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

Autor: Olga Volkov, Shai Efrati, Nachum Gal, Eshel Ben-Jacob, Gregori Fishlev, Mony Friedman, Izhak Kamiager, Haim Golan, Yair Bechor, Jacob Bergan, Kostantin Kliakhandler
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Male
Anatomy and Physiology
Critical Care and Emergency Medicine
lcsh:Medicine
Cardiovascular
Biochemistry
Diagnostic Radiology
law.invention
Randomized controlled trial
Risk Factors
law
Molecular Cell Biology
Neurobiology of Disease and Regeneration
Activities of Daily Living
Pathology
lcsh:Science
Stroke
Neuropathology
Neurons
SPECT imaging
Hyperbaric Oxygenation
Neuronal Plasticity
Multidisciplinary
Neuromodulation
Brain
Neurochemistry
Middle Aged
Oxygen Metabolism
Treatment Outcome
Neurology
Neurointensive Care
Anesthesia
Medicine
Female
Cellular Types
medicine.symptom
Radiology
Research Article
medicine.medical_specialty
Clinical Research Design
Cerebrovascular Diseases
Neuroimaging
Brain damage
Neurological System
Computed Tomography
Hyperbaric oxygen
Diagnostic Medicine
Neurorehabilitation and Trauma
Neuroplasticity
medicine
Humans
Clinical Trials
Biology
Ischemic Stroke
Aged
Tomography
Emission-Computed
Single-Photon
business.industry
lcsh:R
medicine.disease
Clinical trial
Neuroanatomy
Metabolism
Anatomical Pathology
Prospective trial
Nuclear medicine
Quality of Life
Physical therapy
Post stroke
lcsh:Q
business
Neuroscience
Zdroj: PLoS ONE, Vol 8, Iss 1, p e53716 (2013)
PLoS ONE
ISSN: 1932-6203
Popis: 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. Trial Registration ClinicalTrials.gov NCT00715897
Databáze: OpenAIRE
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