Hyperbaric Oxygen Treatment of Dementia and Mild Cognitive Impairment
Some of the most important skills each person uses every day are cognitive skills. These core skills are needed for reading, writing, remembering, paying attention, and reasoning. Cognitive skills are imperative for everyday function and processing, especially of new information. Aging does bring a decline in some cognitive skills, but when a person’s cognitive decline accelerates faster than “normal aging” it is considered Mild Cognitive Impairment or MCI. Further decline eventually reaches the level of global cognitive impairment and the diagnosis of dementia. This decline has multiple individual causes or can result from the accumulation of a variety of lifelong insults to the brain such as tobacco, alcohol, and drugs, traumatic brain injury, toxins, chemicals, strokes, blood vessel (vascular) disease, high blood pressure, diabetes, etc. Hyperbaric oxygen treatment has been proven to help treat symptoms and even reverse the decline for many patients.
What is Dementia and what are the effects of Dementia?
Mild cognitive impairment, or MCI, is characterized by symptoms of memory loss, lessened ability to reason or make decisions, forgetfulness, reduction of time management skills, depression, and anxiety. These symptoms may stay the same for several years or may progress quickly. When they progress to the point of global cognitive impairment MCI becomes dementia. Dementia, but the risk is higher. The symptoms of dementia are the same as MCI but are more severe and can also include more serious vision problems, trouble speaking or reading, social withdrawal, and intense mood swings. These symptoms are not only difficult for the patient, but also for family members and friends.
The classification of dementias is very confusing and seemingly disorganized. Alzheimer’s, responsible for 60-80% of dementias used to be pre-senile dementia, occurring in middle age. Now, it is difficult to define and only confirmed on autopsy. Other dementias are classified based on the regions of the brain primarily involved, e.g. Frontal Dementia (Pick’s Dementia), Fronto-Temporal Dementia, on the cause, e.g. Vascular Dementia (blood vessel disease and strokes) and Creutzfeldt-Jakob Disease (slow viruses), underlying pathology (Lewy-Body Dementia), or genetics (Huntington’s Disease). Regardless of type they are characterized by deficiencies in multiple areas of function: complex attention (focus and switching focus between tasks), learning and memory, executive function (thinking, planning, organizing), language, perceptual-motor (understanding shapes, objects, directions), and social cognition (recognizing people’s facial expressions and behaviors to interact appropriately). More importantly, many of these result from wounds to the brain. Viewed in this context HBOT, a treatment for wounds in any location and of any duration, is a rational choice to treat dementia.
Benefits of Hyperbaric Oxygen Treatment for Dementia
HBOT treatment of dementia began in the 1960s. Multiple studies have been published with conflicting results, however, much of this conflict is likely due to different doses of HBOT employed. The benefits of HBOT in treatment of dementia and MCI can be experienced at any time in a course of hyperbaric treatment. Hyperbaric oxygen treatment of dementia and MCI can improve symptoms and even stabilize a patient’s decline, especially with intermittent treatment over longer periods of time. Brain blood flow scans have shown improvement in blood flow in patients with MCI and dementia treated with HBOT. Exactly how and why this occurs is not yet understood, but it is known that HBOT helps a patient’s body to heal itself through increased oxygen. Brain shrinkage and reduced blood flow to the brain’s tissues are partial causes of this kind of impairment, which hyperbaric oxygen treatment can improve or even reverse. With increased oxygen and blood flow to the brain, tissues that would not otherwise heal can become functional again. The application of HBOT to people with dementia and MCI is expanding. Much of the progress began at our clinic in 1989 with the treatment of the first chronic traumatic encephalopathy (CTE) patient, an ex-world champion boxer with dementia pugilistica. Multiple other patients were treated and eventually the first Alzheimer’s patient in 2001 (see below). The experience at our clinic has been ground-breaking and encouraging for people who experience MCI and dementia.
Why Come to Dr. Harch for Hyperbaric Oxygen Treatment of Dementia
Dr. Harch has been treating and researching the neurological applications of HBOT for over three decades. He has developed a methodology for evaluating patients with neurological disease and dosing HBOT to their condition. FDA-approved drugs have achieved limited success in decreasing symptoms and delaying decline for just a few months. While success varies with different types of dementia and HBOT is not known to cure any dementia, our patients are experiencing improved symptoms, quality of life, and more sustained durations of improvements. HBOT is safe, effective, and FDA approved for numerous uses, all of which are wounding conditions. Complications are rare and side effects are usually minor and manageable, especially when the dosing has been carefully measured for each patient.
Patients who receive HBOT at our clinic have experienced increases in brain function on brain imaging that is responsible for decreased confusion, improved memory skills, functionality, and quality of. These benefits are best sustained by additional intermittent treatment on a longer term basis. Proper dosage and care plans make all the difference in treating dementia and MCI with HBOT.
Hyperbaric Oxygen Treatment of Dementia Case Study
Mr. Earl was a 72 year old man facing institutionalization after the death of his wife. Unbeknownst to the extended family irascible Mr. Earl wasn’t much different from the way they had come to accept him after decades of smoking, drinking, brawling, traumatic brain injuries, and an episode of carbon monoxide poisoning. After the death of his wife it became obvious that Mr. Earl had been supported and sustained by his wife. It was apparent he was not able to care for himself. Over the course of four months he had increasing nightly confusion, memory loss, and paranoia, requiring 5 hospital admissions for intestinal bleeding and confusion. Eventually, he had to be removed from his son’s home due to uncontrollable behavior. During his airline flight to New Orleans for HBOT treatment he deteriorated at altitude, resulting in an air marshall incident and emergency hospital admission on landing in Houston. An extensive evaluation failed to identify other causes of Mr. Earl’s “normal aging.” Following brief testing which showed a Folstein Mini-Mental Status (MMSE) score of 15 (dementia is highly suggested with a score less than 25) Mr. Earl underwent SPECT brain imaging before and after a single HBOT.
Mr. Earl received 40 HBOT’s in one month and experienced a reversal of his dementia with generalized cognitive improvement, increased energy, decreased SOB and confusion, improved sleep, weight gain, and a Folstein MMSE of 23. Repeat SPECT brain imaging showed a global improvement in brain blood flow consistent with his improved condition. Mr. Earl returned to his home to live semi-independently (son lived nearby and helped with groceries and local travel) for the rest of his life.
Mr. Earl’s SPECT scan before HBOT: note the multiple holes in the frontal lobes, the coarse surface of the brain, and the fragmented blood flow in the temporal lobes. Note also the irregular appearance of the blood flow on the slices (on the right side of the picture).
Mr. Earl’s SPECT scan after one HBOT: note the dramatic filling in of the areas of low blood flow in the frontal lobes and temporal lobes. Also, the slices on the right side of the picture show overall better blood flow with less purple and a smoother appearance to the slices.
Note: A SPECT scan is often performed before HBOT and again after one HBOT to display recoverable brain tissue. In order for the increased blood flow to be more permanent, at least approximately 40 treatments are then completed.
Mr. Earl’s SPECT scan after 40 HBOTs: Again, the changes seen after the first HBOT on SPECT are seen after 40 HBOTs, but are now more permanent. Note the overall smoother texture to the slices on the right side of the picture. This global improvement in blood flow is consistent and responsible for Mr. Earl’s overall improved cognition.
