Hyperbaric Oxygen Therapy
The body’s oxygen delivery system (the hemoglobin of the red blood cells) is essentially saturated (98+ %) with oxygen for brain tissue distribution at sea level air pressure. Placing the body in a hyperbaric chamber, that is at a higher than sea level pressure and with increased oxygen supply, causes the fluids of the blood (plasma), the cerebrospinal fluid and the brain cells themselves to become fully saturated with oxygen. This promotes injured brain tissue to recover much of its normal function even months or years after the injury.
The Earth (Courtesy of NASA) – Home of mankind in the 21% Oxygen Era
Our present home on the Earth is a “baric” environment (baric, as in the weight or the pressure of the surrounding atmosphere). We live in a pressure environment that is centered on sea level pressure as being the basic pressure reference point.
Our body physiology is adapted to function best at “one atmosphere,” which is sea level pressure. .
When we go to higher (hypobaric) altitude, say 10,000 feet, the oxygen concentration in the surrounding air is still 21 %, but because there are fewer oxygen and nitrogen molecules in the same volume of air at higher altitude (a lower pressure)here is less oxygen available for living at that higher altitude.
Conversely, when going below sea level, the pressure actually increases, and thus the number of molecules in the same volume of gas increases. Using hyperbarics, we artificially create this situation. And if one simultaneously also supplies additional oxygen, the oxygen concentration is thus dramatically increased. And with that increased oxygen concentration, the oxygen diffuses directly into body tissues, thus by passing the hemoglobin delivery system.
This fact is the basis of Hyperbaric therapy.
The brain is easily “injured” by stroke, degenerative diseases, infections, trauma, inflammation and toxic substances, both environmental and “recreational.” If brain cell injury occurs, the brain cell may be unable to function, but not be dead. The brain cell may not be able to perform its primary functions of electrical signalling or neurotransmitter production, because it is at a low energy level; however, it is not necessarily permanent damaged.
Brain cells must live moment to moment. The brain does not store any nutrient materials. Thus the brain must have them continuously delivered to it. Glucose and oxygen are distributed to the brain by blood flow. Plus, cellular energy is required to remove oxygen from hemoglobin. Some weakened brain cells can no longer muster the energy needed to extract the oxygen they need. With hyperbaric treatment, the oxygen is delivered directly to tissue.
Thus the concept of cell function recovery via hyperbaric oxygen is that the profoundly increased levels of oxygen diffusing directly into the cell causes it to restore its basic level of function and promotes the cell’s recovery to a fully operational neuron interacting with other brain cells.
The exact Hyperbaric Oxygen Therapy mechanism of restoring brain cell function is unknown, but it probably works by reducing neuroinflammation and altering or enhancing mitochondrial function. The secondary events of improved mitochondrial function include:
- growth factor production
- DNA or gene “signaling.”
Outcomes of Hyperbaric Oxygen therapy
The basic overall effect of hyperbaric oxygen therapy is to restore cellular function and cause an amelioration of neurocognitive dysfunction. The brain cell is thus able to again contribute its operational role.
There are also some very significant secondary effects of restored brain cell function manifested in the behavior of the person themselves. Even if there is not complete cellular or brain region functional restoration, a person’s neurological function may be sufficiently improved so that a higher quality of life is obtained. This may result because key portions of a neuronal circuit become operational once again. Soon, there will be other exciting new therapies that can augment or multiply these cellular events of neuronal improvement see Exciting New Therapies.
For example, in a person who has suffered a severe stroke and is thus bed-ridden, improving their function such that they can be up in a wheel chair, can talk when they previously could not, swallow or feed themselves when they previously could not, these seemingly small increments of functional improvement can result in a significant reduction of supportive care and a tremendous improvement in the patient’s experience of the quality of life.
We have experience with stroke and brain injury patients who restore a significant degree of brain function with Hbot therapy even when started 3 or 4 YEARS after the injury and after all other therapies have been tried to no avail. The “farthest out” Hbot therapy success is 13 years after injury. And that was with Hbot alone, not even using a combination of newer therapies that are only now becoming available (see Treatments sections).
An valuable additional improvement can be a significant reduction of the costs and the stress experienced by their caregivers.
SPECT Neuroimaging of Brain Dysfunction
With all brain dysfunctions, hyperbaric therapy addresses both the primary brain dysfunction factor as well as the underlying and co-occurring morbidities.
And brain SPECT imaging, because it provides functional imaging of the entire brain volume, visualizes all of the co-occurring morbidities.
The black area on this pre-Hbot SPECT study represents the focal stroke area in the right frontal cortex, and yet there were other comorbid variables of dysfunction (areas of both increased and decreased function in the left side of the brain, all of which were ignored clinically, until visualized by SPECT imaging.