Hyperbaric Oxygenation Therapy Alleviates Chronic Constrictive Injury–Induced Neuropathic Pain and Reduces Tumor Necrosis Factor-Alpha Production

Li, Fenghua; Fang, Lili; Huang, Shuo; Yang, Zhong-Jin; Nandi, Jyotirmoy; Thomas, S.; Chen, Chung; Camporesi, Enrico M.

doi:10.1213/ane.0b013e31821f9544

Cited by 51 publications

(51 citation statements)

References 46 publications

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“…Recent publications have reported variable outcomes in great part because of using protocols that differ significantly in depth, duration, frequency and number of sessions [36][37][38]. It appears that HBOT can be effective in decreasing chronic inflammation in the brain by reducing pro-inflammatory cytokine activation and through provocation of stem cell activity [7][8][9][10]. The repeat brain SPECT indicated the valuable contribution of this technique as a functional imaging biomarker.…”

Section: Discussionmentioning

confidence: 99%

“…The treatments included 1) hyperbaric oxygen therapy (HBOT), 2) combination therapy of infused ketamine concurrent with transcranial magnetic stimulation (TMS), 3) injections of perispinal etanercept (PSE), and 4) non-invasive trans-nasal Sphenopalatine Ganglion (SPG) block. HBOT is believed to have anti-inflammatory effects, reducing the excess of proinflammatory cytokine activation such as TNF-alpha and facilitating improvement by provocation of stem cell activity [7][8][9][10]. The combination therapy of infused ketamine administered concurrent to TMS appears to address the abnormalities in brain circuits found both in treatment resistant depression and treatment resistant central pain [11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effective Stepwise Anti-inflammatory Treatment for Markedly Disabling Neuropsychiatric Comorbidities: A Case Report

Best¹,

Pavel²

2016

J Neurol Neurosci

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Background: This is the first case report of a stepped novel anti-inflammatory treatment plan for a complicated, markedly disabling neuropsychiatric condition with multiple comorbidities. The treatment consisted of 1) hyperbaric oxygen therapy, 2) combination therapy of infused ketamine applied concurrent with transcranial magnetic stimulation, 3) administration of perispinal etanercept, and finally 4) non-invasive transnasal Sphenopalatine Ganglion block.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effective Stepwise Anti-inflammatory Treatment for Markedly Disabling Neuropsychiatric Comorbidities: A Case Report

Best¹,

Pavel²

2016

J Neurol Neurosci

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“…Recent researches have reported that oxygen therapy appears to be effective in the pain management and show same effectiveness as hyperbaric oxygen. [14][15][16] Though studies have revealed the analgesic effect of hyperbaric oxygen in both rats and human with neuropathic pain, 13,[17][18][19] costs and poor availability limit the use of hyperbaric oxygen. These prompt us to investigate the effect of intermittent normobaric hyperoxia (InHO) in the treatment of neuropathic pain.…”

Section: Introductionmentioning

confidence: 99%

Effect of intermittent normobaric hyperoxia for treatment of neuropathic pain in Chinese patients with spinal cord injury

Gui

Zhao

et al. 2014

Spinal Cord

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Study design: Prospective, randomized and controlled study. Objectives: The aim of the study was to investigate the effect of intermittent normobaric hyperoxia (InHO) for treatment of neuropathic pain in patients with spinal cord injury (SCI). Setting: The First Affiliated Hospital of Nanhua University, Hengyang, Hunan Province, China. Methods: Patients with SCI from Hunan Province were recruited from the First Affiliated Hospital of Nanhua University. History, duration, localization and characteristics of pain were recorded. Visual analog scale (VAS), the Patient Global Impression of Change (PGIC) and Short Form-36 walk-wheel (SF-36ww) was used to investigate the effect of InHO. Patients were randomly assigned to study and control groups. In study group, patients were exposed to pure oxygen via non-rebreathing reservoir mask, which increased the provided oxygen at a rate of 7 l min − 1 for 1 or 4 h daily in 2 weeks. While in control group, patients breathed air via non-rebreathing reservoir mask at the same rate. Results: A total of 62 SCI patients with neuropathic pain were included in the study. The mean age of the patients was 36.85 ± 10.71 years. Out of 62 patients, 21 were tetraplegic and 41 were paraplegic. Overall, 14 patients had complete SCI while 48 patients had incomplete injuries. Three groups were similar with respect to age, gender, duration, smoker or not, level and severity of injury. In the 4 h per day InHO groups, a statistically significant reduction of the VAS values was observed (Po0.05). Significant difference was also found in SF-36ww pain scores and PGIC (Po0.05). However, such an effect was not evident in the control group. In one-third of those, the pain is severe. 3 Chronic neuropathic pain is often associated with conditions such as depression and anxiety, and strongly affects daily functioning and overall quality of life. 4,5 Many people with SCI rate chronic neuropathic pain as one of the most difficult problems to manage. Pharmacotherapy includes anticonvulsants, antidepressants, opioids and local anesthetics, 6,7 but responses vary and side effects limit compliance. Non-pharmacological treatments such as physical therapy, relaxation, hyperbaric oxygen and acupuncture are suggested. [8][9][10][11][12][13] Oxygen therapy has been clinically used for the treatment of chronic obstructive pulmonary disease and severe oxygen desaturation. Recent researches have reported that oxygen therapy appears to be effective in the pain management and show same effectiveness as hyperbaric oxygen. [14][15][16] Though studies have revealed the analgesic effect of hyperbaric oxygen in both rats and human with neuropathic pain, 13,17-19 costs and poor availability limit the use of hyperbaric oxygen. These prompt us to investigate the effect of intermittent normobaric hyperoxia (InHO) in the treatment of neuropathic pain.

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“…Proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) which are released after nerve injury contribute to injury-induced peripheral nerve pathology and to the development of neuropathic pain [10][11][12][13]. TNF-α inhibitors may be administered subsequent to nerve injury where they have been shown to attenuate behavior indicative of neuropathic pain [14,15].…”

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confidence: 99%

Effects of a Tumor Necrosis Factor-Alpha Inhibitor (Etanercept) on the Sciatic Nerve in a Hypoxic Ischemia-Induced Neonatal Rat Model

Büyükakıllı¹,

Atıcı²,

Ballı³

et al. 2014

Adv Clin Exp Med

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Background. Neonatal hypoxic-ischemic (HI) injury has been considered to have acute and long term deleterious effects on many tissues, including the peripheral nerve. Objectives. In this study, the effects of a tumor necrosis factor-alpha (TNF-α) inhibitor (etanercept) on peripheral nerve damage and the ultrastructure of the sciatic nerve and gastrocnemius muscle in rats exposed to HI during the neonatal period were examined. Material and Methods. In this study, 45 seven-day-old rats were used and they were divided into three groups. The right carotid arteries of the rats in the saline and etanercept groups were ligated and put in a hypoxia chamber containing 8% oxygen for two hours. Just after hypoxia, the etanercept group was given 10 mg/kg etanercept, but the saline group had only saline intraperitoneally. The sham group rats' carotid arteries were not ligated or put in hypoxia. The amplitude, area and latency of sciatic nerve compound motor action potential (CMAP), which mainly reflects axonopathy and myelinopathy, were measured using standard techniques in the seventeenth week following the HI. Sciatic nerve and gastrocnemius muscle were evaluated with a transmission electron microscope, and grading for myelin sheath damage was done to all groups. Results. Neuropathy was seen in rats after HI. While treatment with etanercept showed a protective effect for the axons of sciatic nerve, demyelination could not be recovered with etanercept. Conclusions. This study is the first in literature to show a partial interruption of the signal through the peripheral nerve fibers caused by axonal and myelin dysfunction continuation in rats exposed to HI after birth, in the 17

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Hyperbaric Oxygenation Therapy Alleviates Chronic Constrictive Injury–Induced Neuropathic Pain and Reduces Tumor Necrosis Factor-Alpha Production

Abstract: These data show that HBOT alleviates CCI-induced neuropathic pain and inhibits endoneuronal TNF-α production, but not IL-1β in CCI-induced neuropathic pain. Reduced TNF-α production may, at least in part, contribute to the beneficial effect of HBOT.

Cited by 51 publications

References 46 publications

Effective Stepwise Anti-inflammatory Treatment for Markedly Disabling Neuropsychiatric Comorbidities: A Case Report

Effective Stepwise Anti-inflammatory Treatment for Markedly Disabling Neuropsychiatric Comorbidities: A Case Report

Effect of intermittent normobaric hyperoxia for treatment of neuropathic pain in Chinese patients with spinal cord injury

Effects of a Tumor Necrosis Factor-Alpha Inhibitor (Etanercept) on the Sciatic Nerve in a Hypoxic Ischemia-Induced Neonatal Rat Model

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