HJNO Mar/Apr 2019

40 mar / APR 2019  I  Healthcare Journal of New Orleans   Healthcare Briefs (PET) brain imaging, which revealed global and typical metabolic deficits in Alzheimer’s. The patient underwent a total of 40 HBOT treat- ments—five days a week over 66 days. Each treat- ment consisted of 1.15 atmosphere absolute/50 minutes total treatment time. After 21 treat- ments, the patient reported increased energy and level of activity, better mood and ability to perform daily living activities as well as work cross- word puzzles. After 40 treatments, she reported increased memory and concentration, sleep, con- versation, appetite, ability to use the computer, more good days (5/7) than bad days, resolved anxiety, and decreased disorientation and frus- tration. Tremor, deep knee bend, tandem gain, and motor speed were also improved. Repeat 18FDG PET imaging one month post-HBOT showed global 6.5–38 percent improvement in brain metabolism. “We demonstrated the largest improvement in brain metabolism of any therapy for Alzheimer's disease,” noted Harch. “HBOT in this patient may be the first treatment not only to halt, but tem- porarily reverse disease progression in Alzheim- er’s disease.” The report also contains video imaging, including unique rotating PET 3D Surface Reconstructions, which allow the layperson to easily see the improvements in brain function. “PET imaging is used around the world as a biomarker in oncology and cardiology to assay responses to therapy,” said Fogarty. “We now have an irrefutable biomarker system that this intervention has promise where no other real hope for recovery of dementia has ever existed before.” The physicians report that two months post- HBOT, the patient felt a recurrence in her symp- toms. She was retreated over the next 20 months with 56 HBOTs (total 96) at the same dose, sup- plemental oxygen, and medications with stabil- ity of her symptoms and Folstein Mini-Mental Sta- tus exam. According to the National Institutes of Health, “Alzheimer’s disease is an irreversible, progres- sive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. It is the most com- mon cause of dementia in older adults. Alzheim- er's disease is currently ranked as the sixth lead- ing cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people.” The authors note that four pathological pro- cesses have been identified and primary treat- ment is with acetylcholinesterase inhibitors or the N-methyl-D-aspartate receptor antagonist memantine, which have been shown to have a positive impact on Alzheimer’s disease progres- sion with no significant disease-modifying effects. HBOT is an epigenetic modulation of gene expression and suppression to treat wounds and disease pathophysiology, particularly inflamma- tion. HBOT targets all four of the pathological processes of AD by affecting the microcircula- tion; mitochondrial dysfunction, and biogenesis; reducing amyloid burden and tau phosphoryla- tion; controlling oxidative stress; and reducing inflammation. The first successful HBOT-treated case of Alzheimer’s disease was published in 2001. The present case report is the first patient in a series of 11 HBOT-treated patients with Alzheimer’s dis- ease whose symptomatic improvement is docu- mented with18fluorodeoxyglucose positron emis- sion tomography (18FDG PET). “Our results suggest the possibility of treating Alzheimer’s disease long-term with HBOT and pharmacotherapy,” concluded Harch. Haydee Bazan, PhD, Awarded International Honor Haydee Bazan, PhD, professor of neuroscience, ophthalmology, and biochemistry and molecu- lar biology at LSU Health New Orleans School of Medicine, will be inducted into the Associa- tion for Research in Vision and Ophthalmology (ARVO) Fellows Class of 2019 as a Gold Fellow in the spring. Bazan’s laboratory has been a leader in uncov- ering mechanisms to restore alterations in cor- neal nerves and the significance of innervation to regulate impaired corneal sensation that can lead to corneal ulcers, melting and perforation. These alterations frequently occur after refractive surgery, cornea transplant, herpes viral infection, chemical burns, keratoconus, multiple sclerosis, Sjogren's syndrome, and can result from aging, severe dry eye, and diabetes mellitus. Although there are treatments to alleviate severe dry eye, there are no therapies to compensate for the loss of innervation. Bazan's research builds upon her discovery that a key protein, pigment epithelium- derived factor (PEDF), plus the fatty acid docosa- hexaenoic acid (DHA) or the docosanoid deriva- tive Neuroprotectin D1 (NPD1) stimulate nerve regeneration after corneal surgery that damages the stromal nerves. The cornea is densely innervated to sustain the integrity of the ocular surface, and her labora- tory was the first to show the entire architecture of human corneal nerves. n Paul Harch, MD Haydee Bazan, PhD