New hyperbaric oxygen therapy protocol can improve cognitive function of older adults
The Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center, together with the Sackler School of Medicine and Sagol School of Neuroscience at Tel Aviv University, announced today that a peer-reviewed study has demonstrated for the first time that hyperbaric oxygen therapy (HBOT) can significantly enhance the cognitive performance of healthy older adults.
The main areas of improvement were attention, information processing speed, and executive function, in addition to the global cognitive function, all of which typically decline with age. Moreover, there was a significant correlation between the cognitive changes and improved cerebral blood flow in specific brain locations.
The study was published on July 15, 2020, in the peer-reviewed journal Aging.
Professor Shai Efrati, Head of the Sagol Center for Hyperbaric Medicine and Research, and Head of Research & Development at Shamir Medical Center, and an Associate Professor at Sackler School of Medicine and Sagol School of Neuroscience at Tel Aviv University, and Dr. Amir Hadanny, the Sagol Center for Hyperbaric Medicine and Research, designed the study based on a unique HBOT protocol developed at the Sagol Center over the past 10 years. The randomized controlled clinical trial included 63 healthy adults (>64) who underwent either HBOT (n=33) or a control period (n=30) for three months. The study’s primary endpoint included a change in general cognitive function measured by a standardized comprehensive battery of computerized cognitive assessments before and after the intervention or control. Cerebral blood flow (CBF) was evaluated by a novel magnetic resonance imaging technique for brain perfusion.
“Age-related cognitive and functional decline has become a significant concern in the Western world. Major research efforts around the world are focused on improving the cognitive performance of the so-called ‘normal’ aging population,” said Prof. Efrati. “In our study, for the first time in humans, we have found an effective and safe medical intervention that can address this unwanted consequence of our age-related deterioration.”
“Over years of research, we have developed an advanced understanding of HBOT’s ability to restore brain function. In the past, we have demonstrated HBOT’s potential to improve/treat brain injuries such as stroke, traumatic brain injury and anoxic brain injury (due to sustained lack of oxygen supply) by increasing brain blood flow and metabolism,” explained Dr. Amir Hadanny. “This landmark research could have a far-reaching impact on the way we view the aging process and the ability to treat its symptoms.”
During HBOT, the patient breaths in pure oxygen in a pressurized chamber where the air pressure is increased to twice that of normal air. This process increases oxygen solubility in the blood that travels throughout the body. The added oxygen stimulates the release of growth factors and stem cells, which promote healing. HBOT has been applied worldwide mostly to treat chronic non-healing wounds.
There is a growing body of evidence on the regenerative effects of HBOT. The researchers have demonstrated that the combined action of delivering high levels of oxygen (hyperoxia) and pressure (hyperbaric environment), leads to significant improvement in tissue oxygenation while targeting both oxygen and pressure sensitive genes, resulting in restored and enhanced tissue metabolism. Moreover, these targeted genes induce stem cell proliferation, reduce inflammation and induce generation of new blood vessels and tissue repair mechanisms.
“The occlusion of small blood vessels, similar to the occlusions which may develop in the pipes of an ‘aging’ home, is a dominant element in the human aging process. This led us to speculate that HBOT may affect brain performance of the aging population,” Prof. Efrati explained. “We found that HBOT induced a significant increase in brain blood flow, which correlated with cognitive improvement, confirming our theory. One can conjecture that similar beneficial effect of HBOT can be induced in other organs of the aging body. These will be investigated in our upcoming research.”
Oxygen in hyperbaric chamber provides relief after radiotherapy
Hyperbaric oxygen therapy (HBOT) can relieve self-reported symptoms and side-effects of radiotherapy against cancer in the pelvic region, a study shows. After 30–40 sessions in a hyperbaric chamber, many patients experienced reductions in bleeding, urinary incontinence, and pain alike.
“This treatment is highly effective for the majority of the patients” states Nicklas Oscarsson, first author of the article, a doctoral student in anesthesiology and intensive care at Sahlgrenska Academy, University of Gothenburg, and senior consultant at Angered Hospital.
Radiotherapy is part of many treatment protocols of cancer in organs such as the prostate, cervix, ovaries, and colon. One side-effect of radiotherapy in the lower abdomen is damage of nearby, healthy tissue such as the urinary tract, bladder, vagina, or rectum.
Symptoms such as a frequent urge to urinate, incontinence, bleeding, and severe abdominal pain cause both physical and social difficulties. These may arise several years after radiotherapy and cause chronic and often increasing discomfort. Often, all these patients can be offered is temporary relief of symptoms or mutilating surgery.
Oxygen and high pressure
In the current study, the first randomized controlled study to compare hyperbaric oxygen with standard care, published in The Lancet Oncology, 223 patients were screened, and 79 were included in the analysis. Patients reported relatively severe symptoms and lifestyle limitations, mainly due to reduced urinary bladder capacity, bleeding, incontinence, and pain.
The patients were treated at university hospitals in five Nordic cities: Bergen in Norway, Copenhagen in Denmark, Gothenburg and Stockholm in Sweden and Turku in Finland. 38 patients, the control group, were given standard care, which normally includes medication and physical therapy, while the other 41 were treated with hyperbaric oxygen for 90 min daily, 30–40 times.
During their sessions each of the latter patients, wearing a snug-fitting oxygen mask or hood, sat in a hyperbaric chamber for one or more persons. The pressure of the oxygen, 240 kilopascals (kPa), corresponded to water pressure at a depth of 14 meters.
Focus on quality of life
In the hyperbaric chamber group, two out of three patients felt that they got better, and in some cases, all symptoms vanished. The others, including the control group, experienced no major changes. The specific focus of the study is self-reported qualitative and quantitative symptoms, and the important issue of the quality of life for cancer survivors.
The study is also linked to the discoveries behind the Nobel Prize in Physiology or Medicine 2019, about how cells sense and adapt to oxygen availability. It was already known that hyperbaric oxygen therapy boosts vascular growth, but there has been little exploration of its specific effects.
In the patients in the study, general health was greatly impaired before treatment, sometimes after long periods of discomfort. Thus, if a patient no longer needed morphine for pain or was able to go to the toilet once a night instead of five times, it was a clear improvement.
“It’s a great pleasure to hear patients tell us how they feel they’re returning to a normal human life. This also applies to those who get better but perhaps aren’t entirely well,” Oscarsson concludes.
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