Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial.

<h4>Background</h4>Recovery after stroke correlates with non-active (stunned) brain regions, which may persist for years. The current study aimed to evaluate whether increasing the level of dissolved oxygen by Hyperbaric Oxygen Therapy (HBOT) could activate neuroplasticity in patients wi...

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Main Authors: Shai Efrati, Gregori Fishlev, Yair Bechor, Olga Volkov, Jacob Bergan, Kostantin Kliakhandler, Izhak Kamiager, Nachum Gal, Mony Friedman, Eshel Ben-Jacob, Haim Golan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0053716
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author Shai Efrati
Gregori Fishlev
Yair Bechor
Olga Volkov
Jacob Bergan
Kostantin Kliakhandler
Izhak Kamiager
Nachum Gal
Mony Friedman
Eshel Ben-Jacob
Haim Golan
author_facet Shai Efrati
Gregori Fishlev
Yair Bechor
Olga Volkov
Jacob Bergan
Kostantin Kliakhandler
Izhak Kamiager
Nachum Gal
Mony Friedman
Eshel Ben-Jacob
Haim Golan
author_sort Shai Efrati
collection DOAJ
description <h4>Background</h4>Recovery after stroke correlates with non-active (stunned) brain regions, which may persist for years. The current study aimed to evaluate whether increasing the level of dissolved oxygen by Hyperbaric Oxygen Therapy (HBOT) could activate neuroplasticity in patients with chronic neurologic deficiencies due to stroke.<h4>Methods and findings</h4>A prospective, randomized, controlled trial including 74 patients (15 were excluded). All participants suffered a stroke 6-36 months prior to inclusion and had at least one motor dysfunction. After inclusion, patients were randomly assigned to "treated" or "cross" groups. Brain activity was assessed by SPECT imaging; neurologic functions were evaluated by NIHSS, ADL, and life quality. Patients in the treated group were evaluated twice: at baseline and after 40 HBOT sessions. Patients in the cross group were evaluated three times: at baseline, after a 2-month control period of no treatment, and after subsequent 2-months of 40 HBOT sessions. HBOT protocol: Two months of 40 sessions (5 days/week), 90 minutes each, 100% oxygen at 2 ATA. We found that the neurological functions and life quality of all patients in both groups were significantly improved following the HBOT sessions while no improvement was found during the control period of the patients in the cross group. Results of SPECT imaging were well correlated with clinical improvement. Elevated brain activity was detected mostly in regions of live cells (as confirmed by CT) with low activity (based on SPECT) - regions of noticeable discrepancy between anatomy and physiology.<h4>Conclusions</h4>The results indicate that HBOT can lead to significant neurological improvements in post stroke patients even at chronic late stages. The observed clinical improvements imply that neuroplasticity can still be activated long after damage onset in regions where there is a brain SPECT/CT (anatomy/physiology) mismatch.
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spelling doaj-art-fe62207f8f8d4e4d8d632d918e0b58e62025-08-20T02:28:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0181e5371610.1371/journal.pone.0053716Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial.Shai EfratiGregori FishlevYair BechorOlga VolkovJacob BerganKostantin KliakhandlerIzhak KamiagerNachum GalMony FriedmanEshel Ben-JacobHaim Golan<h4>Background</h4>Recovery after stroke correlates with non-active (stunned) brain regions, which may persist for years. The current study aimed to evaluate whether increasing the level of dissolved oxygen by Hyperbaric Oxygen Therapy (HBOT) could activate neuroplasticity in patients with chronic neurologic deficiencies due to stroke.<h4>Methods and findings</h4>A prospective, randomized, controlled trial including 74 patients (15 were excluded). All participants suffered a stroke 6-36 months prior to inclusion and had at least one motor dysfunction. After inclusion, patients were randomly assigned to "treated" or "cross" groups. Brain activity was assessed by SPECT imaging; neurologic functions were evaluated by NIHSS, ADL, and life quality. Patients in the treated group were evaluated twice: at baseline and after 40 HBOT sessions. Patients in the cross group were evaluated three times: at baseline, after a 2-month control period of no treatment, and after subsequent 2-months of 40 HBOT sessions. HBOT protocol: Two months of 40 sessions (5 days/week), 90 minutes each, 100% oxygen at 2 ATA. We found that the neurological functions and life quality of all patients in both groups were significantly improved following the HBOT sessions while no improvement was found during the control period of the patients in the cross group. Results of SPECT imaging were well correlated with clinical improvement. Elevated brain activity was detected mostly in regions of live cells (as confirmed by CT) with low activity (based on SPECT) - regions of noticeable discrepancy between anatomy and physiology.<h4>Conclusions</h4>The results indicate that HBOT can lead to significant neurological improvements in post stroke patients even at chronic late stages. The observed clinical improvements imply that neuroplasticity can still be activated long after damage onset in regions where there is a brain SPECT/CT (anatomy/physiology) mismatch.https://doi.org/10.1371/journal.pone.0053716
spellingShingle Shai Efrati
Gregori Fishlev
Yair Bechor
Olga Volkov
Jacob Bergan
Kostantin Kliakhandler
Izhak Kamiager
Nachum Gal
Mony Friedman
Eshel Ben-Jacob
Haim Golan
Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial.
PLoS ONE
title Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial.
title_full Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial.
title_fullStr Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial.
title_full_unstemmed Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial.
title_short Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial.
title_sort hyperbaric oxygen induces late neuroplasticity in post stroke patients randomized prospective trial
url https://doi.org/10.1371/journal.pone.0053716
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