ISRAEL: Israeli researchers find that decades-old stroke damage is reversible with oxygen therapy

Record ID: 397767

  • Title: ISRAEL: Israeli researchers find that decades-old stroke damage is reversible with oxygen therapy
  • Date: 2nd May 2013
  • Summary: ZERIFIN, ISRAEL (APRIL 11, 2013) (REUTERS) BARUCH WALKING UNAIDED AND SITTING NEXT TO HER NEIGHBOUR WHO CALLED THE AMBULANCE AFTER HER STROKE (SOUNDBITE) (Hebrew) IRIT BARUCH, PATIENT, SAYING: "Apparently I had an aneurysm, the blood has burst out inside my head, my head was terribly aching and I woke up my husband - it was the middle of the night - so I woke my husband u
  • Embargoed: 17th May 2013 13:00
  • Keywords:
  • Location: Israel
  • Country: Israel
  • Topics: General,Health,Technology
  • Reuters ID: LVANQSHGZR6DPELH0SMLV721Q51
  • Story Text: Treating brain damaged patients with high levels of oxygen can reinvigorate dormant neurons up to two decades after injury, according to Israeli researchers. The team from Tel Aviv University and Assaf Harofeh Medical Center reported that oxygenating so-called 'metabolically dysfunctional' areas of the brain previously thought to be untreatable can vastly improve patients' motor function, memory, and cognitive functions many years after the original injury.
    Hyperbaric oxygen therapy (HBOT) treatment in itself is nothing new, having been pioneered in the 1960s. But Dr. Shai Efrati, head of research and development at Assaf Harofeh Medical Center, and his team have adapted HBOT to focus on 'metabolically dysfunctional' brain regions which border necrotic (dead) tissue. These regions have long been assumed to be impossible to treat more than six months after the injury, but Efrati says he has been able to reinvigorate brain function in these areas two decades after the brain was damaged.
    Efrati says there are several degrees of brain injury and his staff are specifically targeting those neurons that retain enough energy to stay alive but not enough to fire electrical signals.
    "The cells in this location have unaerobic metabolism. It means that the cell has enough energy to stay alive but it doesn't have the energy needed for the action potential, for the full activity, and this is where the hyperbaric can help," said Efrati. He added: "With the hyperbaric therapy when the metabolic function is being regained in this area the patient can speak again, and if it's the motor area of the hand then the hand will start moving years after the acute injury, which is something that was unbelievable to me. I have been taught in medical school that such neuroplasticity so late after the acute injury cannot happen, but we see it."
    University lecturer Shir Daphna-Tekoah suffered serious brain injuries in June 2005 when the train on which she was travelling derailed at high speed after colliding with a coal truck. Seven people died and almost 200 were injured in the accident. After her initial physical recovery, she found her mental faculties badly affected.
    "I was quite an intellectual person and all of a sudden I couldn't read, I couldn't remember what I'm saying, I couldn't remember where I put things," said Daphna-Tekoah.
    A series of doctors diagnosed post traumatic stress disorder (PTSD) but Daphna-Tekoah refused to accept this conclusion. In desperation she turned to the Assaf Harofeh Medical Center, four and a half years after the crash, a period in which her condition had shown little discernible improvement.
    Efrati and colleagues examined her brain scans and diagnosed brain trauma before treating the areas of Daphna-Tekoah's brain surrounding the necrotic tissue. "They found that the accident damaged, I had a traumatic brain injury, and I entered the treatment for traumatic brain injury and it was amazing, it was a miracle," said Daphna-Tekoah.
    Her initial treatment involved a two-month period of HBOT treatment in a high-pressure chamber where the oxygen-rich air increases oxygen levels in the body tenfold. The treatment comprised 80 hours in the chamber, undertaken in daily two-hour sessions over an eight week period. Daphna-Tekoah still visits the hospital in Zerifin, close to Tel Aviv, regularly.
    Efrati pointed out changes to Daphna-Tekoah's brain from scans taken before and after the HBOT treatment.
    "You can see here that this area are not active, all the blue ones that you see over here, and this is the temporal and this is why she couldn't remember anything because the temporal and the frontal lobe are not active. But look what happened after the treatment. This blue area disappeared and also this temporal area has been improved, and that's why she can walk again, she can teach in the university again, she can write an article again," he said.
    In a study led by Efrati and Professor Eshel Ben-Jacob, of Tel Aviv University, 74 patients who had suffered strokes between six months and three years earlier and whose condition was no longer improving, were treated. To assess the potential impact of HBOT treatment, the anatomical features and functionality of the brain were evaluated using a combination of CT scans to identify necrotic tissue and SPECT scans to determine the metabolic activity level of the neurons surrounding damaged areas.
    But Efrati says he has also seen improvement in patients whose brain injuries occurred up to 20 years before.
    "With the hyperbaric therapy when the metabolic function is being regained in this area the patient can speak again, and if it's the motor area of the hand then the hand will start moving years after the acute injury, which is something that was unbelievable to me. I have been taught in medical school that such neuroplasticity so late after the acute injury cannot happen, but we see it," he said.
    Irit Baruch was one of those involved in the study, and says HBOT has transformed her life. She suffered a catastrophic stroke while at home.
    "Apparently I had an aneurysm, the blood has burst out inside my head, my head was terribly aching and I woke up my husband - it was the middle of the night - so I woke my husband up and told him to call the neighbour, who is a nurse. By the time she got here, it was a few minutes.. seconds, I lost consciousness," said Baruch.
    After her initial treatment Baruch was unable to speak and could only walk slowly, aided by helpers, with a zimmerframe. Now she can walk, talk, read, and live an independent life again.
    "In the beginning I couldn't walk. Now I can walk, maybe not in the best manner, but it is getting better. In the beginning I could not focus on (reading) the lines, now I can read. My speech is also more understandable," said Baruch.
    Efrati and Ben-Jacob believe their adaption of HBOT could help vast numbers of stroke patients deemed to be untreatable regain their independence. The treatment could also be applicable to other disorders such as Alzheimer's disease and vascular dementia in their early stages. Efrati said that, because brain disorders are recognised to be related to inefficient energy supply to the brain, HBOT treatment could correct such metabolic abnormalities before the onset of full dementia, while there is still potential for recovery.
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