Hyperbaric Oxygen Induces Late Neuroplasticity in Post Stroke Patients – Randomized, Prospective Trial

AbstractBackground: Recovery after stroke correlates with non-active (stunned) brain regions, which may persist for years. Thecurrent 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). Allparticipants 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; neurologicfunctions were evaluated by NIHSS, ADL, and life quality. Patients in the treated group were evaluated twice: at baseline andafter 40 HBOT sessions. Patients in the cross group were evaluated three times: at baseline, after a 2-month control period ofno 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 inboth groups were significantly improved following the HBOT sessions while no improvement was found during the controlperiod of the patients in the cross group. Results of SPECT imaging were well correlated with clinical improvement. Elevatedbrain activity was detected mostly in regions of live cells (as confirmed by CT) with low activity (based on SPECT) – regionsof noticeable discrepancy between anatomy and physiology.Conclusions: The results indicate that HBOT can lead to significant neurological improvements in post stroke patients evenat chronic late stages. The observed clinical improvements imply that neuroplasticity can still be activated long afterdamage onset in regions where there is a brain SPECT/CT (anatomy/physiology) mismatch.