Hyperbaric Oxygen Treatments Reviews

Texas researchers have found that patients with long-standing but stable traumatic brain injury (TBI) show a general improvement in speech, memory and attention after undergoing a series of hyperbaric oxygen therapy treatments. Dr. Paul Harch and colleagues presented their findings in Seattle at the Undersea and Hyperbaric Medical Society Annual Scientific Meeting.

The researchers enrolled 11 patients from The Transitional Learning Community in Galveston, Texas, who had chronic stable TBI for at least 3 years. Five of the patients initially had 80 sessions in a multichamber hyperbaric oxygen unit.

Each 60-minute session consisted of raising the atmospheric pressure to 1.5 ATA (atmospheres absolute) and administering 100% oxygen through a mask. After a 5-month rest period, the five patients had another 40 hyperbaric sessions. The remaining six patients, serving as controls, did not undergo hyperbaric oxygen therapy.

SPECT imaging showed that no change occurred in the cerebral blood flow of the six control patients during the study period. However, patients who did receive the hyperbaric oxygen therapy showed an increase in penumbral area cerebral blood flow as well as improvements to their speech and memory functions, Dr. Harch said.

The improvements in these patients peaked at 80 hyperbaric oxygen sessions. “Individualized [hyperbaric oxygen therapy] repeats every 1 to 2 weeks appears to maintain improvement,” Dr. Harch said.

BACKGROUND: Multiple Sclerosis (MS) is a chronic, recurrent and progressive illness with no cure. On the basis of speculative pathophysiology, it has been suggested that Hyperbaric Oxygen Therapy (HBOT) may slow or reverse the progress of the disease. OBJECTIVES: The object of this review was to evaluate the efficacy and safety of HBOT in the treatment of MS. SEARCH STRATEGY: We searched the Cochrane MS Group trials register (July 2002), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2002), MEDLINE (January 1966 to October 2002) and the National Library of Medicine (NLM) database (July 2002), along with specialised hyperbaric resources and handsearching of relevant journals and proceedings. SELECTION CRITERIA: All randomised, controlled trials involving a comparison between HBOT and a sham therapy in MS were evaluated. DATA COLLECTION AND ANALYSIS: Two reviewers independently appraised all comparative trials identified, extracted data and scored them for methodological quality. MAIN RESULTS: We identified ten reports of nine trials that satisfied selection criteria (504 participants in total). Two trials produced generally positive results, while the remaining seven reported generally no evidence of a treatment effect. None of our three a priori subgroup analyses placed these two trials in the same group and were therefore unable to account for this difference. Three analyses (of 21) did indicate some benefit. For example, the mean Expanded Disability Status Scale (EDSS) at 12 months was improved in the HBOT group (group mean reduction in EDSS compared to sham -0.85 of a point, 95% confidence interval -1.28 to -0.42, P = 0.0001). Only the two generally positive trials reported on this outcome at this time (16% of the total participants in this review). REVIEWER’S CONCLUSIONS: We found no consistent evidence to confirm a beneficial effect of hyperbaric oxygen therapy for the treatment of multiple sclerosis and do not believe routine use is justified. The small number of analyses suggestive of benefit are isolated, difficult to ascribe with biological plausibility and would need to be confirmed in future well-designed trials. Such trials are not, in our view, justified by this review.

First of all, it must be understood that hyperbaric oxygen therapy is not a cure for Multiple Sclerosis. You probably already know there is no cure. The usefulness of hyperbaric therapy is to stabilize the patient’s condition and improve their quality of life. Many people suffering from MS report improvements in their overall symptoms and their functional abilities after hyperbaric oxygen therapy. Patients have reported improvements in their ataxia, numbness in their fingers and hands, balance, visual fields, concentration, pain, weakness, and dizziness. It has been shown that very often, improvement can be achieved in bladder-bowel disorders.

Hyperbaric therapy produces vasoconstriction, which causes the dilated leaky blood vessels in MS to constrict back towards a more normal size. Hyperbaric therapy also reduces the internal swelling, due to fluid gathering, which can lead to nerve cells dying. Drugs can force vasoconstriction, but they typically also reduce the amount of available oxygen tissues receive when blood flow is reduced.