Hyperbaric oxygen treatment improved neurophysiologic performance in brain tumor patients after neurosurgery and radiotherapy

Abstract

BACKGROUND:Cognitive performance often is impaired permanently in long-term brain tumor survivors after neurosurgery and radiotherapy. Hyperbaric oxygen treatment (HBOT) stimulates neovascularization of hypoperfused tissue and may result in improved functionality of damaged tissue. In this pilot study, clinical neurophysiologic tests were used to assess the effect of HBOT on brain performance. METHODS: Ten long-term brain tumor survivors received HBOT for severe cognitive deficits after neurosurgery and radiosurgery. Patients were tested before HBOT and at 6 weeks and 4 months after HBOT. The tests comprised a quantitative electroencephalographic (EEG) examination, the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for memory performance, and 2 cognitive tests, the number connection test (NCT) and the continuous reaction time test (CRTT). Late event-related components (LERCs) of averaged evoked EEG responses to a visual odd-ball stimulus were analyzed from whole-head activity maps. For comparison, a control group of healthy individuals (no HBOT) also were investigated. RESULTS: After HBOT, the amplitude of the LERC with the longest latency, P3b (involved in object interpretation) was improved significantly (P ¼ .02). The amplitudes of the N200 (occipital, negative) and the intermediate P3a (centroparietal, positive), LERCs with shorter latencies, and of a small, positive, occipital visual component did not change. Neither latencies nor reaction times changed after HBOT. However, P3a and P3b (parietal, positive) latencies were longer in survivors than in healthy individuals. The NCT produced inconclusive results, but the IQCODE revealed an improvement. When outcomes of the NCT, CRTT, IQCODE, and P3b amplitudes were evaluated in common tests, HBOT appeared to provide substantial improvement (P<.006). CONCLUSIONS: On the basis of the current results, the authors concluded tentatively that HBOT improves neurophysiologic performance in long-term brain tumor survivors.

Neurobiological insight into hyperbaric hyperoxia

“…Recent reports have largely demonstrated that HBO and NBO have positive influences on cognitive abilities, such as memory, visuospatial and verbal abilities, addition (related to working memory function) and n-back tasks (Chung et al 2009, Choi et al 2010, Schellart et al 2011. Our findings suggest that these reported neuro-psychological improvements might be associated during HBO exposure to rCBF distribution changes found in the regions encompassed in the DAS.…”

Hyperbaric oxygen on rehabilitation of brain tumors after surgery and effects on TNF-α and IL-6 levels

“…It has been reported that the course of brain tumors is related to the efficacy of HBO therapy. Early use of HBO has important implications for the reduction of inflammatory factors, improvement of hypoxic symptoms, recovery of nerve function and brain function (23). In this study, cerebral arterial flow velocity in the observation group after treatment (96.74±20.86 cm/sec) was significantly lower than that in the control group (119.52±18.27 cm/sec; P<0.001).…”

A systematic review of cognitive interventions for adult patients with brain tumours

“…16,45 studies did not include a comparator group. In nine of the 21 nonpharmacological intervention studies, preexisting subjective or objective cognitive impairment was a criterion for inclusion in the study [13][14][15]18,20,37,39,40,44 ; hence, these studies evaluated cognitive deficit amelioration (as opposed to prevention). The sample sizes of the nonpharmacological studies included in this review ranged from 3 44 to 143.…”

“…45 Five of the 21 studies were multicentre, 12,19,21,38,42 and the remainder were single-centre studies. 11,[13][14][15][16][17][18]20,22,37,[39][40][41][43][44][45] Like the pharmacological intervention studies, the mean/median age of participants in the nonpharmacological intervention studies was similar, in the fifth and sixth decades of life, although participant ages were not reported in one study. 11 Gender of participants was not reported in two of the studies, 11,21 but where it was, there was reasonable gender balance in most studies.…”

“…For example, donepezil, by inhibiting the breakdown of acetylcholine, could prolong and improve cholinergic function, which is associated with learning and memory. 10 Nonpharmacological interventions that have been used in patients with brain tumours are varied and include cognitive rehabilitation, [11][12][13][14][15][16][17] mindfulness training, 18 exercise therapy, 19 hyperbaric oxygen therapy 20 and dietary intervention. 21 Given the wide diversity in nonpharmacological approaches, the potential mechanisms through which these interventions could bring about a change in cognitive function are likely to be equally varied.…”