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From the Townsend Letter
April 2018

Oxygen and Pressure Epigenetics: Understanding Hyperbaric Oxygen Therapy After 355 Years as the Oldest Gene Therapy Known to Man
by Paul G. Harch, MD
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Despite the "Decade of the Brain" from 1990-20001 and all the advances of modern medicine, treatment of the most common neurological diseases (traumatic brain injury, stroke, and dementia) has made minimal progress in the last 100 years. In 2017 Alzheimer's Dementia alone accounts for 5.4 million cases in the U.S.2 Total costs for dementia are estimated to be $259 million this year.2 The numbers will burgeon in the decades ahead as the Baby Boomers' demographic and the excesses of their earlier years pay a negative dividend.
Imagine for a moment a treatment that generically addresses/treats the underlying pathophysiology of traumatic brain injury (TBI), concussion, stroke, dementia, and many other neurological and systemic diseases, a treatment that not only restores reserve capacity,3 but stimulates repair and regrowth of tissue, a treatment that gives people back their lives.

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Figures 1-4 feature the SPECT brain blood flow scans of the first Alzheimer's patient treated with oxygen and pressure epigenetics. On a challenge from neurologists at the University of Oklahoma School of Medicine, a 58-year-old man was referred for treatment 5.5 years after the diagnosis of Alzheimer's disease. Having failed multiple treatments and shown minimal symptomatic improvement on rivastigmine, the scans document the typical posterior watershed areas of damage in Alzheimer's and the dramatic improvement in regional brain blood flow after one, 40, and 80 hyperbaric oxygen therapy (HBOT) treatments. Simultaneously, the patient's symptoms, quality of life, and Folstein Mini-Mental Status Exam score improved (from 9 to 13); and formal cognitive memory testing by university neuropsychologists recorded the first improvement in their multi-year testing sequence. The case was reported to the US Congress in 2002, along with 14 other cases of chronic traumatic brain injury, substance abuse, mental retardation, cerebral palsy, stroke, alcoholism, carbon monoxide poisoning, shaken baby, and autism.4

Figure 1. Pre-HBOT, SPECT brain blood flow imaging transverse slices and four-view threedimensional surface reconstruction of 58-year-old male with Alzheimer's disease. Color scheme for slices is white, yellow, orange, purple, blue, and black from highest to lowest blood flow. Color scheme for three-dimensional surface reconstructions is aesthetic. Three-dimensional views are top row, left to right: frontal and right lateral; bottom row, left to right: left lateral and top of head. Defects or holes in the surface represent significant relative reductions in blood flow. Note primary defects in parietal/occipital/temporal watershed regions.

Since 2001 this author has treated nearly 1,000 cases of chronic neurological injury spread across 80 or more neurological diagnoses. This includes eight additional Alzheimer's cases, and over 60 cases of cognitive decline/dementia of a variety of causes, including this author's mother, Methylation Summitwhose life and quality of life were prolonged six years with oxygen and pressure epigenetic therapy.5How can 80 intermittent exposures to increased pressure and hyperoxia improve neurocognitive function in a patient with a terminal neurodegenerative disease?How can 14 other cases with a variety of untreatable chronic neurological diseases respond similarly? The answer to this question begs the question of "What is hyperbaric oxygen therapy?" The answer given to this author by his medical school resident was the answer given to his entire generation of physicians: "… a type of oxygen therapy, it's performed in chambers, and it's worthless, unscientific, been thoroughly disproven, charlatanism, snake oil sales, and fraud."5 Eight years later in a diving medicine practice, this author found this wasn't true. The correct answer has vexed the medical profession for 355 years, but will only be apparent after a quick review of the most misunderstood therapy in medicine.

Figure 2. After one HBOT, SPECT brain blood flow imaging transverse slices and four-view three-dimensional surface reconstruction of 58-year-old male with Alzheimer's disease.

Figure 3. After 40 HBOTs, SPECT brain blood flow imaging transverse slices and four-view three-dimensional surface reconstruction of 58-year-old male with Alzheimer's disease.

Hyperbaric therapy originated in England in 16626 and, through the 1930s, consisted exclusively of compressed air. The breadth of its application was reflected in an 1877 review by Arntzenius which featured 300 references.7 Oxygen was added to air decompression treatment tables by the US Navy in the late 1930s, and Dutch surgeons started using high pressure oxygen for surgeries, infections, and poisonings in the 1950s to spawn the modern era of hyperbaric oxygen therapy.5 To organize the new field, establish credibility, and gain reimbursement, early hyperbaric physicians identified a list of purportedly scientifically proven diagnoses that were adopted by the FDA (Table 1).8 The foundation of this list was an arbitrary unscientific definition of HBOT.9 That definition has confused the scientific community, Food and Drug Administration, Medicare, medical insurance companies, and lay public, and stymied the understanding and advance of the therapy ever since:

Hyperbaric oxygen (HBO2) treatment, in which a patient breathes 100% oxygen intermittently while inside a treatment chamber at a pressure higher than sea level pressure (i.e., > 1 atmosphere absolute; atm abs), can be viewed as the new application of an old, established technology to help resolve certain recalcitrant, expensive, or otherwise hopeless medical problems…pressurization should be to 1.4 atm abs or higher.9

The definition omitted the 300+ year contribution of pressurized air6 and lacked any evidence that 1.4 ATA (atmospheres absolute) of pressure was the minimum pressure requirement for HBOT, i.e., 1.399 ATA or less pressure was not. In addition, "certain recalcitrant, expensive, and otherwise hopeless" describes nearly all chronic and most acute medical conditions, yet the list of "certain" diagnoses is 48 in China, and more than 60 in Russia.10 This definition of HBOT appears to change as it crosses national borders, yet scientific principles don't and shouldn't. Sir Isaac Newton's apple falls the same way in the US as it does in Russia, not the opposite direction.

Paul D. Harch, MD

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