Kim et al. (2025)
- Authors: Dr. Laura Kim, Guido Cammà, Dr. Claudia Kedor Peters, Maron Mantwill, Oliver Müller, Nadège Leprêtre, Cornelia Heindrich, Dr. Rebekka Rust, Dr. Moritz Krill, Dr. Tim J. Hartung, Lukas G. Reeß, Dr. Stephan Krohn, Prof. Christian von Heymann, Dr. Kirsten Wittke, Prof. Carsten Finke, Prof. Carmen Scheibenbogen
- Institutes: Institute of Medical Immunology, Charité - Universitätsmedizin Berlin; Center for Hyperbaric Oxygen Therapy and Diving Medicine, Vivantes Klinikum im Friedrichshain; Experimental and Clinical Research Center and Neuro Science Clinical Research Center, Charité - Universitätsmedizin Berlin; Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin; Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin; Neuroscience Clinical Research Center, Charité - Universitätsmedizin Berlin; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin
- Publisher: medRxiv
- Link: DOI
Summary
This study suggests that Hyperbaric Oxygen Therapy (HBOT) may be a feasible and beneficial treatment for some ME/CFS patients, leading to improvements in physical function, fatigue, pain, and cognition. The research also provides a possible biological explanation for these improvements, linking them to a “normalization” of brain connectivity in the thalamus, a key sensory and motor hub. This finding connects with other research suggesting brain network dysregulation is a core feature of ME/CFS. While promising, these results are from a small, uncontrolled, observational study, meaning a placebo effect cannot be ruled out. The authors stress that larger, placebo-controlled trials are required to prove that HBOT is truly effective.
What was researched?
This study aimed to evaluate the effectiveness and feasibility of Hyperbaric Oxygen Therapy (HBOT) 💊 in patients with ME/CFS. The researchers also investigated the treatment’s effects on functional brain changes by using fMRI.
Why was it researched?
ME/CFS is a debilitating disorder characterized by profound fatigue, cognitive impairment, and severe physical dysfunction. While HBOT has been proposed as a potential treatment, its effects on ME/CFS patients have remained “largely unexplored,” creating a need for this investigation.
How was it researched?
This was a prospective cohort study involving 30 ME/CFS patients who each received 40 sessions of HBOT. Outcomes were assessed at baseline, during, and four weeks post-treatment using patient questionnaires (like the SF-36), functional tests (like handgrip strength and exercise capacity), and cognitive tests. Brain functional connectivity (FC) was measured with MRI and compared to 30 matched healthy controls.
What has been found?
HBOT was associated with significant improvements in physical functioning, fatigue, pain, exercise capacity, muscle strength, and information processing speed. Treatment adherence was high and the therapy was well-tolerated. Brain fMRI revealed that ME/CFS patients had thalamic hyperconnectivity (increased functional connectivity) at baseline compared to healthy controls, and this hyperconnectivity “normalized” after the HBOT treatment. Patients who showed a clinical response (defined as a point increase in SF-36 PF) had greater reductions in this hyperconnectivity.
Discussion
The authors highlight the study’s strengths, including its multidimensional assessment (integrating patient-reported, physician-assessed, and neuroimaging data) and the high patient adherence to the protocol. Key limitations include the small sample size, the observational, non-controlled design, and the absence of a sham-treated (placebo) control group. The study also excluded severely affected, homebound patients, so the findings may not apply to that group.
Conclusion & Future Work
The authors conclude that HBOT was well-tolerated and associated with significant clinical improvements and the normalization of thalamic hyperconnectivity, suggesting a potential role for this brain mechanism in ME/CFS pathophysiology. This observational study provides a strong rationale for larger, randomized controlled trials to confirm the treatment’s efficacy.