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Efrati S.,Assaf Harofeh Medical Center | Efrati S.,Institute of Hyperbaric Medicine | Efrati S.,Tel Aviv University | Golan H.,Tel Aviv University | And 20 more authors.
PLoS ONE | Year: 2015

Background Fibromyalgia Syndrome (FMS) is a persistent and debilitating disorder estimated to impair the quality of life of 2-4% of the population, with 9:1 female-to-male incidence ratio. FMS is an important representative example of central nervous system sensitization and is associated with abnormal brain activity. Key symptoms include chronic widespread pain, allodynia and diffuse tenderness, along with fatigue and sleep disturbance. The syndrome is still elusive and refractory. The goal of this study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) on symptoms and brain activity in FMS. Methods and Findings A prospective, active control, crossover clinical trial. Patients were randomly assigned to treated and crossover groups: The treated group patients were evaluated at baseline and after HBOT. Patients in the crossover-control group were evaluated three times: baseline, after a control period of no treatment, and after HBOT. Evaluations consisted of physical examination, including tender point count and pain threshold, extensive evaluation of quality of life, and single photon emission computed tomography (SPECT) imaging for evaluation of brain activity. The HBOT protocol comprised 40 sessions, 5 days/week, 90 minutes, 100% oxygen at 2ATA. Sixty female patients were included, aged 21-67 years and diagnosed with FMS at least 2 years earlier. HBOT in both groups led to significant amelioration of all FMS symptoms, with significant improvement in life quality. Analysis of SPECT imaging revealed rectification of the abnormal brain activity: decrease of the hyperactivity mainly in the posterior region and elevation of the reduced activity mainly in frontal areas. No improvement in any of the parameters was observed following the control period. Conclusions The study provides evidence that HBOT can improve the symptoms and life quality of FMS patients. Moreover, it shows that HBOT can induce neuroplasticity and significantly rectify abnormal brain activity in pain related areas of FMS patients. © 2015 Efrati et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Boussi-Gross R.,Institute of Hyperbaric Medicine | Golan H.,Tel Aviv University | Golan H.,Nuclear Medicine Institute | Fishlev G.,Institute of Hyperbaric Medicine | And 14 more authors.
PLoS ONE | Year: 2013

Background: Traumatic brain injury (TBI) is the leading cause of death and disability in the US. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. The current study tested the effectiveness of Hyperbaric Oxygen Therapy (HBOT) in improving brain function and quality of life in mTBI patients suffering chronic neurocognitive impairments. Methods and Findings: The trial population included 56 mTBI patients 1-5 years after injury with prolonged postconcussion syndrome (PCS). The HBOT effect was evaluated by means of prospective, randomized, crossover controlled trial: the patients were randomly assigned to treated or crossover groups. Patients in the treated group were evaluated at baseline and following 40 HBOT sessions; patients in the crossover group were evaluated three times: at baseline, following a 2-month control period of no treatment, and following subsequent 2-months of 40 HBOT sessions. The HBOT protocol included 40 treatment sessions (5 days/week), 60 minutes each, with 100% oxygen at 1.5 ATA. "Mindstreams" was used for cognitive evaluations, quality of life (QOL) was evaluated by the EQ-5D, and changes in brain activity were assessed by SPECT imaging. Significant improvements were demonstrated in cognitive function and QOL in both groups following HBOT but no significant improvement was observed following the control period. SPECT imaging revealed elevated brain activity in good agreement with the cognitive improvements. Conclusions: HBOT can induce neuroplasticity leading to repair of chronically impaired brain functions and improved quality of life in mTBI patients with prolonged PCS at late chronic stage. Trial Registration: ClinicalTrials.gov NCT00715052 © 2013 Boussi-Gross et al.


Efrati S.,Institute of Hyperbaric Medicine | Efrati S.,Assaf Harofeh Medical Center | Efrati S.,Tel Aviv University | Ben-Jacob E.,Institute of Hyperbaric Medicine | And 3 more authors.
Expert Review of Neurotherapeutics | Year: 2014

Traumatic brain injury (TBI) and stroke are the major causes of brain damage and chronic neurological impairments. There is no agreed-upon effective metabolic intervention for TBI and stroke patients with chronic neurological dysfunction. Clinical studies published this year present convincing evidence that hyperbaric oxygen therapy (HBOT) might be the coveted neurotherapeutic method for brain repair. Here we discuss the multi-faceted role of HBOT in neurotherapeutics, in light of recent persuasive evidence for HBOT efficacy in brain repair and the new understanding of brain energy management and response to damage. We discuss optimal timing of treatment, dosage, suitable candidates and promising future directions. © Informa Uk, Ltd.


Gehmert S.,University of Regensburg | Geis S.,University of Regensburg | Lamby P.,University of Regensburg | Roll C.,University of Regensburg | And 6 more authors.
Clinical Hemorheology and Microcirculation | Year: 2011

Objectives: This study was designed to determine if a) hyperbaric oxygen increases the tissue oxygenation of free flaps and b) verification of this effect is possible by using a recently validated and innovative method for two-dimensional pO 2 measurement (Luminescence lifetime imaging = LLI). Methods: Six patients with a free parascapular flap transplanted to the lower limb received hyperbaric oxygen (HBOT) therapy. The HBOT regimen consisted of treatment over 90 minutes with 100% O 2 (FiO 2 1.0) at 240 kPa (Marx-Schema). The transcutaneous oxygen partial pressure (p tcO 2) was measured over the entire flap with the use of luminescence lifetime imaging (LLI) before and 30, 60, 120 minutes after treatment. The LLI is based on the oxygen dependent quenching of phosphorescence of the indicator dye platinum (II)-octaethyl-porphyrin implemented in a polystyrene sensor foil. Results: In all six free flaps we could find a significant increase of tissue oxygen over the entire flap in form of increased R-values as well as subsequently calculated absolute p tcO 2 values over a period of 120 min after hyperbaric therapy. The p tcO 2 values increased significantly from 42.59 ± 1.11 Torr before to 81.14 ± 5.95 Torr after hyperbaric treatment (p < 0.001). Even after 2 hours the p tcO 2 values were significantly higher (83.45 ± 13.80 Torr) compared with values prior to HBOT (p < 0.006). Conclusions: The findings of this study demonstrated an increase of oxygen supply over the entire flap after hyperbaric oxygen therapy. © 2011 - IOS Press and the authors. All rights reserved.


Ravona-Springer R.,The Medical Memory | Ravona-Springer R.,Tel Aviv University | Haratz S.,Tel Aviv University | Haratz S.,Stroke Unit | And 12 more authors.
Journal of Alzheimer's Disease | Year: 2015

Regression analyses compared 41 type 2 diabetes (T2D) and 131 non-T2D cognitively normal elderly males on the associations of arterial wall function measures [large artery elasticity index (LAEI), small artery elasticity index (SAEI), systemic vascular resistance (SVR), and total vascular impedance (TVI)] with cognitive performance (memory, language, and executive functions), controlling for socio-demographic and cardiovascular factors. Higher LAEI and lower TVI were significantly associated with better executive functions performance in T2D but not in non-T2D subjects. Lower TVI was more associated with better language performance in T2D. Results suggest that arterial wall function is associated with cognition in T2D. © 2015 - IOS Press and the authors. All rights reserved.

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