{"id":7982,"date":"2021-04-05T14:46:33","date_gmt":"2021-04-05T14:46:33","guid":{"rendered":"https:\/\/hyperbaricmontreal.com\/physiopathologie-de-la-maladie-cible\/"},"modified":"2023-04-18T14:28:49","modified_gmt":"2023-04-18T14:28:49","slug":"physiopathologie-de-la-maladie-cible","status":"publish","type":"page","link":"https:\/\/hyperbaricmontreal.com\/fr\/physiopathologie-de-la-maladie-cible\/","title":{"rendered":"Physiopathologie de la maladie cible"},"content":{"rendered":"
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R\u00e9g\u00e9n\u00e9ration <\/span>tissu <\/span>pour <\/span>cibler <\/span>maladie <\/span>Physiopathologie <\/span>
\n W<\/span>
\n<\/i>avec la <\/span>hyperbare <\/span>hyperbare <\/span>hyperbare <\/span><\/p><\/h1><\/div>

August <\/span>13<\/span>, <\/span>2020 <\/span>M<\/span><\/i>att <\/span>Hoffman <\/span><\/p>\n

The <\/i><\/b>director <\/i><\/b>of <\/i><\/b>the <\/i><\/b>S<\/b>agol <\/i><\/b>Center <\/i><\/b>for <\/i><\/b>Hyperbaric <\/i><\/b>Medicine <\/i><\/b>and <\/i><\/b>Research <\/i><\/b>at <\/i><\/b>Yitzhak <\/i><\/b>Shamir <\/i><\/b>M<\/b>edical <\/i><\/b>Center <\/i><\/b>explained <\/i><\/b>his <\/i><\/b>research with <\/i><\/b>hyperbaric <\/i><\/b>oxygen <\/i><\/b>therapy <\/i><\/b>and <\/i><\/b>explored <\/i><\/b>the <\/i><\/b>potential <\/i><\/b>it <\/i><\/b>may <\/i><\/b>hold <\/i><\/b>as <\/i><\/b>a <\/i><\/b>regenerative <\/i><\/b>treatment<\/i><\/b>. <\/i><\/b><\/p>\n

\"\"<\/span><\/p>\n

Shai <\/span>Efrati<\/span>, <\/span>MD<\/span>, <\/span>director, <\/span>Sagol <\/span>Center <\/span>for <\/span>Hyperbaric <\/span>Medicine <\/span>and <\/span>Research <\/span><\/p>\n

After <\/span>conducting <\/span>studies <\/span>in <\/span>a number <\/span>of <\/span>other conditions<\/span>, <\/span>including <\/span>stroke<\/span>, <\/span>early<\/span>–<\/span>stage <\/span>work <\/span>is <\/span>now <\/span>being <\/span>done <\/span>to <\/span>explore <\/span>hyperbaric <\/span>oxygen therapy <\/span>as <\/span>a possible <\/span>treatment <\/span>for <\/span>patients <\/span>with <\/span>mild <\/span>cognitive <\/span>impairment<\/span>, <\/span>and <\/span>even <\/span>dementia<\/span>. <\/span><\/p>\n

New <\/span>data <\/span>have <\/span>implied that <\/span>it <\/span>may <\/span>hold <\/span>promise <\/span>for <\/span>those <\/span>with <\/span>diseases <\/span>like <\/span>Alzheimer <\/span>and <\/span>dementia<\/span>, <\/span>as <\/span>a <\/span>randomized <\/span>comparison <\/span>with <\/span>placebo <\/span>for <\/span>3 <\/span>months <\/span>suggested <\/span>that <\/span>the <\/span>oxygen <\/span>therapy <\/span>induced <\/span>cognitive <\/span>enhancements <\/span>as <\/span>evaluated <\/span>by perfusion <\/span>magnetic <\/span>resonance <\/span>imaging <\/span>(<\/span>MRI<\/span>)<\/span>. <\/span><\/p>\n

The research <\/span>was <\/span>led by <\/span>Shai Efrati<\/span>, <\/span>MD<\/span>, <\/span>director<\/span>, <\/span>Sagol <\/span>Center <\/span>for <\/span>Hyperbaric <\/span>Medicine <\/span>and <\/span>Research<\/span>, <\/span>Yitzhak <\/span>Shamir <\/span>Medical <\/span>Center<\/span>; <\/span>and <\/span>associate <\/span>professor<\/span>, <\/span>Sackler <\/span>Faculty <\/span>of <\/span>Medicine <\/span>and <\/span>Sagol <\/span>School <\/span>of <\/span>Neuroscience <\/span>Tel <\/span>Aviv <\/span>University<\/span>. <\/span>All <\/span>told<\/span>, <\/span>it <\/span>found <\/span>that <\/span>a <\/span>significant <\/span>group<\/span>–<\/span>by<\/span>–<\/span>time <\/span>interaction <\/span>in <\/span>global <\/span>cognitive <\/span>function <\/span>was <\/span>observed <\/span>compared <\/span>to control <\/span>(<\/span><\/i>P <\/span><\/i>= <\/span>0017<\/span>)<\/span>, <\/span>with <\/span>the <\/span>most <\/span>impressive <\/span>improvements <\/span>in <\/span>attention <\/span>(<\/span>net <\/span>effect <\/span>size <\/span>= <\/span>0<\/span>.<\/span>745<\/span>) <\/span>and <\/span>information <\/span>processing <\/span>speed <\/span>(<\/span>net <\/span>effect <\/span>size <\/span>= <\/span>0<\/span>.<\/span>788<\/span>)<\/span>. <\/span><\/p>\n

To <\/span>find <\/span>out <\/span>more <\/span>about <\/span>hyperbaric <\/span>oxygen <\/span>therapy<\/span>, <\/span>the <\/span>promise <\/span>of <\/span>these <\/span>findings<\/span>, <\/span>and <\/span>its <\/span>future <\/span>utility <\/span>as <\/span>a <\/span>treatment<\/span>, <\/span>Neurology <\/span><\/i>Liv<\/span><\/i>e <\/span>spoke <\/span>with <\/span>E<\/span>f<\/span>rati<\/span>. <\/span><\/p>\n

NeurologyLive <\/span><\/i>How <\/span>did <\/span>y<\/span><\/i>ou <\/span>react <\/span>to <\/span>the <\/span>findings <\/span>and <\/span>has <\/span>this <\/span>prompted <\/span>any <\/span>plans <\/span>for <\/span>further <\/span>work<\/span>? <\/span><\/p>\n

Shai <\/span>Efrati<\/span>, <\/span>MD<\/span>: <\/span>We <\/span>are <\/span>very <\/span>happy <\/span>to <\/span>see <\/span>first <\/span>of <\/span>all <\/span>the <\/span>correlation <\/span>between <\/span>the <\/span>tissue <\/span>and <\/span>the <\/span>cognitive <\/span>function<\/span>. <\/span>This <\/span>is <\/span>great <\/span>because <\/span>at <\/span>the <\/span>end <\/span>of <\/span>the <\/span>day<\/span>, <\/span>we are <\/span>dealing <\/span>with <\/span>physiology<\/span>, <\/span>not deep <\/span>psychology<\/span>. <\/span>Psychology <\/span>is <\/span>very <\/span>important<\/span>, <\/span>but <\/span>here <\/span>we <\/span>are <\/span>dealing <\/span>with <\/span>pure <\/span>biology<\/span>. <\/span><\/i>W<\/span><\/i>e <\/span>have <\/span>done <\/span>animal <\/span>studies<\/span>, <\/span>and <\/span>others <\/span>have <\/span>done <\/span>animal <\/span>studies<\/span>, <\/span>and <\/span>the <\/span>main <\/span>advantage <\/span>of <\/span>those <\/span>is <\/span>that <\/span>you <\/span>can <\/span>take <\/span>the <\/span>brai<\/span>n <\/span>out<\/span>, <\/span>look <\/span>at <\/span>it <\/span>on <\/span>the <\/span>microscope <\/span>something <\/span>that <\/span>we <\/span>are <\/span>still <\/span>not <\/span>doing <\/span>on <\/span>humans<\/span>. <\/span><\/p>\n

It<\/span>‘<\/span>s <\/span>exciting<\/span>, <\/span>and <\/span>based <\/span>on <\/span>this<\/span>, <\/span>there <\/span>is <\/span>now <\/span>an <\/span>ongoing research <\/span>program with <\/span>MCI<\/span>, <\/span>which <\/span>is <\/span>mild <\/span>cognitive <\/span>impairment<\/span>. <\/span>So <\/span>not <\/span>the <\/span>fully <\/span>functional <\/span>brain<\/span>, <\/span>it<\/span>‘<\/span>s <\/span>a <\/span>step <\/span>afterwards<\/span>. <\/span>We <\/span>want <\/span>to <\/span>see <\/span>if <\/span>we <\/span>can <\/span>reverse <\/span>that <\/span>as <\/span>well<\/span>. <\/span>We <\/span>will <\/span>have <\/span>to <\/span>find <\/span>the <\/span>optimal <\/span>candidates<\/span>–<\/span>that <\/span>needs <\/span>to <\/span>be <\/span>defined <\/span>based <\/span>on <\/span>what <\/span>we <\/span>see <\/span>in <\/span>the <\/span>biology<\/span>, <\/span>not <\/span>ba<\/span>sed <\/span>on <\/span>the <\/span>cognitive <\/span>function<\/span>. <\/span>We <\/span>need <\/span>to <\/span>see <\/span>how <\/span>far <\/span>we <\/span>can <\/span>take <\/span>it <\/span>meaning<\/span>, <\/span>what <\/span>these <\/span>the <\/span>worst <\/span>patient <\/span>that <\/span>can <\/span>improve <\/span>with <\/span>the <\/span>treatment <\/span>and <\/span>we <\/span>have<\/span>. <\/span>We <\/span>have <\/span>a <\/span>lot <\/span>to <\/span>learn with <\/span>regard <\/span>to <\/span>that<\/span>. <\/span><\/p>\n

Are <\/span>there <\/span>any <\/span>other <\/span>conditions <\/span>for <\/span>which <\/span>you<\/span>‘<\/span>re <\/span>exploring <\/span>hyperbaric <\/span>oxygen <\/span>therapy<\/span>? <\/span><\/p>\n

What <\/span>we <\/span>have <\/span>now <\/span>in <\/span>our <\/span>research <\/span>program <\/span>includes<\/span>, <\/span>of <\/span>course<\/span>, <\/span>stroke<\/span>–<\/span>not <\/span>every <\/span>stroke <\/span>is suitable<\/span>, <\/span>we <\/span>need <\/span>to <\/span><\/p>\n

see <\/span>the <\/span>wound <\/span>and <\/span>see <\/span>if <\/span>the <\/span>wound <\/span>is <\/span>suitable<\/span>. <\/span>We <\/span>also <\/span>have <\/span>an ongoing <\/span>program <\/span>for <\/span>TBI <\/span>or <\/span>traumatic <\/span>b<\/span>rain <\/span>injury <\/span>a <\/span>special <\/span>focus <\/span>on <\/span>the <\/span>post<\/span>–<\/span>concussion <\/span>syndrome<\/span>, <\/span>which <\/span>is <\/span>a <\/span>huge <\/span>problem<\/span>; <\/span>an <\/span>ongoing <\/span>program <\/span>in <\/span>fibromyalgia<\/span>, <\/span>the <\/span>chronic <\/span>pain <\/span>syndrome<\/span>. <\/span>Not <\/span>every <\/span>fibromyalgia<\/span>, <\/span>just <\/span>the <\/span>ones <\/span>where <\/span>we <\/span>can <\/span>see <\/span>the <\/span>metabolic <\/span>dysfunction <\/span>in <\/span>the <\/span>brain<\/span>. <\/span><\/p>\n

Generally <\/span>speaking<\/span>, <\/span>it<\/span>‘s looks <\/span>like <\/span>we <\/span>are <\/span>dealing <\/span>with <\/span>a <\/span>lot <\/span>of <\/span>stuff<\/span>. <\/span>But <\/span>we <\/span>are <\/span>not<\/span>. <\/span>We <\/span>are <\/span>dealing <\/span>with wounds<\/span>. <\/span>We <\/span>characterize <\/span>the <\/span>wounds <\/span>in <\/span>the <\/span>brain<\/span>, <\/span>and <\/span>if <\/span>they <\/span>are <\/span>suitable<\/span>, <\/span>we <\/span>will <\/span>treat <\/span>them<\/span>. <\/span>Now<\/span>, <\/span>if <\/span>this <\/span>wound <\/span>was <\/span><\/p>\n

initiated <\/span>by <\/span>mechanical <\/span>injury <\/span>or <\/span>by <\/span>stroke <\/span>or <\/span>by <\/span>hemorrhage<\/span>, <\/span>for <\/span>us<\/span>, <\/span>it <\/span>doesn<\/span>‘<\/span>t <\/span>matter <\/span>because <\/span>you<\/span>‘re <\/span>looking <\/span>at <\/span>the <\/span>wound<\/span>–<\/span>you<\/span>‘<\/span>re <\/span>looking <\/span>at <\/span>the <\/span>final <\/span>results<\/span>. <\/span>You <\/span>characterize <\/span>the <\/span>tissue <\/span>and <\/span>then <\/span>treat <\/span>it<\/span>. <\/span><\/p>\n

This <\/span>is <\/span>also <\/span>something <\/span>new <\/span>as an <\/span>approach<\/span>. <\/span>You<\/span>‘<\/span>re <\/span>saying<\/span>, <\/span>\u00ab\u00a0<\/span>Okay<\/span>, <\/span>I<\/span>‘<\/span>m <\/span>dealing <\/span>with <\/span>a <\/span>tissue<\/span>, <\/span>let <\/span>me <\/span>see what <\/span>the <\/span>wound <\/span>is<\/span>.<\/span>\u00a0\u00bb <\/span>For <\/span>example<\/span>, <\/span>if <\/span>you <\/span>have <\/span>a <\/span>wound <\/span>in <\/span>the <\/span>leg<\/span>, <\/span>it <\/span>doesn<\/span>‘<\/span>t <\/span>matter <\/span>if <\/span>a <\/span>c<\/span>ar <\/span>ran <\/span>over <\/span>your <\/span>leg <\/span>and <\/span>caused <\/span>the <\/span>problem <\/span>or <\/span>somebody <\/span>hit <\/span>you <\/span>in <\/span>the <\/span>leg<\/span>. <\/span>In <\/span>the <\/span>end<\/span>, <\/span>it<\/span>‘<\/span>s <\/span>a <\/span>problem <\/span>that <\/span>needs <\/span>to <\/span>be <\/span>cured<\/span>. <\/span>It<\/span>‘<\/span>s <\/span>the <\/span>same <\/span>way <\/span>doesn<\/span>‘<\/span>t matter <\/span>if <\/span>it <\/span>was <\/span>induced <\/span>by <\/span>that<\/span>, <\/span>that<\/span>, <\/span>or <\/span>that<\/span>. <\/span>Le<\/span>t<\/span>‘<\/span>s <\/span>characterize <\/span>the <\/span>wound <\/span>at <\/span>the <\/span>moment<\/span>, <\/span>see <\/span>the <\/span>physiology<\/span>, <\/span>and <\/span>based <\/span>on <\/span>this<\/span>, <\/span>make <\/span>a <\/span>decision <\/span>if <\/span>this <\/span>can <\/span>be <\/span>good <\/span>for <\/span>that <\/span>kind <\/span>of <\/span>damage <\/span>or <\/span>not<\/span>. <\/span>So<\/span>, <\/span>it <\/span>looks <\/span>like <\/span>we <\/span>are <\/span>dealing <\/span>with <\/span>a <\/span>lot <\/span>of <\/span>stuff<\/span>, <\/span>but <\/span>for <\/span>us<\/span>, <\/span>it<\/span>‘<\/span>s <\/span>just <\/span>one <\/span>thing<\/span>. <\/span><\/p>\n

Do <\/span>you <\/span>feel <\/span>that <\/span>there <\/span>a <\/span>specific <\/span>population <\/span>of <\/span>patients <\/span>with <\/span>dementia <\/span>or <\/span>Alzheimer <\/span>that <\/span>might <\/span>derive <\/span>benefit <\/span>from <\/span>this<\/span>? <\/span><\/p>\n

I <\/span>will <\/span>start <\/span>from <\/span>the <\/span>g<\/span>roup <\/span>that <\/span>we <\/span>have <\/span>v<\/span><\/i>ery <\/span>good <\/span>efficacy <\/span>with <\/span>which <\/span>is <\/span>the <\/span>mice <\/span>that have Alzheimer<\/span>. <\/span>In <\/span>mice <\/span>that <\/span>have <\/span>Alzheimer<\/span>–<\/span>yo<\/span>u <\/span>can <\/span>read <\/span>our <\/span>publication<\/span>–<\/span>we <\/span>can <\/span>demonstrate <\/span>how <\/span>we <\/span>can <\/span>reverse <\/span>the <\/span>Alzheimer <\/span>with <\/span>this <\/span>treatment<\/span>. <\/span>We <\/span>can <\/span>see <\/span>the <\/span>amyloid <\/span>plaque <\/span>disappearing<\/span>, <\/span>the <\/span>cognitive impairment <\/span>improving<\/span>, <\/span>the <\/span>brain<\/span>, <\/span>all <\/span>of <\/span>it<\/span>. <\/span>But <\/span>we <\/span>are <\/span>not <\/span>mice<\/span>. <\/span>T<\/span>h<\/span>at<\/span>‘<\/span>s <\/span>a <\/span>small <\/span>problem<\/span>. <\/span><\/p>\n

In <\/span>human <\/span>beings<\/span>, <\/span>we <\/span>haven<\/span>‘<\/span>t <\/span>done <\/span>a <\/span>study <\/span>in <\/span>Alzheimer<\/span>. <\/span>I think <\/span>that <\/span>with <\/span>Alzheimer<\/span>, <\/span>it<\/span>‘<\/span>s <\/span>too <\/span>late<\/span>. <\/span>You <\/span>don<\/span>‘<\/span>t <\/span>have <\/span>tissue<\/span>. <\/span>The <\/span>main <\/span>issue <\/span>is <\/span>to <\/span>start <\/span>early<\/span>, <\/span>whether <\/span>it<\/span>‘<\/span>s <\/span>normal <\/span>aging or <\/span>mild <\/span>cognitive <\/span>impairment<\/span>, <\/span>it <\/span>doesn<\/span>‘t <\/span>matter <\/span>because <\/span>with <\/span>the <\/span>vascular <\/span>dementia <\/span>at <\/span>the <\/span>end<\/span>, <\/span>you <\/span>don<\/span>‘<\/span>t <\/span>have <\/span>tissue<\/span>. <\/span>But <\/span>if <\/span>you <\/span>start <\/span>as <\/span>early <\/span>as <\/span>in <\/span>normal <\/span>aging<\/span>, <\/span>maybe <\/span>a <\/span>bit <\/span>later <\/span>on <\/span>in <\/span>mild <\/span>cognitive <\/span>impairment<\/span>, <\/span>you <\/span>still <\/span>have <\/span>tissue <\/span>that <\/span>can <\/span>be recovered<\/span>. <\/span>That <\/span>is <\/span>the <\/span>main <\/span>thing<\/span>. <\/span>Don<\/span>‘<\/span>t <\/span>wait<\/span>. <\/span>Start <\/span>early<\/span>, <\/span>keep <\/span>the <\/span>tissue<\/span>, <\/span>and <\/span>once <\/span>you <\/span>have <\/span>it<\/span>, <\/span>you <\/span>can <\/span>continue <\/span>keeping <\/span>it <\/span>up<\/span>. <\/span><\/p>\n

Is <\/span>there <\/span>a <\/span>way <\/span>to <\/span>identify <\/span>these <\/span>patients <\/span>early <\/span>enough<\/span>, <\/span>or <\/span>do <\/span>you <\/span>think <\/span>that that<\/span>‘<\/span>s <\/span>still <\/span>going <\/span>to <\/span>be <\/span>a <\/span>problem <\/span>with <\/span>hyperbaric <\/span>oxygen <\/span>therapy<\/span>? <\/span><\/p>\n

\"\"They <\/span>say <\/span>a <\/span>lot <\/span>about <\/span>the <\/span>amyloid <\/span>because today<\/span>, <\/span>it<\/span>‘<\/span>s <\/span>quite clear <\/span>to <\/span>all <\/span>of <\/span>us <\/span>that <\/span>the <\/span>amyloid <\/span>is <\/span>not the <\/span>one <\/span>that <\/span>caused <\/span>the <\/span>problem<\/span>. <\/span>It<\/span>‘<\/span>s <\/span>a <\/span>result <\/span>of <\/span>the <\/span>problem<\/span>. <\/span>Once <\/span>you <\/span>have <\/span>continuous <\/span>inflammation <\/span>in <\/span>certain <\/span>areas <\/span>of <\/span>the <\/span>brain<\/span>, <\/span>then <\/span>you will <\/span>have <\/span>the <\/span>amyloid <\/span>stuck <\/span>in <\/span>over <\/span>there<\/span>. <\/span><\/p>\n

We <\/span>can <\/span>say <\/span>that with <\/span>confidence <\/span>today <\/span>because <\/span>we <\/span>know <\/span>with <\/span>all <\/span>the <\/span>antibodies <\/span>against <\/span>the <\/span>amyloid<\/span>, <\/span>we <\/span>know <\/span>that <\/span>they <\/span>are <\/span>removing <\/span>it<\/span>, <\/span>but <\/span>still <\/span>there <\/span>is <\/span>no <\/span>significant <\/span>change in <\/span>the <\/span>clinical <\/span>course <\/span>of <\/span>the <\/span>disease<\/span>. <\/span>So <\/span>that<\/span>‘s <\/span>what <\/span>we <\/span>got<\/span>. <\/span>For <\/span>example<\/span>, <\/span>if <\/span>we <\/span>are <\/span>treating <\/span>mice <\/span>with <\/span>Alzheimer <\/span>with <\/span>hyperbaric<\/span>, <\/span>we <\/span>are <\/span>not <\/span>targeting <\/span>amyloid<\/span>. <\/span>We <\/span>are <\/span>not <\/span>moving <\/span>amyloid <\/span>out<\/span>. <\/span>But <\/span>as <\/span>a <\/span>result <\/span>of <\/span>the <\/span>improvement <\/span>in <\/span>the <\/span>tissue<\/span>, <\/span>the <\/span>amyloid <\/span>is <\/span>also <\/span>declining<\/span>. <\/span>Not <\/span>because <\/span>we <\/span>target <\/span>them <\/span>amyloid<\/span>, <\/span>we <\/span>are <\/span>targeting <\/span>the <\/span>core <\/span>issue<\/span>. <\/span><\/p>\n

Can <\/span>we <\/span>diagnose <\/span>that <\/span>early <\/span>stage<\/span>? <\/span>Yes<\/span>. <\/span>First <\/span>of <\/span>all<\/span>, <\/span>you <\/span>need <\/span>a <\/span>certain <\/span>suspicion<\/span>, <\/span>clinical <\/span>suspicion<\/span>. <\/span>People <\/span>feel <\/span>that <\/span>suspicion<\/span>. <\/span>If <\/span>you <\/span>feel that <\/span>your <\/span>cognition <\/span>is <\/span>declining <\/span>a <\/span>bit <\/span>don<\/span>‘<\/span>t <\/span>ignore <\/span>that<\/span>. <\/span>That<\/span>‘<\/span>s <\/span>the <\/span>first <\/span>signal<\/span>. <\/span>If <\/span>you <\/span>don<\/span>‘t <\/span>remember <\/span>the <\/span>bulk <\/span>of <\/span>the <\/span>page <\/span>that <\/span>you <\/span>just <\/span>read <\/span>a <\/span>couple <\/span>of <\/span>minutes <\/span>before<\/span>, <\/span>don<\/span>‘<\/span>t <\/span>s<\/span>ay<\/span>, <\/span>\u00ab\u00a0<\/span>T<\/span>h<\/span>at<\/span>‘<\/span>s <\/span>okay<\/span>.<\/span>‘ <\/span>Say<\/span>, <\/span>\u00ab\u00a0<\/span>Okay<\/span>, <\/span>I <\/span>have <\/span>a <\/span>problem<\/span>. <\/span>Let<\/span>‘<\/span>s <\/span>see <\/span>how <\/span>I <\/span>can <\/span>face <\/span>it<\/span>.<\/span>‘ <\/span>T<\/span>h<\/span>at<\/span>‘<\/span>s <\/span>the <\/span>first <\/span>warning <\/span>sign<\/span>. <\/span><\/p>\n

With <\/span>regard <\/span>to <\/span>the <\/span>brain <\/span>if <\/span>you <\/span>are <\/span>doing <\/span>the <\/span>type <\/span>of <\/span>brain <\/span>imaging <\/span>that <\/span>we <\/span>have <\/span>used <\/span>along <\/span>the <\/span>studies<\/span>, <\/span>then <\/span>you can <\/span>see <\/span>the <\/span>decline <\/span>in <\/span>perfusion<\/span>. <\/span>In <\/span>normal <\/span>MRI<\/span>, <\/span>you <\/span>can <\/span>see <\/span>some <\/span>white <\/span>patches <\/span>that <\/span>are <\/span>popping <\/span>up <\/span>all <\/span>over<\/span>. <\/span>That <\/span>is <\/span>also <\/span>a <\/span>warning <\/span>sign<\/span>. <\/span>The <\/span>main <\/span>problem <\/span>was <\/span>that <\/span>until <\/span>today<\/span>, <\/span>we <\/span>don<\/span>‘<\/span>t <\/span>have <\/span>any <\/span>biological <\/span>intervention <\/span>that <\/span>can <\/span>actually <\/span>do <\/span>something <\/span>with <\/span>regard <\/span>to <\/span>the <\/span>basic <\/span>of <\/span>the <\/span>biology<\/span>. <\/span>By <\/span>doing <\/span>what <\/span>we <\/span>are <\/span>doing<\/span>, <\/span>and <\/span>what <\/span>others <\/span>are <\/span>now <\/span>investigating<\/span>, <\/span>is <\/span>to <\/span>tackle <\/span>the <\/span>basic <\/span>biology <\/span>that that <\/span>caused <\/span>the <\/span>disease<\/span>. <\/span>Not <\/span>the <\/span>symptoms<\/span>, <\/span>not <\/span>the <\/span>neurotransmitter<\/span>. <\/span>Those <\/span>are <\/span>not <\/span>the <\/span>problem<\/span>. <\/span>The <\/span>amyloid <\/span>plaques <\/span>are <\/span>not the <\/span>problem<\/span>, <\/span>they <\/span>are <\/span>the <\/span>results <\/span>of <\/span>the <\/span>pathophysiology <\/span>process<\/span>. <\/span>You <\/span>need <\/span>to <\/span>target <\/span>the <\/span>pathophysiology <\/span>process<\/span>, <\/span>not <\/span>the <\/span>results <\/span>of <\/span>the <\/span>pathophysiology <\/span><\/p>\n

This <\/span>is <\/span>this <\/span>is <\/span>an <\/span>understanding <\/span>we <\/span>have <\/span>today <\/span>in <\/span>the <\/span>community<\/span>. <\/span>We <\/span>need <\/span>to <\/span>tackle <\/span>it <\/span>right <\/span>away<\/span>. <\/span>For <\/span>example<\/span>, <\/span>if <\/span>you<\/span>‘<\/span>re <\/span>changing <\/span>your habits <\/span>by <\/span>playing <\/span>sports <\/span>and <\/span>eating <\/span>well<\/span>–<\/span>which <\/span>are <\/span>things <\/span>that <\/span>are <\/span>not <\/span>related <\/span>to <\/span>the <\/span>brain <\/span>in <\/span>the <\/span>long <\/span>term<\/span>, <\/span>you<\/span>‘<\/span>re <\/span>doing <\/span>good <\/span>to <\/span>your <\/span>brain <\/span>because <\/span>you <\/span>are <\/span>reducing <\/span>the <\/span>atherosclerosis <\/span>plaque<\/span>. <\/span>You <\/span>are <\/span>targeting <\/span>the <\/span>basic pathophysiology<\/span>. <\/span>It <\/span>will <\/span>not <\/span>go <\/span>backwards<\/span>, <\/span>but <\/span>you <\/span>are <\/span>reducing <\/span>the <\/span>rate <\/span>of <\/span>the <\/span>decline<\/span>. <\/span>With <\/span>the <\/span>hyperbaric <\/span>oxygen <\/span>therapy<\/span>, <\/span>you <\/span>can <\/span>take <\/span>it <\/span>backwards <\/span>because <\/span>you <\/span>can <\/span>generate <\/span>angiogenesis <\/span>and <\/span>other <\/span>stuff <\/span>like <\/span>t<\/span>his<\/span>. <\/span>This <\/span>is <\/span>the <\/span>concept<\/span>. <\/span><\/p>\n

How <\/span>quickly <\/span>do <\/span>you <\/span>think <\/span>this <\/span>could <\/span>be <\/span>used <\/span>in <\/span>a <\/span>widespread <\/span>fashion<\/span>, <\/span>and <\/span>how <\/span>expensive <\/span>would <\/span>it <\/span>be <\/span>potentially <\/span>for <\/span>institutions <\/span>that <\/span>don<\/span>‘<\/span>t <\/span>have <\/span>access <\/span>to <\/span>it <\/span>to <\/span>implement <\/span>it<\/span>? <\/span>Like <\/span>anything <\/span>new<\/span>, <\/span>when <\/span>it <\/span>starts<\/span>, <\/span>it <\/span>cost <\/span>a <\/span>lot<\/span>. <\/span>You <\/span>don<\/span>‘<\/span>t <\/span>have <\/span>in <\/span>a <\/span>ton <\/span>of <\/span>other <\/span>places<\/span>. <\/span>I <\/span>remember <\/span>my <\/span>father <\/span>with <\/span>the <\/span>first <\/span>cellular <\/span>phone<\/span>. <\/span>He <\/span>used <\/span>to <\/span>have <\/span>a <\/span>bag <\/span>he <\/span>had <\/span>to <\/span>carry <\/span>all <\/span>over<\/span>–<\/span>you <\/span>could <\/span>buy <\/span>either <\/span>a <\/span>house <\/span>or <\/span>to <\/span>buy <\/span>a <\/span>cell phone<\/span>. <\/span>That <\/span>was your <\/span>choice<\/span>. <\/span>But <\/span>today<\/span>, <\/span>anybody<\/span>, <\/span>everybody <\/span>can <\/span>have <\/span>it<\/span>. <\/span><\/p>\n

We <\/span>have <\/span>our <\/span>center <\/span>in <\/span>Israel<\/span>, <\/span>which <\/span>is <\/span>the <\/span>biggest <\/span>in <\/span>the <\/span>world<\/span>, <\/span>where <\/span>we <\/span>are <\/span>treating <\/span>more <\/span>than <\/span>250 <\/span>patients <\/span>a <\/span>day<\/span>. <\/span>Now <\/span>we <\/span>have <\/span>started <\/span>to <\/span>have <\/span>affiliated <\/span>centers tha<\/span>t <\/span>are <\/span>working <\/span>exactly <\/span>as <\/span>we <\/span>are<\/span>. <\/span>We <\/span>are <\/span>training <\/span>the <\/span>physicians<\/span>, <\/span>the <\/span>medical <\/span>staff<\/span>. <\/span>We <\/span>have <\/span>the <\/span>first <\/span>center <\/span>built <\/span>up <\/span>in <\/span>the <\/span>US <\/span>in <\/span>Florida<\/span>, <\/span>called <\/span>the <\/span>Aviv <\/span>Clinic<\/span>. <\/span>It<\/span>‘<\/span>s <\/span>a <\/span>center <\/span>exactly <\/span>like <\/span>we <\/span>have <\/span>in <\/span>Israel<\/span>. <\/span>The <\/span>staff <\/span>have <\/span>been <\/span>trained<\/span>, <\/span>they <\/span>have <\/span>all <\/span>the <\/span>knowledge<\/span>, <\/span>all <\/span>the <\/span>data<\/span>. <\/span>T<\/span>hey <\/span>ar<\/span>e <\/span>doing <\/span>the <\/span>same <\/span>MRI <\/span>that <\/span>we <\/span>are <\/span>doing <\/span>over <\/span>here <\/span>with <\/span>the <\/span>perfusion <\/span>cognitive <\/span>test<\/span>–<\/span>everything <\/span>is <\/span>matched<\/span>. <\/span>There <\/span>are <\/span>additional centers <\/span>that <\/span>are <\/span>being <\/span>built <\/span>all <\/span>over<\/span>, <\/span>and <\/span>the <\/span>center <\/span>that <\/span>we <\/span>have <\/span>now <\/span>in <\/span>Florida <\/span>will <\/span>be <\/span>a <\/span>trai<\/span>n<\/span>ing <\/span>center <\/span>for <\/span>the <\/span>additional <\/span>centers <\/span>in <\/span>the <\/span>US<\/span>. <\/span><\/p>\n

It <\/span>will <\/span>go <\/span>but <\/span>like <\/span>anything <\/span>new <\/span>at <\/span>the <\/span>beginning<\/span>. <\/span>Unfortunately<\/span>, <\/span>it<\/span>‘<\/span>s <\/span>not <\/span>available <\/span>for <\/span>all<\/span>, <\/span>but <\/span>i<\/span>t <\/span>will <\/span>get <\/span>there<\/span>. <\/span>It <\/span>will <\/span>just <\/span>take <\/span>some <\/span>time<\/span>. <\/span><\/p>\n

Transcript <\/span><\/i>edited <\/span><\/i>for <\/span><\/i>clarity <\/span><\/i><\/p>\n

REFERENCE <\/span><\/p>\n

Efrati <\/span>S<\/span>, <\/span>Fishlev <\/span>G<\/span>, <\/span>Bechor <\/span>Y<\/span>, <\/span>et <\/span>al<\/span>. <\/span>Hyperbaric <\/span>oxygen <\/span>induces <\/span>late <\/span>neuroplasticity <\/span>in <\/span>post <\/span>stroke <\/span>patients<\/span>–<\/span>– <\/span>randomized <\/span>prospective <\/span>trial<\/span>. <\/span>PLoS <\/span><\/i>One <\/span><\/i>2013<\/span>,<\/span>8<\/span>(1<\/span>)<\/span>:<\/span>e5<\/span>3<\/span>716<\/span>. <\/span>doi<\/span>: <\/span>10<\/span>.<\/span>1371<\/span>\/<\/span>journal<\/span>.<\/span>pone<\/span>.<\/span>0053716<\/span>. <\/span><\/p>\n<\/div>

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