Hyperbaric oxygen therapy improves neurocognitive functions of post-stroke patients – a retrospective analysis

Abstract

Background: Previous studies have shown that hyperbaric oxygen therapy (HBOT) can improve the motor functions and memory of post-stroke patients in the chronic stage. Objective: The aim of this study is to evaluate the effects of HBOT on overall cognitive functions of post-stroke patients in the chronic stage. The nature, type and location of the stroke were investigated as possible modifiers. Methods: A retrospective analysis was conducted on patients who were treated with HBOT for chronic stroke (>3 months) between 2008-2018. Participants were treated in a multi-place hyperbaric chamber with the following protocols: 40 to 60 daily sessions, 5 days per week, each session included 90 min of 100% oxygen at 2 ATA with 5 min air brakes every 20 minutes. Clinically significant improvements (CSI) were defined as > 0.5 standard deviation (SD). Results: The study included 162 patients (75.3% males) with a mean age of 60.75 ± 12.91. Of them, 77(47.53%) had cortical strokes, 87(53.7%) strokes were located in the left hemisphere and 121 suffered ischemic strokes (74.6%). HBOT induced a significant increase in all the cognitive function domains (p < 0.05), with 86% of the stroke victims achieving CSI. There were no significant differences post-HBOT of cortical strokes compared to sub-cortical strokes (p > 0.05). Hemorrhagic strokes had a significantly higher improvement in information processing speed post-HBOT (p < 0.05). Left hemisphere strokes had a higher increase in the motor domain (p < 0.05). In all cognitive domains, the baseline cognitive function was a significant predictor of CSI (p < 0.05), while stroke type, location and side were not significant predictors. Conclusions: HBOT induces significant improvements in all cognitive domains even in the late chronic stage. The selection of post-stroke patients for HBOT should be based on functional analysis and baseline cognitive scores rather than the stroke type, location or side of lesion.

Functional MRI (fMRI) Evaluation of Hyperbaric Oxygen Therapy (HBOT) Efficacy in Chronic Cerebral Stroke: A Small Retrospective Consecutive Case Series

“…The ECHM document is from 2016. In the meantime, many papers [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ] have been published in favour of HBOT, so that its level of evidence may have been increased.…”

COVID‑19 and ischemic stroke: Mechanisms of hypercoagulability (Review)

“…Mechanical ventilation is a key treatment for patients with severe COVID-19 with ARDS. Hyperbaric oxygen therapy has been shown to improve neurological function in patients with stroke ( 83 ). Extracorporeal membrane oxygenation has been used in the treatment of COVID-19-related ARDS ( 84 ).…”

“…Klok et al (60) The prophylactic dose of enoxaparin should be increased from 40 mg daily to 80 mg twice a day for cOVId-19 patients admitted to the IcU. Hyperbaric oxygen therapy has been shown to improve neurological function in patients with stroke (83). Extracorporeal membrane oxygenation has been used in the treatment of cOVId-19-related ARdS (84).…”

Molecular and Therapeutic Aspects of Hyperbaric Oxygen Therapy in Neurological Conditions

“…There are several treatment protocols, which vary according to the pathologies. For instance, treatment of diabetic wounds typically lasts for 30-40 days, at pressures of 2.0-2.4 ATA [25], whereas for stroke, in several studies the treatment that was used lasted for two months, with the subject being treated five days a week at a pressure of two ATA [26,27]. By providing a high-pressure oxygen-rich environment, HBOT increases the concentration of dissolved oxygen in the blood plasma and arterial oxygen pressure, which in turn might assist in supplying oxygen to hypoxic tissue [28,29].…”