1,354 research outputs found

    Neurobiological insight into hyperbaric hyperoxia

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    Aim: Hyperbaric hyperoxia (HBO) is known to modulate aerobic metabolism, vasoreactivity and blood flow in the brain. Nevertheless, mechanisms underlying its therapeutic effects, especially in traumatic brain injury (TBI) and stroke patients, are debated. The present study aimed at investigating regional cerebral blood flow (rCBF) distribution during acute HBO exposure. Methods: Regional cerebral blood flow response was investigated in seven healthy subjects exposed to either normobaric normoxia or HBO with ambient pressure/inspired oxygen pressure of 101/21 and 250/250 kPa respectively. After 40 min at the desired pressure, they were injected a perfusion tracer and subsequently underwent brain single photon emission computed tomography. rCBF distribution changes in the whole brain were assessed by Statistical Parametric Mapping. Results: During HBO, an increased relative rCBF distribution was found in sensory-motor, premotor, visual and posterior cingulate cortices as well as in superior frontal gyrus, middle/inferior temporal and angular gyrus and cerebellum, mainly in the dominant hemisphere. During normobaric normoxia, a higher 99mTc-HMPAO distribution in the right insula and subcortical structures as well as in bilateral hippocampi and anterior cingulated cortex was found. Conclusions: The present study firstly confirmed the rCBF distribution increase during HBO in sensory-motor and visual cortices, and it showed for the first time a higher perfusion tracer distribution in areas encompassed in dorsal attention system and in default mode network. These findings unfold both the externally directed cognition performance improvement related to the HBO and the internally directed cognition states during resting-state conditions, suggesting possible beneficial effects in TBI and stroke patients

    Application of medical gases in the field of neurobiology

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    Medical gases are pharmaceutical molecules which offer solutions to a wide array of medical needs. This can range from use in burn and stroke victims to hypoxia therapy in children. More specifically however, gases such as oxygen, helium, xenon, and hydrogen have recently come under increased exploration for their potential theraputic use with various brain disease states including hypoxia-ischemia, cerebral hemorrhages, and traumatic brain injuries. As a result, this article will review the various advances in medical gas research and discuss the potential therapeutic applications and mechanisms with regards to the field of neurobiology

    Phase II trial of radiotherapy after hyperbaric oxygenation with chemotherapy for high-grade gliomas

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    We conducted a phase II trial to evaluate the efficacy and toxicity of radiotherapy immediately after hyperbaric oxygenation (HBO) with chemotherapy in adults with high-grade gliomas. Patients with histologically confirmed high-grade gliomas were administered radiotherapy in daily 2 Gy fractions for 5 consecutive days per week up to a total dose of 60 Gy. Each fraction was administered immediately after HBO with the period of time from completion of decompression to irradiation being less than 15 min. Chemotherapy consisted of procarbazine, nimustine (ACNU) and vincristine and was administered during and after radiotherapy. A total of 41 patients (31 patients with glioblastoma and 10 patients with grade 3 gliomas) were enrolled. All 41 patients were able to complete a total radiotherapy dose of 60 Gy immediately after HBO with one course of concurrent chemotherapy. Of 30 assessable patients, 17 (57%) had an objective response including four CR and 13 PR. The median time to progression and the median survival time in glioblastoma patients were 12.3 months and 17.3 months, respectively. On univariate analysis, histologic grade (P=0.0001) and Karnofsky performance status (P=0.036) had a significant impact on survival, and on multivariate analysis, histologic grade alone was a significant prognostic factor for survival (P=0.001). Although grade 4 leukopenia and grade 4 thrombocytopenia occurred in 10 and 7% of all patients, respectively, these were transient with no patients developing neutropenic fever or intracranial haemorrhage. No serious nonhaematological or late toxicities were seen. These results indicated that radiotherapy delivered immediately after HBO with chemotherapy was safe with virtually no late toxicity in patients with high-grade gliomas. Further studies are required to strictly evaluate the effectiveness of radiotherapy after HBO for these tumours

    Effects of hyperoxia on 18F-fluoro-misonidazole brain uptake and tissue oxygen tension following middle cerebral artery occlusion in rodents: Pilot studies.

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    PURPOSE: Mapping brain hypoxia is a major goal for stroke diagnosis, pathophysiology and treatment monitoring. 18F-fluoro-misonidazole (FMISO) positron emission tomography (PET) is the gold standard hypoxia imaging method. Normobaric hyperoxia (NBO) is a promising therapy in acute stroke. In this pilot study, we tested the straightforward hypothesis that NBO would markedly reduce FMISO uptake in ischemic brain in Wistar and spontaneously hypertensive rats (SHRs), two rat strains with distinct vulnerability to brain ischemia, mimicking clinical heterogeneity. METHODS: Thirteen adult male rats were randomized to distal middle cerebral artery occlusion under either 30% O2 or 100% O2. FMISO was administered intravenously and PET data acquired dynamically for 3hrs, after which magnetic resonance imaging (MRI) and tetrazolium chloride (TTC) staining were carried out to map the ischemic lesion. Both FMISO tissue uptake at 2-3hrs and FMISO kinetic rate constants, determined based on previously published kinetic modelling, were obtained for the hypoxic area. In a separate group (n = 9), tissue oxygen partial pressure (PtO2) was measured in the ischemic tissue during both control and NBO conditions. RESULTS: As expected, the FMISO PET, MRI and TTC lesion volumes were much larger in SHRs than Wistar rats in both the control and NBO conditions. NBO did not appear to substantially reduce FMISO lesion size, nor affect the FMISO kinetic rate constants in either strain. Likewise, MRI and TTC lesion volumes were unaffected. The parallel study showed the expected increases in ischemic cortex PtO2 under NBO, although these were small in some SHRs with very low baseline PtO2. CONCLUSIONS: Despite small samples, the apparent lack of marked effects of NBO on FMISO uptake suggests that in permanent ischemia the cellular mechanisms underlying FMISO trapping in hypoxic cells may be disjointed from PtO2. Better understanding of FMISO trapping processes will be important for future applications of FMISO imaging

    New Treatment Options for Concussions Using Hyperbaric Oxygen Therapy

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    Background: Millions of Americans experience concussions every year. With new attention from the media looking into the long-term sequela of concussions, more research and studies are initiated to find an effective treatment. Concussions happen after an impact to the head or body that causes a pathologic disruption in normal brain function. Symptoms most commonly associated with the trauma are headaches, emotional distress, vestibular disturbances and sensitivity to light. Historically, treatment has been physical and cognitive rest. Methods: A systematic search of PubMed was performed to identify articles pertaining to the use of hyperbaric oxygen therapy in concussions and traumatic brain injuries in all settings including; adults and children, sports related, civilian and service members. Clinical trials, review articles and animal studies were included, and research was synthesized to review the effect of hyperbaric oxygen therapy on concussions. Hyperbaric Oxygen Therapy: Treatment employs increased atmospheric pressures and 100% oxygen to diffuse pure oxygen into hemoglobin and plasma, increasing oxygen saturation in hypoxic environments by as much as 700%. Hyperbaric oxygen therapy is not a new treatment but has not been approved for many neurological diseases. Use of this therapy has been found to be quite safe and research has proven it to be effective. Conclusion: More studies on the use of hyperbaric oxygen for concussion therapy is needed to support evidence-based medical decision making. Optimistic civilian and military patients worldwide hope that research will continue, and hyperbaric oxygen therapy will become a mainstay treatment for all scopes of severity in traumatic brain injuries

    Partial pressure of oxygen in the human body: a general review

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    The human body is a highly aerobic organism, in which it is necessary to match oxygen supply at tissue levels to the metabolic demands. Along metazoan evolution, an exquisite control developed because although oxygen is required as the final acceptor of electron respiratory chain, an excessive level could be potentially harmful. Understanding the role of the main factors affecting oxygen availability, such as the gradient of pressure of oxygen during normal conditions, and during hypoxia is an important point. Several factors such as anaesthesia, hypoxia, and stress affect the regulation of the atmospheric, alveolar, arterial, capillary and tissue partial pressure of oxygen (PO2). Our objective is to offer to the reader a summarized and practical appraisal of the mechanisms related to the oxygen's supply within the human body, including a facilitated description of the gradient of pressure from the atmosphere to the cells. This review also included the most relevant measuring methods of PO2 as well as a practical overview of its reference values in several tissues

    Oxygen, a Key Factor Regulating Cell Behavior during Neurogenesis and Cerebral Diseases

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    Oxygen is vital to maintain the normal functions of almost all the organs, especially for brain which is one of the heaviest oxygen consumers in the body. The important roles of oxygen on the brain are not only reflected in the development, but also showed in the pathological processes of many cerebral diseases. In the current review, we summarized the oxygen levels in brain tissues tested by real-time measurements during the embryonic and adult neurogenesis, the cerebral diseases, or in the hyperbaric/hypobaric oxygen environment. Oxygen concentration is low in fetal brain (0.076–7.6 mmHg) and in adult brain (11.4–53.2 mmHg), decreased during stroke, and increased in hyperbaric oxygen environment. In addition, we reviewed the effects of oxygen tensions on the behaviors of neural stem cells (NSCs) in vitro cultures at different oxygen concentration (15.2–152 mmHg) and in vivo niche during different pathological states and in hyperbaric/hypobaric oxygen environment. Moderate hypoxia (22.8–76 mmHg) can promote the proliferation of NSCs and enhance the differentiation of NSCs into the TH-positive neurons. Next, we briefly presented the oxygen-sensitive molecular mechanisms regulating NSCs proliferation and differentiation recently found including the Notch, Bone morphogenetic protein and Wnt pathways. Finally, the future perspectives about the roles of oxygen on brain and NSCs were given

    Diseases Treated With Hyperbaric Oxygen Therapy; a Literature Review

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    Hyperbaric oxygen therapy (HBO) is defined as the inhalation of 100% oxygen inside a hyperbaric chamber that is pressurized to greater than 1 atmosphere (Atm). Typical HBO regimens use 1.5 to 2.5 Atm pressure for durations of 30 to 90 minutes, repeated multiple times. The time between and the total number of repeat sessions varies widely. The effectiveness of hyperbaric oxygen therapy for treatment of some diseases such as intravascular emboli, decompression sickness, anaerobic infections, CO poisoning was confirmed. For some diseases, such as traumatic brain injuries, the effectiveness of hyperbaric oxygen therapy as described by investigators is controversial. Chinese authors have reported many articles regarding treatment of neonatal hypoxia with hyperbaric oxygen therapy, but in other points of the world, this depth of experience does not exist. Recently, some other diseases, such as purpura fulminans, and pancreatitis, have been treated by hyperbaric oxygen therapy. In conclusion, if equipment for hyperbaric oxygen therapy is available, many patients will benefit by this method of treatment

    Inhaled Oxygen as a Quantitative Intravascular MRI Contrast Agent

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    Increasing the fraction of inspired oxygen (FiO2) generates MR contrast by two distinct mechanisms: increased T2 from deoxyhemoglobin dilution in venous compartments (blood oxygenation level-dependent effect or BOLD) and reduced TΒ­1 from paramagnetic molecular oxygen dissolved in blood plasma and tissues. Many research and clinical applications using hyperoxic contrast have recently emerged, including delineating ischemic stroke penumbra, oxygen delivery to tumors, and functional MRI data calibration. However, quantitative measurements using this contrast agent depend on the precise knowledge of its effects on the MR signal – of which there remain many crucial missing pieces. This thesis aims to obtain a more quantitative understanding of intravascular hyperoxic contrast in vivo, with the hope of increasing its precision and utility. Specifically, our work focuses on the following areas: (1) paramagnetic effects of molecular oxygen BOLD and arterial spin labeling (ASL) data, (2) degree and temporal characteristics of hyperoxia-induced reductions in cerebral blood flow (CBF), (3) use of oxygen in quantitative measurements of metabolism, and (4) biophysical mechanisms of hyperoxic T1 contrast. In Chapter 2, the artifactual influence of paramagnetic molecular oxygen on BOLD-modulated hyperoxic gas studies is characterized as a function of static field strength, and we show that optimum reduction in FiO2 mitigates this effect while maintaining BOLD contrast. Since ASL measurements are highly sensitive to arterial blood TΒ­1 (T1a), the value of T1a in vivo is determined as a function of arterial oxygen partial pressure in Chapter 3. The effect of both the degree and duration of hyperoxic exposure on absolute CBF are quantified using simultaneous ASL and in vivo T1a measurements, as described in Chapter 4. In Chapter 5, hyperoxic gas calibration of BOLD/ASL data is used to measure cerebral oxygen metabolism in a hypermetabolic swine model, with our results comparing favorably to 17O2 measurements of absolute metabolism. In Chapter 6, a model to describe the relationship between CBF, oxygen consumption, and hyperoxic T1 reduction is developed, which allows for a more rigorous physiological interpretation of these data. Taken together, this work represents several important steps towards making hyperoxia a more quantitative MRI contrast agent for research and clinical applications

    Respiratory challenge MRI: practical aspects

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    Respiratory challenge MRI is the modification of arterial oxygen (PaO2) and/or carbon dioxide (PaCO2) concentration to induce a change in cerebral function or metabolism which is then measured by MRI. Alterations in arterial gas concentrations can lead to profound changes in cerebral haemodynamics which can be studied using a variety of MRI sequences. Whilst such experiments may provide a wealth of information, conducting them can be complex and challenging. In this paper we review the rationale for respiratory challenge MRI including the effects of oxygen and carbon dioxide on the cerebral circulation. We also discuss the planning, equipment, monitoring and techniques that have been used to undertake these experiments. We finally propose some recommendations in this evolving area for conducting these experiments to enhance data quality and comparison between techniques
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