The Effect of Hyperbaric Oxygen Therapy on Functional Impairments Caused by Ischemic Stroke

Abstract

Background While research suggests a benefit of hyperbaric oxygen therapy (HBOT) for neurologic injury, controlled clinical trials have not been able to clearly define the benefits. Objective To investigate the effects of HBOT on physical and cognitive impairments resulting from an ischemic stroke. Methods Using a within-subject design a baseline for current functional abilities was established over a 3-month period for all subjects (n=7). Each subject then received two 4-week periods of HBOT for a total of 40 90-minute treatments over a 12-week period. Subjects completed a battery of assessments and had blood drawn six times over the 9-month total duration of the study. Results We found improvements in cognition and executive function as well as physical abilities, specifically, improved gait. Participants reported improved sleep and quality of life following HBOT treatment. We also saw changes in serum levels of biomarkers for inflammation and neural recovery. In the functional domains where improvement was observed following HBOT treatment, the improvements were maintained up to 3 months following the last treatment. However, the physiological biomarkers showed a pattern of more transient changes following HBOT treatment. Conclusions Findings from this study support the idea of HBOT as a potential intervention following stroke.

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

“…Some papers [ 24 , 27 , 28 ] reported that HBOT is able to stimulate neuroplasticity even years after a brain insult.…”

“…Although the mechanisms underlying HBOT brain effects have to be clearly defined yet [ 28 ], it seems that many factors are involved: inflammation modulation [ 25 ], strengthening of the antioxidant endogenous system [ 29 , 30 ], neoangiogenesis stimulation in the damaged tissues [ 21 , 31 ] and tissue repair stimulation by bone marrow staminal cells mobilization [ 32 ]. All these mechanisms could account for HBOT ability to stimulate neoangiogenesis and neuroplasticity even years after the brain insult.…”

Molecular and Therapeutic Aspects of Hyperbaric Oxygen Therapy in Neurological Conditions

“…Several studies have found that aside from the decrement in the secretion of proinflammatory cytokines, HBOT attenuates neuroinflammation via enhancement of immune cell secretion of anti-inflammatory cytokines [28,88,89]. In animal models, HBOT increased the expression levels of mRNA encoding the anti-inflammatory cytokine interleukin (IL-4), as measured by real-time quantitative PCR [28], and increased the concentration of the anti-inflammatory cytokine IL-10 in the cortices, as measured by ELISA [88].…”

“…In animal models, HBOT increased the expression levels of mRNA encoding the anti-inflammatory cytokine interleukin (IL-4), as measured by real-time quantitative PCR [28], and increased the concentration of the anti-inflammatory cytokine IL-10 in the cortices, as measured by ELISA [88]. Changes in anti-inflammatory cytokines were found in human patients with various neurological conditions as well [89].…”

Hyperbaric Oxygen Improves Cerebral Ischemia/Reperfusion Injury in Rats Probably via Inhibition of Autophagy Triggered by the Downregulation of Hypoxia‐Inducing Factor‐1 Alpha

“…The effectiveness of HBO is related to improving hypoxia, microcirculation, and metabolism and preventing further progression of deleterious secondary effects [12]. A large number of animal experiments and clinical trials have shown that HBO alleviates infarct size and oedema and reduces the permeability of the blood-brain barrier, which has a positive effect on ischemic stroke [13][14][15][16]. Spatial memory has been effectively improved in rats with ischemic hypoxic brain injury, and this improvement may be attributable to the preservation of damaged cortical and hippocampal cells [17].…”