TUESDAY, Jan. 22 (HealthDay News) -- Researchers in Israel
report that they harnessed the same type of therapy that helps
scuba divers recover from the bends to spur recovery in stroke
survivors.
The treatment, known as hyperbaric oxygen therapy, involves
closing the patient in a room with higher-than-normal air pressure,
then delivering oxygen to rejuvenate damaged brain cells, called
neurons. Oxygen levels in the body are increased tenfold with this
therapy, the researchers said.
The 59 patients in the study showed differing levels of
recovery, but some improvements were dramatic.
One 61-year-old woman who could not bathe, dress or climb stairs
without help after suffering a stroke a year earlier was able to
not only bathe and dress on her own, but also was able to shop and
cook independently, the researchers said.
Another participant, this one a 62-year-old woman who had had a
stroke 14 months earlier, regained lost language and reading skills
and was able to walk, climb stairs and eat on her own. Before the
stroke, she needed help with all of these activities.
Stroke from either a clot or a bleed in the brain can result in
problems with mobility, loss of reading and speaking ability, and
the inability to complete some of the most basic tasks of daily
life, such as bathing, dressing and walking.
It is the leading cause of disability among adults in the United
States.
Physical, speech and occupational therapy can help with recovery
in the early weeks and months after a stroke, but many patients
still don't fully recover their abilities.
Hyperbaric oxygen therapy is currently approved in the United
States for decompression sickness (the bends), wound healing,
carbon monoxide poisoning, skin grafts and thermal burns, among
other applications, said the study's author, Dr. Shai Efrati, a
faculty member at Tel Aviv's Sackler School of Medicine.
The findings are published in the January issue of the journal
PLoS ONE.
Although the therapy has been studied in some patients soon
after they experienced a stroke, this is the first study to look at
the therapy in patients in the "late-chronic phase" after the
stroke, the researchers said.
All participants in this study had suffered an ischemic or
hemorrhagic stroke between six and 36 months earlier, and none had
shown improvements in their condition for at least a month.
Half of the group received 90-minute sessions of oxygen therapy
five days a week for two months while the other half received no
treatment for two months and then started the oxygen therapy.
Brain imaging done before and after oxygen therapy showed
improvements in brain activity after the therapy was completed, and
some patients showed impressive functional improvements.
There were a few patients for whom improvements were marginal,
said study co-author Eschel Ben-Jacob, a physicist with Tel Aviv
University's School of Physics and Astronomy and the Sagol School
of Neuroscience.
Side effects were fairly minimal: Six participants experienced
ear troubles due to pressurization and two patients with a history
of seizures had mild convulsions.
Two years after the treatment ended, the improvements held.
"The rationale is that once the damaged brain area has been reactivated, there is no going backward unless there is another insult," said Efrati, who also is head of the Hyperbaric Institute at Assaf-Harofeh Medical Center in Israel.
Ben-Jacob said high levels of oxygen allow neurons that have
been damaged but are not destroyed to become active again,
reconnecting with other neurons and firing the signals needed to
maintain healthy brain function.
The researchers believe oxygen therapy also may be able to help
people with other neurological conditions, such as Alzheimer's, and
are currently studying it in patients with traumatic brain
injury.
The study did have one significant limitation in that there was
no group that did not receive oxygen therapy for the sake of
comparison, Ben-Jacob pointed out.
But another expert noted that the trial followed what is
considered the gold standard for assessing how effective a
treatment is during a clinical trial. The stroke victims who got
the oxygen therapy first were chosen randomly, the treatment
regimens were compared going forward in time and other factors that
might have influenced the outcome were controlled for, explained
Dr. J. Bradley White. He is an assistant professor of neuroscience
at Texas A&M Health Science Center College of Medicine and a
neurosurgeon with the Texas Brain and Spine Institute in Bryan.
"People will look at this and see they did it the right way," he said. "I think it will garner more attention."
White added that although more studies are needed, he found the
findings "exciting and promising."
More information
The
U.S. National Library of Medicinehas more on
hyperbaric oxygen therapy.