Can HBOT Reduce Post-Stroke Fatigue and Depression? What Evidence Suggests

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Post-stroke fatigue and depression are among the most debilitating sequelae of stroke, often lingering long after the initial neurological event. These conditions significantly impact quality of life, functional recovery, and social participation. While conventional therapies — such as physical rehabilitation, antidepressants, and cognitive-behavioral strategies — remain central to post-stroke care, researchers and clinicians are exploring adjunctive treatments to further enhance recovery. One such therapeutic approach gaining attention is

Hyperbaric Oxygen Therapy (HBOT) — a medical treatment that delivers 100% oxygen in a pressurized chamber, increasing oxygen availability in tissues. This article examines the potential of HBOT to reduce post-stroke fatigue and depression and what evidence exists to support its use.

Understanding Post-Stroke Fatigue and Depression:Stroke survivors frequently report persistent fatigue, described as an overwhelming sense of tiredness that is not proportional to activity levels, and depression, characterized by persistent low mood, lack of motivation, and decreased ability to enjoy life. Both conditions can be interlinked: chronic fatigue may worsen mood, and depression can intensify feelings of exhaustion. Traditional rehabilitation often addresses motor and speech deficits but may fall short in alleviating these less visible, yet profoundly life-altering symptoms.

What Is Hyperbaric Oxygen Therapy (HBOT)?HBOT involves breathing pure oxygen in a pressurized environment — usually at pressures higher than atmospheric. Under these conditions, oxygen dissolves more efficiently in the blood and is delivered more effectively to tissues throughout the body, including areas with compromised blood flow after a stroke. The theoretical basis for using HBOT in stroke rehabilitation revolves around oxygen’s role in cellular metabolism, neuroplasticity, and inflammation modulation.

Evidence for HBOT in Reducing Fatigue:Although research is still emerging, several clinical studies have reported that HBOT may improve energy levels in post-stroke patients. Increased oxygenation is thought to support mitochondrial function — the energy producers within cells — potentially reducing the pervasive fatigue experienced by stroke survivors. Small randomized trials and observational studies have documented improvements in patient-reported fatigue scores following a series of HBOT sessions, suggesting a promising role for oxygen therapy in mitigating this stubborn symptom.

Evidence for HBOT in Alleviating Depression:Depression after stroke is likewise linked to biochemical changes in the brain, neuroinflammation, and disrupted neural networks. Preliminary evidence indicates that HBOT may exert mood-enhancing effects by promoting neurogenesis (growth of new neural cells), reducing inflammatory markers, and enhancing the brain’s capacity to repair damaged pathways. Some studies have shown significant reductions in depression scores among post-stroke individuals who underwent HBOT, compared to controls receiving standard care alone.

Conclusion:While larger, high-quality clinical trials are needed to definitively establish the effectiveness of HBOT for post-stroke fatigue and depression, current evidence points toward meaningful benefits for many patients. HBOT’s capacity to enhance oxygen delivery, support metabolic recovery, and potentially stimulate brain repair offers a compelling adjunctive option in comprehensive stroke rehabilitation. As research evolves, HBOT may become a more widely accepted tool to improve the often-overlooked aspects of stroke recovery such as fatigue and mood disturbances.

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