Hyperbaric Oxygen Therapy for Alzheimer's Prevention? 

Megan Brooks

September 21, 2021

Hyperbaric oxygen therapy (HBOT) increases cerebral blood flow and improves cognitive performance in older adults with memory problems, early research suggests.  

"By treating vascular dysfunction, we're mapping out the path toward Alzheimer's prevention," study investigator Shai Efrati, MD, with the Sagol School of Neuroscience, Tel Aviv University, Israel, said in a statement.

"More research is underway to further demonstrate how HBOT can improve cognitive function and become an influential tool in the imperative fight against the disease," said Efrati, who heads the Sagol Center for Hyperbaric Medicine and Research in Israel.

The study was published online September 9 in the journal Aging.

Mounting Evidence of Brain Benefit

"The beneficial effect of HBOT on cognitive function was demonstrated in previous studies in patients suffering from the consequences of traumatic brain injury, stroke, anoxic brain injury, and normal aging," Efrati told Medscape Medical News

In the current study, six older adults (mean age 70 ± 2.68 years) with significant memory loss at baseline underwent 60 HBOT sessions within 3 months.

Before and after HBOT, researchers measured cerebral blood flow (using MRI dynamic susceptibility contrast sequential imaging) and cognitive function (using computerized cognitive tests).

Following HBOT, the researchers observed significant increases in cerebral blood flow in several brain areas, including Brodmann areas 1, 2, 32, 34, 40, 42, 43, and 48 of the cerebral cortex. 

Cognitive assessment following HBOT showed a significant increase in global cognitive score (P = .004), with the greatest improvement seen in memory, attention, and information processing speed.

Following HBOT, average memory scores improved to the mean score, normalized to age and education level, the investigators report.

"The improvements in these scores correlate with improved short and working memory, and reduced times of calculation and response, as well as increased capacity to choose and concentrate on a relevant stimulus," they write.

In mice genetically engineered to develop Alzheimer's, "we demonstrated directly on brain tissue that HBOT can reverse the core pathophysiology responsible for the development of the disease, including the expected accumulation of amyloid plaques and brain tissue hypoxia," said Efrati.

He said a larger clinical study is planned in patients suffering from early-stage Alzheimer's disease.

"Intriguing" Data

Weighing in on the study for Medscape Medical News, Paul G. Harch, MD, who has been on the forefront of clinical research into HBOT for more than three decades, said, "It is seemingly more confirmation of previous work on the subject of HBOT treatment of dementia."

Harch said he has treated "over 40 Alzheimer's patients now," including one with "amazing PET metabolism improvements, which were widespread, very similar" to the findings in the current study.

"My findings, however, have been that approximately 30%-35% of Alzheimer's patients don't respond clinically to HBOT," said Harch, clinical professor of medicine at Louisiana State University Health Sciences Center in New Orleans.

Also weighing in on the study, Rebecca Edelmayer, PhD, senior director of scientific engagement for the Alzheimer's Association, noted that while the research is intriguing, it is in mice and a small number of humans — and no control group. "Therefore," she said, "it is difficult to draw any conclusions from the results."

"Given increasing interest among the research community in regards to nondrug approaches for Alzheimer's disease, HBOT may be worth pursuing in larger, well-controlled, longer-term studies to determine if it can not only improve cognition, but possibly alter the underlying biological processes that cause brain cell death," Edelmayer added.

"Much more research is needed," she said, "before this particular therapy can be recommended to individuals with Alzheimer's or other forms of dementia."

This work was supported in part by the Israeli Ministry of Science, Technology and Space, Israel Science Foundation, Deutsche Forschungsgemeinschaft, The Aufzien Family Center for the Prevention and Treatment of Parkinson's Disease at Tel Aviv University, and the European Research Council. Efrati is a co-founder and shareholder at AVIV Scientific Ltd, which focuses on aging and hyperbaric medicine. Harch is the owner of Harch Hyperbaric Oxygen Therapy, Inc. Edelmayer has disclosed no relevant financial relationships.

Aging. Published online September 9, 2021. Full text

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