organs with oxygen dissolved in blood plasma, cerebrospinal and lymphatic fluid in the amounts up to 20 times higher then when breathing air at normal one atmosphere of pressure. This makes transport of oxygen to poorly perfused, swollen, inflamed and damaged nerve tissue much easier. Since we do not poses a storage of oxygen, to be used in time of need, continuous daily therapy over several weeks is needed to restore the brain micro-circulation and normal oxygen delivery that will initiate repair, and preserve the viability of healthy brain tissue.  Lost function is regained through formation of new connections among the newly-differentiated and surviving nerve cells.  Oxygen therapy is the key therapy and most effective therapy in neurorehabiltation of brain or spinal cord after initial intervention and can not be replaced by any other therapy. It is however, important to combine hyperbaric oxygen therapy with physical, occupational, speech and other rehabilitation therapies to achieve better and quicker results. 

Alzheimer and Dementia
Many illnesses connected with aging can be avoided or slowed down through optimal cell health. Oxygen levels in arterial blood in a 70 year old are 20% lower than in a 30-50 year old. When combined with trauma, years of drug use and/or chronic illness the sustained lack of oxygen and poor brain circulation can cause progressive brain cell damage (even nerve cell death) and abnormal brain function shown as: memory loss, impaired learning, problem solving and judgment, resulting in myriad of social, emotional and physical problems that can be categorized as Alzheimer and Dementia.

The good news is that with adding extra oxygen thru hyperbaric oxygen therapy the optimal brain function can be restored. Improved brain oxygenation promotes healthier brain metabolism and brain activity (See ref Sep. 2017). Hyperbaric oxygen can induce angiogenesis (new capillary growth) and neurogenesis - regeneration of nerve fibers (see reference list 2017). Reestablished brain microcirculation also reduces neuro-inflammation and nerve cell apoptosis in dementia (see Reference list 2018) as well as in other hypoxic/ischemic brain injury or stroke. Recent study (2017) shows that dementia caused by prolonged anesthesia during surgery was successfully treated with hyperbaric oxygen 4.5 years after onset as well as post stroke depression (ref 2015)

On a longer scale hyperbaric oxygen therapy provides neuroprotection by stimulating oxidative cerebral energy metabolism and neuroplasticity and is best utilized in the early stages of diagnosis or as a preventive therapy against dementia onset.

Protective role of oxygen
Hyperbaric Oxygen promotes neurogenesis (growth and development of neurons - nerve cells) and nerve regeneration (the growth and reconnection of viable and functional neural connections) called also neuroplasticity. Damaged brain is highly responsive to additional oxygen and results in improved mental function such as: speech, comprehension, memory, executive function as well as coordination and balance are seen very soon after initiation of the treatment and are irreversible if proper brain oxygenation is maintained. In addition to functional recovery, hyperbaric oxygenation also creates more resilient nerve cells and protects against re-occurrence of disabling clinical events such as stroke.  

Further reading:

  1. Balasubramanian P, Delfavero J, Nyul-Toth A, Tarantini A, Gulej R and Tarantini S (2021) Integrative Role of Hyperbaric Oxygen Therapy on Healthspan, Age-Related Vascular Cognitive Impairment, and Dementia. Front. Aging 2:678543. doi: 10.3389/fragi.2021.678543
  2. Harch PG, Fogarty EF. Hyperbaric oxygen therapy for Alzheimer’s dementia with positron emission tomography imaging: a case report. Med Gas Res. 2018;8(4):181-184.
  3. Shapira R, Efrati S, Ashery U. Hyperbaric oxygen therapy as a new treatment approach for Alzheimer's disease. Neural Regen Res. 2018 May;13(5):817-818.
  4. Best S, Pavel DG. Treatment of post-anesthesia dementia with perispinal etanercept injection and hyperbaric oxygen therapy: a case report. J Med Case Rep. 2017 Apr 14;11(1):105
  5. Boussi-Gross R, Golan H, Fishlev G, Bechor Y, Volkov O, Bergan J, Friedman M, Hoofien D, Shlamkovitch N, Ben-Jacob E, Efrati S. Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury - randomized prospective trial. PLoS One. 2013 Nov 15;8(11)
  6. Efrati S, Fishlev G, Bechor Y, Volkov O, Bergan J, Kliakhandler K, Kamiager I, Gal N, Friedman M, Ben-Jacob E, Golan H. Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial. PLoS One. 2013;8(1):e53716
  7. Tal S, Hadanny A, Sasson E, Suzin G, Efrati S. Hyperbaric Oxygen Therapy Can Induce Angiogenesis and Regeneration of Nerve Fibers in Traumatic Brain Injury Patients. Front Hum Neurosci. 2017 Oct 19;11:508
  8. Hadanny A, Golan H, Fishlev G, Bechor Y, Volkov O, Suzin G, Ben-Jacob E, Efrati S. Hyperbaric oxygen can induce neuroplasticity and improve cognitive functions of patients suffering from anoxic brain damage. Restor Neurol Neurosci. 2015;33(4):471-86.
  9. Yan D, Shan J, Ze Y, Xiao-Yan Z, Xiao-Hua H. The effects of combined hyperbaric oxygen therapy on patients with post-stroke depression. J Phys Ther Sci. 2015 May;27(5):1295-7
  10. Vadas D, Kalichman L, Hadanny A, Efrati S. Hyperbaric Oxygen Environment Can Enhance Brain Activity and Multitasking Performance. Front Integr Neurosci. 2017 Sep 27;11:25.

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Alzheimer study!

Drs. Paul Harch and Edward Fogarty concludes: "... a 9-week treatment of low-pressure HBOT (40 sessions) in a patient with AD [Alzheimer's Dementia] caused a significant increase in global metabolism on 18FDG PET imaging with concomitant symptomatic improvement." 

And the positive effect persisted after the therapy was discontinued: "Continued HBOT [Hyperbaric oxygen therapy] in conjunction with standard pharmacotherapy maintained the patient’s symptomatic level of function over an ensuing 22 months.

Reference: 

Harch PG, Fogarty EF. Hyperbaric oxygen therapy for Alzheimer’s dementia with positron emission tomography imaging: A case report. Med Gas Res [serial online] 2018 [cited 2019 Jan 25];8:181-4. Available from: http://www.medgasres.com/text.asp?2018/8/4/181/248271

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