Document Detail


Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial.
MedLine Citation:
PMID:  23335971     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: 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.
METHODS AND FINDINGS: 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.
CONCLUSIONS: 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.
Authors:
Shai Efrati; Gregori Fishlev; Yair Bechor; Olga Volkov; Jacob Bergan; Kostantin Kliakhandler; Izhak Kamiager; Nachum Gal; Mony Friedman; Eshel Ben-Jacob; Haim Golan
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2013-01-15
Journal Detail:
Title:  PloS one     Volume:  8     ISSN:  1932-6203     ISO Abbreviation:  PLoS ONE     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-21     Completed Date:  2013-06-27     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  101285081     Medline TA:  PLoS One     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e53716     Citation Subset:  IM    
Affiliation:
The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel. efratishai@013.net
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00715897
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Aged
Brain / pathology
Female
Humans
Hyperbaric Oxygenation* / adverse effects
Male
Middle Aged
Neuronal Plasticity*
Quality of Life
Risk Factors
Stroke / diagnosis,  physiopathology*,  therapy*
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
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