Hyperbaric oxygen therapy improves neurocognitive functions of post-stroke patients – a retrospective analysis

Abstract.Background: Previous studies have shown that hyperbaric oxygen therapy (HBOT) can improve the motor functions andmemory of post-stroke patients in the chronic stage.Objective: The aim of this study is to evaluate the effects of HBOT on overall cognitive functions of post-stroke patients inthe chronic stage. The nature, type and location of the stroke were investigated as possible modifiers. Methods: A retrospective analysis was conducted on patients who were treated with HBOT for chronic stroke (>3 months) between 2008-2018. Participants were treated in a multi-place hyperbaric chamber with the following protocols: 40 to 60 daily sessions, 5 days per week, each session included 90 min of 100% oxygen at 2 ATA with 5 min air brakes every 20 minutes. Clinically significant improvements (CSI) were defined as > 0.5 standard deviation (SD).Results: The study included 162 patients (75.3% males) with a mean age of 60.75 ± 12.91. Of them, 77(47.53%) had corticalstrokes, 87(53.7%) strokes were located in the left hemisphere and 121 suffered ischemic strokes (74.6%).HBOT induced a significant increase in all the cognitive function domains (p < 0.05), with 86% of the stroke victims achiev ing CSI. There were no significant differences post-HBOT of cortical strokes compared to sub-cortical strokes (p > 0.05).Hemorrhagic strokes had a significantly higher improvement in information processing speed post-HBOT (p < 0.05). Lefthemisphere strokes had a higher increase in the motor domain (p < 0.05). In all cognitive domains, the baseline cognitivefunction was a significant predictor of CSI (p < 0.05), while stroke type, location and side were not significant predictors.Conclusions: HBOT induces significant improvements in all cognitive domains even in the late chronic stage. The selectionof post-stroke patients for HBOT should be based on functional analysis and baseline cognitive scores rather than the stroketype, location or side of lesion.