Healthy Living
Brain Injury
By David Perlmutter, MD, FACN
Until quite recently, precious few therapeutic modalities were available to hasten the recovery of damaged neurons in head injured individuals. Medical science has explored a wide variety of avenues to achieve this goal including nutritional support, medications designed to act as "metabolic enhancers," and creative forms of physical and cognitive rehabilitative techniques. Unfortunately, even under the best of circumstances, significant recovery is often limited.
Now, a new and exciting technique which involves increasing the oxygenation of brain tissue, has now been demonstrated to have profound potential in improving brain function in these patients. Hyperbaric oxygen therapy is actually a fairly simple technique in which patients are exposed to pure oxygen under increased atmospheric pressure for a specified length of time. In fact, hyperbaric oxygen therapy is not new on the medical scene - it has been used for decades as a means of enhancing tissue oxygenation to improve would healing, salvage limbs which would otherwise have been amputated due to poor blood supply, and in a variety of other conditions characterized by poor blood flow and oxygenation.
In a recent article appearing in the Southern Medical Journal, Dr. Richard Neubauer, a pioneer in the use of hyperbaric oxygen therapy for brain disorders, demonstrated profound improvements of brain metabolic activity in brain injured patients. (See Book Review in this issue.) His research utilized a specific form of brain imaging, SPECT, to detect changes of brain metabolic activity following hyperbaric oxygen therapy treatment. Specifically, Dr. Neubauer believes that the target of hyperbaric oxygen therapy are those neurons that although compromised in their function, still retain viability. Dr. Neubauer calls these damaged nerve cells "idling neurons," implying that their metabolic machinery can be enhanced. As he states, "Brain injuries, regardless of their cause, share common pathophysiologic pathways that result in the destruction of neurons, and, to a varying extent, formation of idling neurons." Further, he stated that various forms of brain injury have " … a common pathophysiology and may include a penumbra of recoverable tissue. We propose that hyperbaric oxygen therapy be used routinely as an early diagnostic tool and as an adjunct to physical rehabilitation for patients with brain injuries. We also believe that research in this area would be promising."
In various other countries including South Korea, Japan, China, Russia, Italy, Germany, and Great Britain, hyperbaric oxygen therapy is routinely used as an adjunctive treatment for various forms of brain injury. Its therapeutic usefulness is likely a result of a variety of factors. First, hyperbaric oxygen leads to stabilization of cell membranes within the brain providing an improved environment for metabolic activity. Second, the increased oxygen levels provided by hyperbarics activates specific white blood cells which function to clear debris left by the damaging event. Third, the level of brain free radicals is reduced. These are damaging chemicals which result as a consequence of normal brain metabolism. Fourth, and perhaps most importantly, hyperbaric oxygen therapy dramatically increases the growth of new blood vessels to the damaged brain areas.
It is unclear why hyperbaric oxygen therapy, so widely used throughout the rest of the world, has not yet gained a significant foothold in the American armamentarium of therapeutic techniques for brain injury. Perhaps it is because oxygen itself cannot be patented and therefore cannot be promoted by a specific pharmaceutical company. Nevertheless, now that well respected scientific journals are publishing articles demonstrating the profound effectiveness of this technique, we will likely see greater availability of hyperbaric oxygen therapy in the United States in years to come.
To obtain more information about hyperbaric oxygen therapy call (941) 434-9OXY (434-9699).