The Post Traumatic Stress Disorder Unit
What is PTSD?
Post-Traumatic Stress Disorder (PTSD) is the long-term imprint of life threatening event, of sexual violence or of an event that might have caused serious injury.
The Syndrome is characterized by various intrusive symptoms such as nightmares and flashbacks. People with PTSD may avoid situations or people that remind them of the traumatic event, and they may have strong negative reactions to something as ordinary as a loud noise or an accidental touch.
PTSD may also be a result of prolonged abuse and childhood adversities, in such cases it is defined as complex PTSD (cPTSd). cPTSD is characterized by disturbed emotional regulation, somatic pain, and most commonly sense and acts of dissociation.
The clinical symptoms of PTSD contribute to considerable social, occupational and interpersonal dysfunction, and severe personal suffering.
Today it is accepted that the traumatic event culminates by long term brain changes. These changes may be regarded as actual "wounds in the brain" “which are responsible for the non-remitting nature of the disorder.
PTSD and the Biological barrier:
Long term changes in brain activity and structure can be demonstrated using advanced imaging techniques in people with PTSD years after the traumatic event. These brain damaged regions, can be regarded as “non-healing brain wounds”, and are responsible for the limited success of most currently available interventions and should thus be the target of treatments that can induce neuroplasticity repairment of the damage brain tissue.
In recent years there is growing evidence of the neuroplasticity effects of Hyperbaric Oxygen Therapy (HBOT). HBOT can induce stem cells proliferation, improve brain tissue oxygenation and metabolism, induce generation of new blood vessels (angiogenesis) and neuron (neurogenesis) and those can lead to regeneration of damaged brain tissue.
Our PTSD Studies
Combat related PTSD - The first randomized controlled trial in this field, published in 2022 ,demonstrated significant improvement in post-traumatic symptoms following HBOT. The study included 35 veterans with PTSD who have failed to improve after psychotherapy or pharmacotherapy. Patients were randomized to HBOT or control group for three months. An improvement was demonstrated in all classes of PTSD symptoms, including intrusive symptoms, avoidance, cognitions and mood changes and hyper arousal among patients allocated to HBOT. Depression symptoms commonly found among patients with PTSD improved as well. Moreover, in this study, we have used high-resolution functional brain imaging (fMRI) together with MRI-DTI to demonstrate brain function and microstructural brain integrity. HBOT induced improvement in the non-functioning brain activity and improved microstructural integrity. Currently the second combat related PTSD study is running aiming to characterize the brain changes which benefit the most from HBOT and to specify the biological markers for the ones who can benefit the most from the treatment.
Sexual abuse related PTSD - The first randomized control study was published in 2018. The study included 30 women with history of childhood sexual abuse and diagnosis of Fibromyalgia (chronic pain syndrome) who were randomized to HBOT or control group. After 60 HBOT sessions, findings demonstrated micro-structural and functional changes in the brain, together with improvements in pain symptoms, quality of life and psychological distress. Current a 2nd study is ongoing aiming to compare head-to-head HBOT to pharmaceutical treatment in a similar population.
Biological markers for post-traumatic stress disorder - a comprehensive research program aiming to identify the objective biological fingerprints of PTSD using cutting edge technologies in the fields of fMRI, DTI-MRI, EEG, and autonomic function.
About us:
The PTSD unit at the Sagol Center is led by Dr. Keren Doenyas-Barak and includes a multidisciplinary team of physicians, psychiatrists, psychologists, and MRI professionals all with expertise in the field of PTSD. The Center has its own in-house MRI and EEG units specializing in PTSD populations as well.
Contact Us:
To schedule appointments and for further details:
Call us at +972-8-9772712
Email us at: PTSD-hbo@shamir.gov.il OR kerendb@shamir.gov.il
Research
Keren Doenyas-Barak, Ilan Kutz, Erez Lang, Amir Assouline, Amir Hadanny, Kristoffer C. Aberg, Gabriela Levi, Ilia Beberashvili, Avi Mayo and Shai Efrati
Hyperbaric Oxygen Therapy for Veterans With Combat-Associated Posttraumatic Stress Disorder: A Randomized, Sham-Controlled Clinical Trial
Keren Doenyas-Barak, Ilan Kutz, Erez Lang, Gabriela Levi & Shai Efrati
Memory surfacing among veterans with PTSD receiving hyperbaric oxygen therapy
Amir Hadanny & Shai Efrati
Treatment Of Persistent Post Concussion Syndrom Due To Mild TBI
Amir Hadanny, Joseph Maroon & Shai Efrati
The Efficacy Of Hyperbaric Oxygen Therapy In Traumatic Brain Injury Patients Review And Clinical Guidlines
Shai Efrati & Eshel Ben-Jacob
Reflections On The Neurotherapeutic Effects Of Hyperbaric Oxygen
Dr Keren Doenyas-Barak, Dr Ilan Kutz, Ms Gabriela Levi, Dr Erez Lang, Prof. Ilia Beberashvili & Prof. Shai Efrati
Hyperbaric Oxygen Therapy for Veterans With Treatment-resistant PTSD: A Longitudinal Follow-up Study
Keren Doenyas-Barak, Merav Catalogna, Ilan Kutz, Gabriela Levi, Amir HadannyID, Sigal Tal, Shir Daphna Tekoha, Efrat Sasson,Yarden Shechter & Shai Efrati
Hyperbaric oxygen therapy improves symptoms, brain’s microstructure and functionality in veterans with treatment resistant post-traumatic stress disorder: A prospective, randomized, controlled trial
Hadanny Amir & Efrati Shai
Hyperoxic Hypoxic Paradox Biomolecules
Susan R. Andrews & Paul G. Harch
Harch's Dose Response Curve
Keren Doenyas-Barak, Ilan Kutz, Erez Lang, Rachel Merzbach, Rachel Lev Wiesel, Rahav Boussi-Gross & Shai Efrati
Frontiers Review
Gil Suzin, Keren Doenyas-Barak, Amir Hadanny, Mohammed Elamir , Roger Miller & Shai Efrati
Hyperbaric Oxygen Therapy for Military Post-Traumatic Stress Disorder in Elderly Veterans: Case Studies, Literature Review, and Discussion
Doenyas-Barak Keren, Kutz Ilan, Lang Erez, Assulin Amir, Hadanny Amir, Kristoffer Aberg, Gabriela Levi, Ilia Beberashvili, Mayo Avi & Efrati Shai
Hyperbaric Oxygen Therapy for Veterans Suffering from Combat-associated PostTraumatic Stress Disorder: A Randomized, Sham-controlled Clinical Trial