Hyperbaric Oxygen Treatment-From Mechanisms to Cognitive Improvement

Irit Gottfried, Nofar Schottlender, Uri Ashery, Irit Gottfried, Nofar Schottlender, Uri Ashery

Abstract

Hyperbaric oxygen treatment (HBOT)-the medical use of oxygen at environmental pressure greater than one atmosphere absolute-is a very effective therapy for several approved clinical situations, such as carbon monoxide intoxication, incurable diabetes or radiation-injury wounds, and smoke inhalation. In recent years, it has also been used to improve cognition, neuro-wellness, and quality of life following brain trauma and stroke. This opens new avenues for the elderly, including the treatment of neurological and neurodegenerative diseases and improvement of cognition and brain metabolism in cases of mild cognitive impairment. Alongside its integration into clinics, basic research studies have elucidated HBOT's mechanisms of action and its effects on cellular processes, transcription factors, mitochondrial function, oxidative stress, and inflammation. Therefore, HBOT is becoming a major player in 21st century research and clinical treatments. The following review will discuss the basic mechanisms of HBOT, and its effects on cellular processes, cognition, and brain disorders.

Keywords: Alzheimer’s disease; brain disorders; cognition; hyperbaric oxygen treatment (HBOT); neuroinflammation; neuroprotection.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
HBOT improves brain function. HBOT has been shown to improve cerebral blood flow, brain metabolism, and brain microstructure, leading to improved cognitive functions, physical functions, sleep, and gait.
Figure 2
Figure 2
HBOT affects multiple cellular and molecular pathways. HBOT affects several molecular and cellular pathways that are important for cellular and neuronal recovery including neuroprotection via SIRT1, oxidative stress via SIRT1 and Nrf-2, apoptosis via SIRT1, neurogenesis via Wnt3. Green frames represent proteins and processes that are upregulated; red frames represent proteins and processes that are downregulated. Abbreviations: nuclear factor erythroid 2-related factor 2 (Nrf-2), nuclear factor kappa B (NF-κB), Hypoxia-Inducible Factor 1-alpha (HIF1a), heme oxygenase 1 (HO-1), superoxide dismutase 1 (SOD1), malondialdehyde (MDA), B-cell lymphoma 2 (Bcl2), Bcl-2-associated X protein (Bax), vascular endothelial growth factor (VEGF-A), Glutathione-S-transferases (GST), Glutathione Peroxidase (GPx), tumor necrosis factor alpha (TNFa), Wnt Family Member 3 (Wnt3).

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