H2​ and the Brain: A New Hope for Acute Stroke Patients 🧠

Molecular hydrogen (H2​) is stepping out of the science lab and into the spotlight. Known primarily as a basic element, it's now being recognized by the medical community as a powerful therapeutic antioxidant. This role is particularly promising for treating conditions like acute cerebral infarction (stroke), which involves significant oxidative stress.

A recent randomized controlled clinical study investigated just how safe and effective H2​ gas inhalation is for acute stroke patients. Here’s a closer look at what the study found.

How the Study Worked

Researchers enrolled 50 patients who were in the acute stage of a cerebral infarction with mild-to-moderate severity(NIHSS scores of 2–6). They were divided into two groups:

• H2​ Group (25 patients): Inhaled 3% H2​ gas for one hour, twice a day, for the first seven days.

• Control Group (25 patients): Received standard conventional intravenous medications. Notably, most control patients received edaravone, a scavenger of free radicals, as part of their treatment.

• The goal was to check the H2​ treatment's safety and effectiveness using various daily and weekly evaluations over a two-week period.

Safety First: H2​ is Well-Tolerated

The first and most critical finding was that the H2​ treatment was safe.

• The H2​ group showed no significant adverse effects.

• Daily checks of vital signs (like blood pressure and pulse rate) and weekly blood tests showed no statistical difference between the two groups, confirming the safety of H2​ even for the elderly patients in the study.

• A bonus finding: The H2​ group showed a significant improvement in oxygen saturation compared to the control group.

Effectiveness: Better Outcomes for H2​ Patients

The study tracked improvements in brain tissue recovery and patient function, where the H2​ group often performed better than the control group.

1. Brain Tissue Recovery (MRI)

Magnetic Resonance Imaging (MRI) was used to evaluate the infarction site. The severity was measured using the Relative MRI Signal Intensity (RSI).

• The RSI changes were statistically significant between the two groups on Day 7 and Day 14.

• The data suggested that the pathological change was milder and recovered more quickly in the H2​ group compared with the control group.

• The H2​ group's RSI reached an almost normal level by Day 14, suggesting that hydrogen therapy may help protect the penumbra—the tissue surrounding the stroke core that can still be saved.

2. Neurological Status (NIHSS Scores)

The NIHSS score quantifies the severity of a stroke.

• The neurological improvement was more marked in the H2​ group.

• The difference was statistically significant on all evaluation days (Days 3, 5, 7, 9, 11, and 14).

• Significantly, the H2​ group showed marked improvement by Day 3, while the control group's scores actually worsened slightly at that early time point.

  
  

3. Daily Living Function (Barthel Index)

The ability of patients to perform Activities of Daily Living (ADL) was evaluated by physical therapy using several indexes, including the Barthel Index (BI), which focuses on physical function disorders like eating, dressing, and bathing.

• Only the difference in improvement for the Barthel Index was statistically significant between the two groups.

• The better improvement in the BI score suggests that H2​ treatment achieved a marked achievement in physical function for a short, two-week examination period.

The Big Picture

The results strongly suggest that the inhalation of H2​ gas is safe and effective in patients with acute cerebral infarction. Because inhaled H2​ gas acts rapidly, it is particularly suitable for defending against acute oxidative stress in an emergency.

The authors conclude that H2​-gas therapy has the potential for widespread and general application as a safe, novel treatment for acute cerebral infarction. This small study certainly suggests that hydrogen may become an important tool in the fight against stroke.

What are your thoughts on using a gas like H2​ for emergency medical treatment?

Reference:

https://pubmed.ncbi.nlm.nih.gov/28669654/