What Is Multiple Sclerosis?
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system in which the immune system attacks myelin, the protective sheath surrounding nerve fibres.
The loss of myelin disrupts the transmission of nerve impulses, resulting in a wide range of neurological symptoms that vary considerably from one patient to another.
The condition primarily affects young adults between the ages of 20 and 40 and is more common in women. Symptoms depend on the location of the demyelinating plaques and commonly include fatigue, mobility difficulties, spasticity, ataxia, sensory disturbances, visual problems such as optic neuritis, cognitive impairment and bladder dysfunction.
The course of the disease is highly individual. Some patients experience mild symptoms for decades, while others progress more rapidly towards disability.
Characteristics of Multiple Sclerosis
From a therapeutic perspective, one of the most important characteristics of multiple sclerosis is the presence of two distinct phases of tissue injury: active inflammation, which causes acute demyelination, and the gradual neuronal degeneration that follows and is responsible for permanent disability.
In nerve fibres that have lost their myelin but remain viable, nerve signals are transmitted with considerable instability. Any increase in body temperature or reduction in energy efficiency may worsen symptoms, a response known as Uhthoff’s phenomenon.
Energy failure in demyelinated neurons is a central feature of the disease. Without myelin, nerve conduction requires considerably more energy. Even mild hypoxia may substantially aggravate this energy imbalance, highlighting the importance of adequate oxygenation for the function of affected nerve fibres.
Scientific Basis
The use of hyperbaric oxygen therapy in multiple sclerosis has been studied since the 1980s, with mixed but noteworthy findings.
Studies have reported improvements in muscle strength, reduced spasticity, better bladder control and reduced fatigue in certain subgroups of patients, particularly those with primary progressive multiple sclerosis and those who are not experiencing an acute relapse. However, the response is not universal, and not all patients benefit to the same extent.
The biological rationale focuses on improving the energy efficiency of demyelinated neurons through increased oxygenation, reducing neuroinflammation and potentially supporting remyelination through the activation of oligodendrocytes.
The scientific community continues to evaluate this approach, with growing interest in patients with stable diseases who are seeking ways to improve their quality of life.
The Role of Hyperbaric Oxygen Therapy
In multiple sclerosis, hyperbaric oxygen therapy is used strictly as an adjunctive option. It does not replace neurological monitoring, disease-modifying treatment or physiotherapy, and it has not been shown to alter the course of the disease.
However, for patients experiencing severe fatigue, spasticity or bladder difficulties, it may provide meaningful support for everyday function.
Increased oxygenation may improve the energy efficiency of demyelinated nerve fibres, allowing more effective nerve conduction with lower metabolic demand. This may reduce neurological fatigue, one of the most disabling symptoms of multiple sclerosis, and improve functional endurance.
Treatment is administered outside periods of acute relapse, typically in courses of 20 to 40 sessions, and always under close neurological supervision.