Multiple Sclerosis (MS)

Multiple Sclerosis (MS) Is a complex neurodegenerative disease that is currently incurable. The disease can cause problems with balance, muscle control, vision and other basic bodily functions. MS is thought to be an autoimmune disease in which the body attacks (in variable degrees) myelin, the fatty sheaths that insulate nerves, producing symptoms from mild to significant physical disabilities. Basically, MS is a chronic inflammatory disease of the brain. The hallmark of MS is symptomatic episodes that occur months or years apart (relapses) followed by times of recovery (remission). Current approaches to treatment include 1) prevention of disease progression and reduction in relapse rate 2) treatment of acute exacerbations 3) treatment of chronic symptoms. Despite new treatments and technologies, therapies to control inflammation and physical symptoms remain ineffective. Symptoms include trouble walking, fatigue, muscle weakness or spasms, double vision, numbness/tingling, sexual problems, poor bowel/bladder control, pain, depression, problems focusing.

Hyperbaric oxygen therapy (HBOT) has been postulated to modify progression of disease and reduce relapse rate, but not control acute exacerbations or chronic symptoms. (Thom 2008). Response has been shown to be better in patients with less advance disease and related to frequency and continuity of treatment.

HBOT Research Shows:

  • Reduces inflammation 
  • Modulates overactive immune system 
  • Relieves tissue hypoxia leading to resumption of normal aerobic metabolism 
  • Nerve cell damage protection 
  • Maintain integrity of blood brain barrier 
  • Help damaged tissue regeneration 
  • May reduce fatigue and cognitive impairment 

Benefits of HBOT for Multiple Sclerosis (MS):

Increases Amount of Oxygen in the Blood

Stimulates development of new blood vessels from pre-existing vessels as well as the natural development of new blood vessels.

Reduces Inflammation & Swelling

Suppresses the cellular activity of the immune system which triggers swelling when an injury or damage to the body occurs.  While this reaction is meant to start healing and protect from injury it can result in secondary injury, pain, and prolonged recovery time.

Preserves, Repairs, & Enhances Cellular Functions

Boosts cellular metabolism, promotes rapid cell reproduction, and enhances collagen synthesis. Collagen is a protein in connective tissues like skin.

Key Research on Hyperbaric Oxygen Treatment for Multiple Sclerosis (MS)

Hyperbaric oxygen and multiple sclerosis: final results of a placebo-controlled, double-blind trial.

The long term results are reported of a trial involving 120 patients with chronic multiple sclerosis who were randomised to receive either 100% oxygen at 2 atmospheres absolute (ATA) for 90 minutes daily for 20 sessions or placebo therapy with air using a simulated compression procedure. The previous finding of subjective improvement in bowel/bladder function at the end of treatment was not confirmed by objective urodynamic assessment. The treatment did not alter disease progression as measured by the Kurtzke disability status scale nor did it alter the rate of acute relapse. There was less deterioration in cerebellar function at one year in the treated patients as measured by the Kurtzke functional systems scale. No other differences were found between the two groups. Psychometric tests and measurements of lymphocyte sub-populations showed no treatment related effects. Evoked potential studies showed no improvements but there was a significant reduction in amplitude of the visual evoked potential in the treated patients at the end of therapy. This might indicate a reversible degree of retinal damage induced by oxygen toxicity.

Recent News on Hyberbaric Oxygen Treatment for Multiple Sclerosis (MS)

Additional Research

Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews.

Multiple sclerosis (MS) is a major cause of chronic, neurological disability, with a significant long-term disability burden, often requiring comprehensive rehabilitation. To systematically evaluate evidence from published Cochrane Reviews of clinical trials to summarise the evidence regarding the effectiveness and safety of rehabilitation interventions for people with MS (pwMS), to improve patient outcomes, and to highlight current gaps in knowledge. We searched the Cochrane Database of Systematic Reviews up to December 2017, to identify Cochrane Reviews that assessed the effectiveness of organised rehabilitation interventions for pwMS. Two reviewers independently assessed the quality of included reviews, using the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) tool, and the quality of the evidence for reported outcomes, using the GRADE framework. Overall, we included 15 reviews published in the Cochrane Library, comprising 164 randomised controlled trials (RCTs) and four controlled clinical trials, with a total of 10,396 participants. The included reviews evaluated a wide range of rehabilitation interventions, including: physical activity and exercise therapy, hyperbaric oxygen therapy (HBOT), whole-body vibration, occupational therapy, cognitive and psychological interventions, nutritional and dietary supplements, vocational rehabilitation, information provision, telerehabilitation, and interventions for the management of spasticity.

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Manipulation of Oxygen and Endoplasmic Reticulum Stress Factors as Possible Interventions for Treatment of Multiple Sclerosis: Evidence for and Against.

Multiple sclerosis (MS) is normally considered a chronic inflammatory disease of the central nervous system (CNS), where T-cells breaching the blood brain barrier react against proteins of the axonal myelin sheaths, leading to focal plaques and demyelination in the brain and spinal cord. Many current therapies are immunosuppressive in nature and are designed to target the immune system at an early stage of the disease. But there is no cure and MS may evolve into a neurodegenerative disease, where immunomodulatory treatments appear less effective. Neurodegeneration is influenced by oxidative and endoplasmic reticulum (ER) mediated stress which can be induced independently of immune processes. Since 1970, MS patients have been self-managing their long term symptoms using hyperbaric oxygen and reporting improvement in their symptoms, especially bladder control.

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Brain perfusion imaging with voxel-based analysis in secondary progressive multiple sclerosis patients with a moderate to severe stage of disease: a boon for the workforce.

The present study was carried out to evaluate cerebral perfusion in multiple sclerosis (MS) patients with a moderate to severe stage of disease. Some patients underwent hyperbaric oxygen therapy (HBOT) and brain perfusion between before and after that was compared. We retrospectively reviewed 25 secondary progressive (SP)-MS patients from the hospital database. Neurological disability evaluated by Expanded Disability Status Scale Score (EDSS). Brain perfusion was performed by (99 m) Tc-labeled bicisate (ECD) brain SPECT and the data were compared using statistical parametric mapping (SPM). In total, 16 patients underwent HBOT. Before HBOT and at the end of 20 sessions of oxygen treatment, 99mTc-ECD brain perfusion single photon emission computed tomography (SPECT) was performed again then the results were evaluated and compared. Brain perfusion was performed by (99 m) Tc-labeled bicisate (ECD) brain SPECT and the data were compared using statistical parametric mapping (SPM). A total of 25 SP-MS patients, 14 females (56 %) and 11 males (44 %) with a mean age of 38.92 ± 11.28 years included in the study. The mean disease duration was 8.70 ± 5.30 years. Of the 25 patients, 2 (8 %) had a normal SPECT and 23 (92 %) had abnormal brain perfusion SPECT studies. The study showed a significant association between severity of perfusion impairment with disease duration and also with EDSS (P <0.05). There was a significant improvement in pre- and post-treatment perfusion scans (P <0.05)

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Observations on the brain vasculature in multiple sclerosis: A historical perspective.

To review the literature on vascular aspects of multiple sclerosis (MS) specifically pathological observations of the perivenular distribution of MS lesions and venous pathology in MS. Comprehensive literature search from 2012 back to 1839. One hundred and thirty two papers from 1839 to 2012 were included in this study. Multiple authors observed central venules in MS lesions as a feature of MS with the first specific mention by Rindfleisch in 1863. Recent high field strength MRI has reintroduced the perivenular distribution of MS lesions to a new generation, and has suggested that there is disease specificity to this distribution. In addition Putnam and others in the 1930s hypothesized that venous disease was causative for MS. Treatments based on these observations have included anticoagulation, hyperbaric oxygen therapy, and recently endovascular venous procedures.

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Complementary and alternative medicine in multiple sclerosis.

Complementary and alternative medicine (CAM) is used by one-half to three-fourths of patients with multiple sclerosis (MS). Despite this widespread use, CAM may not be discussed in the course of a conventional medical visit. When considered in the context of MS, CAM therapies have a wide range of risk-benefit profiles. Some CAM therapies, such as acupuncture, cranberry, vitamin D, tai chi, and yoga, are low risk and possibly beneficial. Other CAM therapies, such as immune-stimulating supplements, bee venom, and hyperbaric oxygen, are ineffective, dangerous, or unstudied. Providing access to information about the risks and benefits of CAM therapies may increase the quality of care that is provided to patients with MS.

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Mechanism of lysine oxidation in human lens crystallins during aging and in diabetes.

Oxidative mechanisms during nuclear sclerosis of the lens are poorly understood, in particular metal-catalyzed oxidation. The lysyl oxidation product adipic semialdehyde (allysine, ALL) and its oxidized end-product 2-aminoadipic acid (2-AAA) were determined as a function of age and presence of diabetes. Surprisingly, whereas both ALL and 2-AAA increased with age and strongly correlated with cataract grade and protein absorbance at 350 nm, only ALL formation but not 2-AAA was increased by diabetes. To clarify the mechanism of oxidation, rabbit lenses were treated with hyperbaric oxygen (HBO) for 48 h, and proteins were analyzed by gas and liquid chromatography mass spectrometry for ALL, 2-AAA, and multiple glycation products. Upon exposure to HBO, rabbit lenses were swollen, and nuclei were yellow. Protein-bound ALL increased 8-fold in the nuclear protein fractions versus controls. A dramatic increase in methyl-glyoxal hydroimidazolone and carboxyethyl-lysine but no increase of 2-AAA occurred, suggesting more drastic conditions are needed to oxidize ALL into 2-AAA. Indeed the latter formed only upon depletion of glutathione and was catalyzed by H(2)O(2).

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Hyperbaric oxygenation in fluid microembolism.

Because clinicians require objectively demonstrable neurological deficits to confirm a diagnosis, the recognition of embolic events in the nervous system is generally restricted to the effects of ischemic necrosis produced by arterial occlusion. However, magnetic resonance imaging (MRI) has shown that lesser degrees of damage associated with small emboli are common, especially in the mid brain, and are usually clinically silent. They are frequently associated with atheromatous embolism in the elderly, but microembolic debris, such as fat, is common in the systemic venous return of healthy people and generally trapped in the microcirculation of the lung being removed by phagocytosis. However, pulmonary filtration may fail and microemboli may also pass through an atrial septal defect in so-called ‘paradoxical’ embolism. Studies of bubbles formed on decompression in diving have demonstrated the importance of pulmonary filtration in the protection of the nervous system and that filtration is size dependant, as small bubbles may escape entrapment. Fluid and even small solid emboli, arresting in or passing through the cerebral circulation, do not cause infarction, but disturb the blood-brain barrier inducing what has been termed the ‘perivenous syndrome’.

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Alternative and complementary therapies in multiple sclerosis.

Most MS patients use unconventional therapies, usually as complementary measures in addition to the conventional treatment. Only a few adequate clinical trials exist in this field. By definition, the efficacy of these therapies is unproven. Moreover, the possible risks are also largely unknown. Some therapies rely on rational pathophysiological considerations, other must be regarded as potentially harmful. The influence of diet on MS is unproven. Possibly, unsaturated fatty acids are beneficial. However, a few randomized trials yielded inconclusive results. Long-term supplementation of Vitamin D is associated with a decreased MS incidence. There is, however, insufficient evidence for an influence of Vitamin D on the course of the disease. Because of the high prevalence of osteoporosis in MS patients, prophylaxis with Vitamin D and Calcium is widely accepted. The effects of various minerals, selenium, antioxidant compounds, fish oil or vitamins remain speculative.

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References
  1. Barnes, MP et al: Hyperbaric oxygen and multiple sclerosis: final results of a placebo-controlled, double-blind trial. J Neurol Neurosurg Psychiatry 50(11):1402-6, 1987)
  2. Fischer BH, Marks M, Reich T. Hyperbaric-oxygen treatment of multiple sclerosis: a randomized, placebo-controlled, double-blind study. N Engl J Med 1983; 308:181-6
  3. https://www.nejm.org/doi/full/10.1056/NEJM198301273080402?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed

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