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Abstract
Topics: Functional Magnetic Resonance Imaging (fMRI) evaluation of HyberBaric Oxygen Therapy (HBOT) effects on chronic cerebral stroke Patients (Pts). Introduction: Our aim was to evaluate with fMRI, in a 3 Tesla system, the functional effects of HBOT on the Central Nervous System (CNS) in four Pts with established ischaemic and haemorrhagic cerebral strokes (2 Pts each). To our knowledge, no author used fMRI technique for this purpose, till now. Methods: All four Pts underwent a fMRI study before and after 40 HBOT sessions, with a time window of a few days. They carried out two language (text listening, silent word-verb generation) and two motor (hand and foot movements) tasks (30 s On-Off block paradigms). Results: After HBOT, all Pts reported a clinical improvement, mostly concerning language fluency and motor paresis. fMRI analysis demonstrated an increase in both the extent and the statistical significance of most of the examined eloquent areas. Conclusions: These changes were consistent with the clinical improvement in all Pts, suggesting a possible role of fMRI in revealing neuronal functional correlates of neuronal plasticity and HBOT-related neoangiogenesis. Although only four Pts were examined, fMRI proved to be a sensitive, non-invasive and reliable modality for monitoring neuronal functional changes before and after HBOT.
Highlights
HyperBaric Oxygen Therapy (HBOT) is a safe technique, successfully used in many pathologies
Since HBOT is allowed for this clinical indication by the
10th ECCHM, Pts were enrolled after an appropriate informed consent and exclusion of any possible contraindications during a thorough clinical examination in the outpatient clinic
Summary
HyperBaric Oxygen Therapy (HBOT) is a safe technique, successfully used in many pathologies. In our country (Italy), we refer to the European Committee for Hyperbaric. Medicine (ECHM), revised in the 2017 Tenth European Committee for Hyperbaric Medicine (10th ECCHM) [1]. Among Type 3 recommendations, chronic stroke is present, with a Level C evidence, where: Type 3, in humans, means “Weak evidence of beneficial action based only on uncontrolled studies (historical control group, cohort study)” and Level C means a “Consensus opinion of experts”. No author used fMRI to evaluate HBOT functional effects on the CNS of Pts with established strokes. Our aim was to evaluate functional HBOT effects in chronic stroke Pts’ CNS by fMRI. We chose fMRI because it is a non–invasive technique, allowing the safe and repetitive in vivo study of local functional neuronal changes
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