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Efrati S.,The Institute of Hyperbaric Medicine | Efrati S.,Research and Development Unit | Efrati S.,Tel Aviv University | Fishlev G.,The Institute of Hyperbaric Medicine | And 14 more authors.
PLoS ONE | Year: 2013

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. © 2013 Efrati et al.

Boussi-Gross R.,The Institute of Hyperbaric Medicine | Golan H.,Nuclear Medicine Institute | Volkov O.,Nuclear Medicine Institute | Bechor Y.,The Institute of Hyperbaric Medicine | And 7 more authors.
Neuropsychology | Year: 2015

Objective: Several recent studies have shown that hyperbaric oxygen (HBO2) therapy carry cognitive and motor therapeutic effects for patients with acquired brain injuries. The goal of this study was to address the specific effects of HBO2 on memory impairments after stroke at late chronic stages. Method: A retrospective analysis was conducted on data of 91 stroke patients 18 years or older (mean age ~60 years) who had either ischemic or hemorrhagic stroke 3-180 months before HBO2 therapy (M = 30-35 months). The HBO2 protocol included 40 to 60 daily sessions, 5 days per week, 90 min each, 100% oxygen at 2ATA, and memory tests were administered before and after HBO2 therapy using NeuroTrax's computerized testing battery. Assessments were based on verbal or nonverbal, immediate or delayed memory measures. The cognitive tests were compared with changes in the brain metabolic state measured by single-photon emission computed tomography. Results: Results revealed statistically significant improvements (p < .0005, effect sizes medium to large) in all memory measures after HBO2 treatments. The clinical improvements were well correlated with improvement in brain metabolism, mainly in temporal areas. Conclusions: Although further research is needed, the results illustrate the potential of HBO2 for improving memory impairments in poststroke patients, even years after the acute event. © 2014 American Psychological Association.

Peleg R.K.,Assaf Harofeh Medical Center | Peleg R.K.,Tel Aviv University | Fishlev G.,The Institute of Hyperbaric Medicine | Bechor Y.,The Institute of Hyperbaric Medicine | And 9 more authors.
Diving and Hyperbaric Medicine | Year: 2013

Introduction: A decrease in blood glucose levels (BGL) during hyperbaric oxygen treatment (HBOT) is a well-recognised phenomenon, but studies of this are limited and inconclusive. This study evaluated the effect of HBOT on BGL in patients with diabetes mellitus (DM), traumatic brain injury (TBI) or stroke and healthy volunteers in a prospective, open, controlled trial. Methods: Thirty-nine participants were enrolled and evaluated twice: once during HBOT (90 minutes at 203 kPa), and once during a control session on normobaric air. Sessions were held up to two weeks apart and participants were instructed to eat the same diet. BGl was measured before, during and at the completion of each session. Results: For the whole study group, there was a small but statistically significant decrease in BGL in both the HBOT (7.27 ± 3.66 mmol L-1 before to 6.71 ± 3.88 mmol L-1 after, P = 0.037) and control (air) sessions (7.43 ± 3.49 mmol L-1 before to 6.71 ± 3.77 mmol L-1 after, P = 0.004). This fall did not differ between the two conditions (P = 0.59). Examining the three groups separately, BGL fell in all three subgroups, but this fall was only statistically significant for the air session in the diabetic group. There were no statistically significant differences in the BGL reduction when HBOT was compared to normobaric air in any of the three subgroups. Conclusions: BGL may decrease during HBOT and accordingly it should be monitored before entering the chamber. However, this decrease in BGL should probably not be attributed to the hyperbaric environment per se.

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