Summary: Those who have PTSD who are unresponsive to traditional treatments have shown that hyperbaric oxygen therapy ( HBOT ) can help them with their symptoms. In a review of combat soldiers, HBOT led to significant decreases in flashes, anger, and hypervigilance, and was associated with increased mental communication on imaging scans. The professional process, developed over years, involves 60 sessions of breathe pure air under great pressure.
The findings provide a new hope for the “biological gash” linked to PTSD, according to the results. Researchers emphasize the need for skilled teams to treat patients in specific respiratory centers. Millions of people affected by PTSD may be helped by this treatment on a global scale.
Important Information:
- Veterans who were resistant to other medications had considerably reduced their Anxiety signs with HBOT.
- The treatment promotes mind connectivity and healing, noticeable on imaging scans.
- The treatment method involves 60 high-pressure sessions with real air.
Origin: Tel Aviv University
Researchers from Tel Aviv University and the Shamir Medical Center’s Sagol Center for Hyperbaric Medicine and Research have demonstrated that HBOT, which improves the condition of PTSD patients who have not responded to counseling or clinical drugs, improves their quality of life.
The researchers say,” Our exclusive therapeutic protocol affects the natural brain’ wound’ associated with PTSD, and essentially reduces common symptoms such as flashbacks, hypervigilance, and irritability. We think that thousands of PTSD patients and their families around the world can resurrect after learning about our findings.
Prof. Shai Efrati and Dr. Keren Doenyas-Barak from Tel Aviv University’s University of Medical and Health Sciences and the Shamir Medical Center’s Sagol Center for Hyperbaric Medicine and Research led the study. Another contributors include Dr. Ilan Kutz, Gabriela Levi, Dr. Erez Lang, Dr. Amir Asulin, Dr. Amir Hadanny, and Dr. Ilia Beberashvili from the Shamir Medical Center, and Dr. Kristoffer Aberg and Dr. Avi Mayo from the Weizmann Institute.
The report was  , published , in , The Journal of Clinical Psychiatry.
According to Prof. Efrati,” According to our terrible situation, Israel has become a world leader in the field of PTSD. Before the Hamas assault on Oct. 7, 2023, about 6, 000 Army soldiers had been recognized as PTSD patients, with many others, both soldiers and citizens, not but acknowledged by the government.
Following Oct. 7 and the ensuing conflict, these numbers have risen sharply. Tens of thousands of men, and much larger amounts of citizens, are likely to be diagnosed with PTSD.
” The Sagol Center for Hyperbaric Medicine, the largest of its kind in the earth, is rising to the challenge—with a complete medical array comprising hyperbaric facilities combined with various mental health professionals, psychologists and psychiatrists. We currently treat hundreds of PTSD sufferers each day, with an annual goal of one thousand.
Dr. Doenyas-Barak adds”, PTSD ( Post-Traumatic Stress Disorder ) is defined as the mental outcome of exposure to a life-threatening event. About 20 % of those who have undergone such an experience will develop PTSD, which can lead to substantial social, behavioral, and occupational dysfunctions.
In extreme cases, the disorder can severely impact their quality of life, family life, and professional performance. Symptoms include a range of emotional and cognitive changes, nightmares and flashbacks, hypervigilance, irritability, and avoidance—so as not to trigger traumatic experiences.
” In many cases, PTSD is resistant to psychotherapy and common psychiatric medications. Studies on those who are therapy-resistant have discovered changes in brain tissue structure and function, or a “biological wound” that accounts for such treatment resistance. In our study, we wanted to know whether hyperbaric therapy can benefit these patients.
The study, which began in 2019 and ended in the summer of 2023, included 98 male IDF veterans diagnosed with combat-associated PTSD, who had not responded to either psychotherapy or psychiatric medications.
Participants were divided into two groups: one group received HBOT treatment, breathing pure high-pressure oxygen, while the other went through the same procedure, but received a placebo treatment, breathing regular air. Twenty-eight members of each group completed the process and the following evaluation.
Dr. Doenyas-Barak explains,” The HBOT was administered in accordance with a unique treatment protocol developed at our center. In our hyperbaric chamber, each patient is exposed to pure, 100 % oxygen at a pressure of two atmospheres ( twice the normal air pressure at sea level ) for a series of 60 two-hour treatments.
Our protocol specifies that the patient alternately breathes regular air and oxygen every 20 minutes. The tissue-level oxygen level drop causes healing to begin and thus enhances the therapeutic effect.
The results were encouraging, with improvements observed both at the clinical level and in fMRI imaging. The group receiving hyperbaric therapy also experienced a reduction in all typical PTSD symptoms in addition to improved brain network connectivity. In the placebo group, on the other hand, no change was observed in either the brain or clinical symptoms.
Prof. Efrati adds”, Our study demonstrated that HBOT induces biological healing in the brain of PTSD sufferers. Clinical symptoms are also affected by the biological wound being treated. We think that HBOT can help a large number of PTSD sufferers worldwide recover from their experiences and reclaim a normal life in their communities and families thanks to the specially developed protocol we have developed.
Prof. Efrati argues that only professional hyperbaric centers, where treatment is provided by multidisciplinary teams with experience in trauma care, should offer patients with PTSD HBOT. Unsupervised, private hyperbaric chambers are unable to provide the proven, effective protocol.
Additionally, thorough professional evaluations are essential to ensure that patients are suitable for HBOT and to determine what additional support is required throughout their treatment journey.
About this news from PTSD research
Author: Shai Efrati
Source: Tel Aviv University
Contact: Shai Efrati – Tel Aviv University
Image: The image is credited to Neuroscience News
Original Research: Open access.
By Shai Efrati and colleagues, they have developed a “hyperbaric oxygen therapy for veterans with combat-associated posttraumatic stress disorder.” Journal of Clinical Psychiatry
Abstract
Veterans with Combat-Associated Posttraumatic Stress Disorder receive hyperbaric oxygen therapy.
Objective: Cumulative studies show that novel protocols for hyperbaric oxygen therapy ( HBOT ) may induce neuroplasticity and reduce posttraumatic stress disorder ( PTSD ) clinical symptoms. The aim of the current study was to evaluate the effects of HBOT on veterans with combat-associated PTSD ( CA-PTSD ) in a randomized, sham-controlled trial.
Methods:  , Male veterans aged 25–60 years with CA-PTSD, with a Clinician-Administered PTSD Scale for , DSM-5 , ( CAPS-5 ) score above 20, were included. A history of traumatic brain injury, other psychiatric conditions, or HBOT contraindication were among the exclusion criteria. Participants were chosen at random to participate in a fake or HBOT intervention.
Both interventions involved 60 daily sessions, with 90 minutes of either 100 % oxygen at 2 atmospheres absolute ( ATA ) ( HBOT ) or 21 % oxygen at 1.02 ATA ( sham ) with 5-minute air breaks every 20 minutes. CAPS-5 score, Beck Depression Inventory-II ( BDI-II ), the Depression, Anxiety and Stress Scale 21 Items ( DASS-21 ), and resting-state functional magnetic resonance imaging ( rsfMRI ) were assessed at baseline and posttreatment, with the primary end point defined as a 30 % reduction in CAPS-5 score from baseline.
Results:  , The study was conducted between February 2020 and July 2023. Of 63 veterans who underwent randomization, 56 completed the study protocol ( 28 in each group ). The HBOT group showed a significant decrease in mean CAPS-5 total score, from 42.57 ±9.29 at baseline to 25.8±9.5 following HBOT ( P< ,.001 ) and 25.08± 13.08 at follow-up ( P< ,.001 ). The sham group demonstrated a significant increase in CAPS-5 total score from baseline to follow-up, from 45.11 ±8.99 to 47.75± 11.27 following HBOT ( P=.069 ) and 49.22± 10.26 at follow-up ( P=.011 ).
Significant improvements in the depression domain of the DASS-21 questionnaire and BDI-II were demonstrated ( F=4.55,  , P=.03 and , F=4.2,  , P=.04, respectively ). DASS-21’s stress and anxiety domains did not reach statistical significance. Analysis of rsfMRI demonstrated improved connectivity within the 3 main networks ( default-mode network, central-executive network, salience network ) in HBOT vs sham groups.
Conclusions:  , Dedicated HBOT protocol can improve PTSD symptoms of veterans with CA-PTSD. The improved clinical outcome was accompanied by rsMRI-proven enhanced functional connectivity.
Trial Registration:  , ClinicalTrials. gov identifier: NCT04518007
