Clinical Interventions in Aging (Mar 2019)
Normobaric oxygen: a novel approach for treating chronic cerebral circulation insufficiency
Abstract
Jiayue Ding,1–3,* Da Zhou,1–3,* Cheng Liu,1,4 Liqun Pan,1–3 Jingyuan Ya,1–3 Yuchuan Ding,3,5 Xunming Ji,2,3,6 Ran Meng1–3 1Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; 2Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing 100053, China; 3Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; 4Department of Neurology, Yongxin People’s Hospital, Ji’an 343400, China; 5Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI 48201, USA; 6Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China *These co-first authors contributed equally to this work Abstract: Chronic cerebral circulation insufficiency (CCCI) is viewed as an alarming state induced by long-term reduction in cerebral perfusion, which is associated with neurological deficits and high risk of stroke occurrence or recurrence. CCCI accounts for a large proportion of both outpatients and inpatients with cerebrovascular diseases, while management of CCCI remains a formidable challenge to clinicians. Normobaric oxygen (NBO) is an adjuvant hyperoxygenation intervention supplied with one atmosphere pressure (1 ATA =101.325 kPa). A plethora of studies have demonstrated the efficacy of NBO on the penumbra in acute stroke. NBO has been shown to increase the oxygen pressure, raise the intracranial blood flow, protect blood–brain barrier and enhance neuroprotective effects. As similar underlying mechanisms are shared by the penumbra in stroke and the ischemic–hypoxic brain tissues in CCCI, we speculate that NBO may serve as a promising therapeutic strategy for attenuating short-term symptoms or improving long-term clinical outcomes among patients with CCCI. Due to the scant research exploring the efficacy and safety of NBO for treating CCCI so far, both experimental and clinical studies are warranted to verify our hypothesis in the future. Keywords: chronic cerebral circulation insufficiency, normobaric oxygen, therapeutic strategy, stroke, clinical outcome