title: Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial.
abstract: 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.
  
  
  RESULTS
  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.
authors: The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel. efratishai@013.net
authors: Shai
authors: S
authors: Efrati
authors: Gregori
authors: G
authors: Fishlev
authors: Yair
authors: Y
authors: Bechor
authors: Olga
authors: O
authors: Volkov
authors: Jacob
authors: J
authors: Bergan
authors: Kostantin
authors: K
authors: Kliakhandler
authors: Izhak
authors: I
authors: Kamiager
authors: Nachum
authors: N
authors: Gal
authors: Mony
authors: M
authors: Friedman
authors: Eshel
authors: E
authors: Ben-Jacob
authors: Haim
authors: H
authors: Golan
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009473:Neuronal Plasticity; D011788:Quality of Life; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome