Hyperbaric oxygen may induce angiogenesis in patients suffering from prolonged post-concussion syndrome due to traumatic brain injury

Article type: Research Article

Authors: Tal, Sigal^{b; c; 1} | Hadanny, Amir^{a; b; 1} | Berkovitz, Nadav^{b; c} | Sasson, Efrat^d | Ben-Jacob, Eshel^{e; f; g} | Efrati, Shai^{a; b; e; f; *}

Affiliations: [a] Sagol Center for Hyperbaric Medicine and Research, Assaf Harofeh Medical Center, Zerifin, Israel | [b] Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel | [c] Radiology Department, Assaf Harofeh Medical Center, Zerifin, Israel | [d] WiseImage, Hod Hasharon, Israel | [e] Research and Development Unit, Assaf Harofeh Medical Center, Zerifin, Israel | [f] Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel | [g] School of Physics and Astronomy, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel-Aviv University, Tel-Aviv, Israel

Correspondence: [*] Corresponding author: Dr. Shai Efrati, The Sagol Center for Hyperbaric Medicine and Research, Assaf Harofeh Medical Center, Zerifin 7030, Israel. Tel.: +972 89779395; Fax: +972 89542238; E-mail: efratishai@013.net

Note: [1] Equal contribution

Abstract: Purpose:Recent clinical studies present convincing evidence that hyperbaric oxygen therapy (HBOT) may be the coveted neurotherapeutic method for brain repair. One of the most interesting ways in which HBOT can induce neuroplasticity is angiogenesis.The objective in this study was to assess the neurotherapeutic effect of HBOT in post TBI patients using brain perfusion imaging and clinical cognitive functions. Methods:Retrospective analysis of patients suffering from chronic neuro-cognitive impairment from TBI treated with HBOT. The HBOT protocol included 60 daily HBOT sessions, 5 days per week. All patients had pre and post HBOT objective computerized cognitive tests (NeuroTrax) and brain perfusion MRI. Results:Ten post-TBI patients were treated with HBOT with mean of 10.3±3.2 years after their injury. After HBOT, whole-brain perfusion analysis showed significantly increased cerebral blood flow and cerebral blood volume. Clinically, HBOT induced significant improvement in the global cognitive scores (p = 0.007). The most prominent improvements were seen in information processing speed, visual spatial processing and motor skills indices. Conclusion:HBOT may induce cerebral angiogenesis, which improves perfusion to the chronic damage brain tissue even months to years after the injury.

Keywords: Hyperbaric oxygen, angiogenesis, MRI, perfusion, cognitive, TBI, post concussion

DOI: 10.3233/RNN-150585

Journal: Restorative Neurology and Neuroscience, vol. 33, no. 6, pp. 943-951, 2015