Methods and systems for improving cognitive performance

Abstract

The present disclosure relates to methods and systems for improving cognitive performance. More specifically, the present disclosure relates to methods and systems for cognitive training under high-stress conditions.

Description

Technical Field

[0001] The present disclosure relates to methods and systems for improving cognitive performance. More specifically, the present disclosure relates to methods and systems for cognitive training under high-stress conditions. Background Art

[0002] The following is a list of references that are considered relevant to the background of the subject matter of the present disclosure:

[0003] [1]Vadas et al., Frontiers in Integrative Neuroscience 2017,11,25

[0004] [2] Gill et al., J Appl Physiol 2014, 117(4), 406-412

[0005] [3]Ergen et al., Clin Neurophysiol 2017, 128(4), 579-588

[0006] [4] Yu et al., Clin Neurophysiol 2015, 126(11), 2058-2067

[0007] [5]Komiyama et al., Sci Rep 2017,7(1),10,000

[0008] [6] Su et al., Zhonghua Yu Fang 2016, 50(7), 600-604

[0009] [7]Bayer et al., Adv Gerontol 2017, 30(2), 255-261

[0010] [8]Malle et al., Aerosp Med Hum Perform 2016,87(1),3-12

[0011] [9] Goodwin et al., Neuroimage 2009, 47(2), 573-580

[0012]

[10] Chung et al., Physiol Meas 2007, 28(4), 389-396

[0013]

[11] Scholey et al., Physiol Behav 1999, 67(5), 783-789

[0014]

[12] Scholey et al., Psychopharmacology 1998,140(1),123-126

[0015]

[13] Tennstedt et al., J Aging Health 2013, 25(8), 3S-20S

[0016]

[14] Ball et al., JAMA 2002, 288(18), 2271-2281.

[0017]

[15] Noice et al., J Aging Health 2004, 16(4), 562-585

[0018]

[16] Neely et al., J Gerontol B 1995,50(3),134-140

[0019]

[17] Unverzagt et al., J Int Neuropsychol Soc 2009,13(6),953-960

[0020]

[18] Willis et al., JAMA 2006, 296(23), 2805-2814

[0021]

[19] Wolinsky et al., J Gerontol A 2006, 61(12), 1324-1329

[0022] Acknowledgment herein of the above references should not be inferred as meaning that these references are in any way relevant to the patentability of the subject matter of the present disclosure.

[0023] background

[0024] Hyperbaric therapy for various conditions has been known for many years, for example, to treat the effects of decompression sickness or carbon monoxide poisoning, to treat arterial gas embolism, to promote skin growth in burn patients, etc. Such treatment is usually performed by enclosing the patient in a chamber in which a controlled increase in pressure can be obtained. In some treatment protocols, the patient is also exposed to an oxygen-rich environment during hyperbaric therapy [1-12]. Cognitive training under ambient conditions has been shown to improve cognitive function in patients with various cognitive impairments [13-19]. To date, due to the severe restrictions imposed on hyperbaric treatment conditions (usually performed in a narrow tubular chamber that leaves little room for the patient to move and / or prevents the insertion of electrical equipment into it due to the oxygen-rich environment), the impact of alternative treatment routes such as cognitive training performed during hyperbaric therapy has yet to be studied.

[0025] General Description

[0026] The present disclosure relates to methods and systems for improving (e.g., enhancing) cognitive function by combining hyperbaric exposure in an oxygen-rich environment with cognitive training performed in a hyperbaric chamber. Such combined treatment is intended to improve cognitive function with a lasting effect, i.e., to achieve and maintain improvement after treatment (i.e., to maintain the therapeutic effect on cognitive function achieved by treatment for at least a period of time after treatment).

[0027] Therefore, one aspect of the present invention provides a method for improving cognitive performance in a subject, the method comprising treating the subject through one or more treatment cycles, each treatment cycle comprising exposing the subject to hyperbaric conditions and an oxygen-enriched environment, and performing at least one cognitive training task during the exposure.

[0028] In some embodiments, combining exposure to hyperbaric conditions and an oxygen-enriched environment with at least one cognitive training task performed during said exposure results in a synergistic effect on improvements in cognitive performance.

[0029] In the context of the present disclosure, the term improvement (or any language variation thereof) is intended to include the induction of at least one desired effect of the cognitive performance of the subject or produced by the cognitive performance of the subject. Therefore, by the method disclosed herein, the subject can be treated by treatment itself or by induction to induce, enhance, improve, prevent or reduce at least one effect related to cognitive ability by the related mechanism causing cognitive performance improvement. The term also means to include improving the undesirable symptoms associated with cognitive impairment, preventing its performance before such symptoms occur, slowing down the development of cognitive impairment, slowing down the deterioration of the symptoms associated with cognitive impairment, slowing down the irreversible damage caused in the progressive chronic stage of cognitive impairment, delaying the occurrence of the progressive stage, alleviating the severity of cognitive impairment, improving the recovery of brain injury, improving normal cognitive function, or a combination of two or more of the above.

[0030] In some embodiments, the methods improve or enhance cognitive performance in the subject.

[0031] In other embodiments, the methods reduce or prevent at least one symptom associated with at least one impaired cognitive function.

[0032] In other embodiments, the methods increase the subject's compliance to perform cognitive training and / or complete a set of one or more treatment cycles.

[0033] The term cognitive performance (or cognitive function, used interchangeably in this disclosure) is meant to include any psychological or intellectual process involving perception, thinking, reasoning, memory, sensation, imagination, etc., which enables a subject to perform a defined mental task. Exemplary, non-limiting cognitive functions may be verbal memory, non-verbal memory, immediate memory, delayed memory, information processing speed, attention, executive function, motoric function, visual perception, multitasking, visual-spatial recognition, verbal expression, navigation, intelligence, working memory, task switching, response inhibition, psychomotor speed, verbal fluency, object naming, word recognition, etc.

[0034] The methods of the present disclosure involve exposing the subject to be treated to hyperbaric and oxygen-rich conditions (hyperbaric oxygen therapy - HBOT) during which the subject is performing at least one cognitive task.

[0035] Hyperbaric conditions refer to exposure of a subject to a pressurized environment, i.e., an environment where the pressure is above standard atmospheric pressure (>1 atm). Such hyperbaric conditions can be obtained by using a hyperbaric chamber that is capable of achieving a controlled increase in pressure when the subject is therein. For example, such a hyperbaric chamber can be suitable for enclosing a single subject, or for enclosing two or more subjects simultaneously.

[0036] According to some embodiments, the hyperbaric conditions comprise exposing the subject to a pressure between about 1.1 atmospheres absolute (ATA) and about 3.2 ATA. In other embodiments, the hyperbaric conditions comprise exposing the subject to a pressure between about 1.2 ATA and about 3 ATA.

[0037] Together with the increased pressure, the subject is exposed to an oxygen-enriched environment, which in some embodiments refers to an environment that contains between about 22% and 100% oxygen by volume. In other embodiments, the oxygen-enriched environment may contain about 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 98% or even 100% oxygen by volume. In some other embodiments, the oxygen-enriched environment contains between about 30% and about 100% oxygen by volume, between about 40% and about 100% oxygen by volume, between about 50% and 100% oxygen by volume, or even between 60% and 100% oxygen by volume.

[0038] In other embodiments, the oxygen-rich environment includes about 21 volume % oxygen provided at above atmospheric pressure.

[0039] The oxygen-rich environment may be provided throughout the volume of the hyperbaric chamber, or may be administered individually to each subject within the chamber, such as via a personal mask, hood, cannula, or the like.

[0040] In some embodiments, the oxygen level in the oxygen-rich environment is maintained constant throughout the treatment cycle.

[0041] In other embodiments, exposure to the oxygen-enriched environment is performed intermittently. In such embodiments, exposure to the oxygen-enriched environment can be performed during a defined time period, with lower oxygen levels (e.g., 21% by volume of oxygen or ambient air) being applied at intervals between the defined time periods. For example, between applying the oxygen-enriched environment, such intervals can be between about 10 seconds and 30 minutes. In some embodiments, the intervals can be between about 1 minute and about 10 minutes.

[0042] According to some embodiments, each treatment cycle may include a total (duration) time of exposure to the oxygen-enriched environment between about 1 minute and 200 minutes. In other embodiments, the total exposure time may be between about 10 minutes and 180 minutes, between about 10 minutes and 160 minutes, between about 10 minutes and 140 minutes, or even between about 10 minutes and 120 minutes. In some other embodiments, the total exposure time may be between about 20 minutes and 200 minutes, between about 30 minutes and 180 minutes, between about 40 minutes and 160 minutes, between about 50 minutes and 140 minutes, or even between about 60 minutes and about 120 minutes.

[0043] During exposure to high pressure and oxygen-enriched conditions (and sometimes also during exposure to intervals between oxygen-enriched environments), the subject is carrying out at least one cognitive training task. In some embodiments, at least one cognitive training task can be selected from one or more tasks: reaction time, double decision, continuous attention, distributed attention, selective attention, working memory, long-term memory, reasoning, auditory processing, verbal memory task, nonverbal memory task, instantaneous memory task, delayed memory task, information processing speed task, attention task, executive function task, motoric task, visual perception task, multi-tasking assignment, visual spatial task, verbal task, navigation task, intelligence task, working memory task, task switching, reaction inhibition task, psychomotor speed task, verbal function task (fluency / naming / vocabulary) etc., and their combination. Cognitive training or cognitive task can be carried out by any appropriate means, for example, by interaction with the operator, interaction with special equipment or tool, carrying out predetermined test or homework etc.

[0044] The method is typically performed for at least 2 treatment cycles, and according to some embodiments, between 5 and 120 cycles. The cycles can be performed daily (i.e., 1 cycle per day). Alternatively, the treatment cycles can be performed every 2 days, every 3 days, every 4 days, every 5 days, every 6 days, every week, every two weeks, etc. As will become apparent to practitioners, the methods disclosed herein may also include any continuous sequence of treatment cycles, for example, stopping for a few days after a certain number of daily cycles (e.g., stopping a 2-day sequence after 5 daily cycles). It should also be understood that the number of cycles may vary depending on the desired level of improvement in cognitive performance and / or the medical / cognitive history or condition of the subject.

[0045] In some embodiments, the treatment conditions (i.e., pressure, volume % oxygen, type of cognitive training task, etc.) can be the same in each treatment cycle. In other embodiments, the treatment conditions vary from cycle to cycle. It should also be understood that in other embodiments, the treatment conditions can vary depending on the condition of the subject and the level of improvement in cognitive performance. For example, several cycles can be performed with a given set of conditions, and then several cycles can be performed with a different set of treatment conditions.

[0046] According to some embodiments, each treatment cycle may be performed for a period of between about 1 minute and 200 minutes.

[0047] According to some embodiments, the method may also include evaluating the cognitive performance of the subject before the exposure to the treatment condition to obtain a first cognitive performance score. In other embodiments, the method may also include evaluating the cognitive performance of the subject after the exposure to the treatment condition to obtain a second cognitive performance score. Comparing the first score and the second score (or applying any suitable algorithm to the first score and the second score) can achieve obtaining the evaluation / assessment score of the subject to determine the progress of the subject. The assessment of cognitive performance can also be performed at any time during the treatment cycle. In some embodiments, the evaluation score of a given treatment cycle (or after a sequence of several cycles) can determine the treatment conditions in one or more subsequent treatment cycles, for example, by comparing with one or more of the current score during the treatment cycle, the relative score of a similar age group, etc.

[0048] The term score refers to any relevant measurable or assessable value, either quantitative or qualitative, that is used to evaluate a subject's cognitive performance.

[0049] The method may also include a compression phase prior to the treatment cycle; compression may generally be performed at a rate between about 0.1 m / min and about 2 m / min. The method may also include a decompression phase after the treatment cycle, which may generally be performed at a decompression rate between about 0.1 m / min and about 2 m / min.

[0050] In some embodiments, at least one treatment cycle may also include at least one physical training task performed under the hyperbaric conditions and oxygen-enriched environment. Physical training may be any suitable physical training known per se, such as cycling, walking, brisk walking, running, jumping, weightlifting, riding a handcycle, etc. It should be understood that in the context of the present disclosure, in addition to cognitive training, physical training may also be used to obtain improvements in one or more cognitive functions.

[0051] The subject is usually a human being, either an adult or a child (a child refers to a subject less than 18 years old). The subject may be healthy, suffer from one or more cognitive disorders or damage or have a history of brain damage. In some embodiments, the subject has a history of brain damage, such as stroke, traumatic brain injury (TBI), ischemia, hemorrhagic injury, traumatic injury, anoxia, hypoxia, damage caused by metabolic disorders, damage caused by toxic exposure and infection. In other embodiments, the subject suffers from neurodegenerative diseases, dementia or mild cognitive impairment. In some other embodiments, the subject suffers from cognitive decline associated with aging. In other embodiments, the subject suffers from cerebral palsy. In other embodiments, the subject suffers from abnormal development. According to some other embodiments, the subject is a healthy subject. According to other embodiments, the subject is pre-diagnosed or not diagnosed as suffering from a disease. According to other embodiments, the subject is a professional athlete (that is, treatment is tailored to improve the cognitive and mental performance of the athlete, rather than his / her physical performance).

[0052] The present disclosure also provides a system for operating the methods described herein.Thus, in another aspect, a system for use in the methods of the present disclosure is provided.

[0053] Another aspect of the present disclosure is a system for operating the methods described herein, the system comprising at least one hyperbaric chamber, the at least one hyperbaric chamber being configured to surround at least one subject and apply hyperbaric conditions thereto; at least one controllable oxygen administration unit, the at least one controllable oxygen administration unit allowing an oxygen-rich environment to be formed within the chamber and / or being configured to administer the oxygen-rich environment to the subject; and at least one cognitive training tool within the chamber, the at least one cognitive training tool being configured to allow the subject to perform the at least one cognitive training task.

[0054] In the context of this disclosure, the term hyperbaric chamber is meant to include a single-place chamber (i.e., for occupancy by a single user) or a multi-place chamber (for occupancy by one or more users). A chamber may be unitary or divided into sub-chambers or treatment areas; the conditions applied in a sub-chamber or area may be the same as or different from the conditions applied in another sub-chamber or area.

[0055] According to some embodiments, the hyperbaric chamber may further include at least one pressurized subchamber, at least one training subchamber, and at least one decompression subchamber. The pressurized subchamber, the training subchamber, and the decompression subchamber may be connected to each other to allow the subject to transfer between them, for example, the subchambers may be integrated with each other.

[0056] In some embodiments, the hyperbaric chamber can be configured to surround a single subject to be treated.

[0057] In other embodiments, the hyperbaric chamber can be configured to enclose two or more subjects to be treated simultaneously therein. In such embodiments, at least one controllable oxygen administration unit can be configured to administer a controlled oxygen-enriched environment to each subject, and / or can be configured to administer a different oxygen-enriched environment to each subject.

[0058] According to some embodiments, at least one cognitive training tool can be configured to allow each subject to perform at least one cognitive training task independently. At least one cognitive training tool can be configured to allow each subject to perform different cognitive training tasks and / or independently of other subjects in the chamber.

[0059] The system may also include at least one physical training tool within the chamber, the physical training tool configured to allow the subject to perform at least one physical training task.

[0060] In some embodiments, the system may further include at least one monitoring unit for monitoring at least one physical parameter of the subject (e.g., heart rate, oxygen saturation level, blood pressure, glucose level, various markers and / or electrolytes, etc.). According to some embodiments, the monitored physical parameters may be used to determine (at least in part) conditions in one or more subsequent treatment cycles.

[0061] In other embodiments, the system may further include at least one controller for operating and controlling the system.

[0062] The system may also include one or more communication tools within the chamber, allowing the subject being treated and an operator residing outside the chamber to communicate with each other during the treatment session.

[0063] The system may also include one or more entertainment and / or interaction tools / units, such as a music player, TV screen, computer interface, etc.

[0064] As used herein, the term about is intended to encompass deviations of ±10% from the value of a specifically mentioned parameter (such as time, pressure, volume %, etc.).

[0065] Whenever a numerical range is indicated herein, it is meant to include any stated numeral (fractional or integer) within the indicated range. The phrases "a range between / between a first indicated numeral and a second indicated numeral" and "a range from / to a first indicated numeral" are used interchangeably herein and are meant to include the first indicated numeral and the second indicated numeral and all fractional and integer numerals therebetween.

[0066] It should be understood that certain feature details of the present disclosure described in the context of separate embodiments for clarity may also be provided in combination in a single embodiment. Conversely, various features described in the context of a single embodiment for brevity may also be provided separately, or in any suitable sub-combination, or if appropriate, in any other described embodiment of the present disclosure. BRIEF DESCRIPTION OF THE DRAWINGS

[0068] In order to better understand the subject matter disclosed herein and to illustrate how the subject matter disclosed herein may be implemented in practice, embodiments will now be described by way of non-limiting examples only, with reference to the accompanying drawings, in which:

[0069] Figure 1 is a schematic illustration of a system suitable for performing the methods described herein, according to an embodiment of the present disclosure.

[0070] Detailed description of the implementation plan

[0071] In the following description, the invention will be described in some detail with reference to a specific embodiment of a system for carrying out the methods described herein. This description is exemplary and does not limit the full scope of the disclosure described.

[0072] refer to Figure 1, a schematic representation of an exemplary system of the present disclosure is shown. System 100 includes a hyperbaric chamber 102, which includes more than one station 104 (three (3) stations in this specific non-limiting example). Each station 104 is configured to accommodate a subject to be treated. The station can be, for example, a sitting, standing or lying position, and after accommodating the subject, the subject is allowed to be exposed to hyperbaric conditions and to allow the subject to perform at least one cognitive training task. Each station 104 also includes a tool (not shown) for providing an oxygen-enriched environment (i.e., an environment with an oxygen concentration greater than 21% by volume) to the subject; such tools can be, for example, an oxygen mask, a protective shield, a cannula, etc. The oxygen supply tool is connected to a controllable oxygen source 108 via a supply line 109, thereby allowing the oxygen level, exposure duration, oxygen exposure spectrum / scheme, etc. of each station 104 to be controlled together or independently of each other. In some configurations, the system also provides an air source 110 connected to each station via a supply line 111, allowing the subject to be exposed to an air environment (i.e., unpressurized air at approximately 21% oxygen by volume) between oxygen-enriched environment exposure periods, depending on the desired treatment regimen.

[0073] Each station 104 is associated with at least one cognitive training tool 106, allowing a subject to perform at least one cognitive training task. In the case of an electronic / digital training tool, the cognitive training tool 106 may be connected to a control system 112 via a line 113 (which may be wired or wireless). The control system 112 may provide and operate cognitive training tasks for each subject, as well as collect data from the subject, and sometimes also analyze the data received from the subject to customize the cognitive training task to be performed by the subject.

[0074] As noted, although Figure 1 Not shown, but the system may include other functions, such as monitoring units, entertainment modules, physical training tools, etc. Although in the specific example, the system is shown to include a hyperbaric chamber, it is within the scope of the present disclosure that the system includes more than one interconnected chamber or sub-chamber, allowing subjects to freely transfer between them while maintaining the hyperbaric conditions in the system. For example, each such sub-chamber can be dedicated to a different type of training or activity performed under hyperbaric and oxygen-enriched conditions. Example

[0075] Example 1: Cognitive Training Comparison Scheme 1

[0076] Cognitive training is performed during exposure to a hyperbaric, oxygen-rich environment with the goal of improving and / or enhancing cognitive abilities. The synergistic effect of cognitive training during hyperbaric oxygen therapy (HBOT) was evaluated by comparing cognitive training during the HBOT phase with and without HBOT.

[0077] Subjects to be treated are patients aged 60-74 years with aging-related functional decline. Screening (inclusion criteria) of subjects - at least 1 standard deviation (SD) below the mean in at least one cognitive domain, as measured using a computerized cognitive assessment (e.g. Neurotrax or any other suitable assessment tool).

[0078] Three groups were tested, each including 10 patients, according to the following groupings:

[0079] 1. Group 1: HBOT and intracavitary cognitive training (60 daily cycles, i.e. 1 cycle per day, for up to 60 days)

[0080] 2. Group 2 (Control 1): HBOT and extra-chamber cognitive training task (60 daily cycles)

[0081] 3. Group 3 (Control 2): ​​Cognitive training task only (60 daily cycles)

[0082] Treatment parameters:

[0083] Pressure in chamber: 2ATA

[0084] Oxygen level: 100%

[0085] Total time: 120 minutes per treatment cycle

[0086] Oxygen clean time: 90 minutes per cycle

[0087] · Oxygen-enriched environment administered via mask

[0088] Total number of cycles: 60

[0089] Number of cycles per week: 5

[0090] Decompression rate: 1m / min

[0091] Pressurization rate: 1m / min

[0092] Air breaks: 5-minute air breaks between every 20-minute oxygen-enriched environment administration (21% oxygen)

[0093] Duration of cognitive training tasks: 25 minutes per cycle

[0094] Cognitive training

[0095] At least one cognitive task selected from (but not limited to):

[0096] οMemory (verbal, nonverbal, immediate, delayed)

[0097] οInformation processing speed

[0098] οNote

[0099] οExecutive Function

[0100] οMuscle movement (motor)

[0101] οVisual perception

[0102] οMulti-tasking

[0103] οNavigation

[0104] οIntelligence

[0105] οWorking memory

[0106] οTask switching

[0107] οReaction inhibition

[0108] οPsychomotor speed

[0109] οSpeech function (fluency / naming / vocabulary)

[0110] οReaction time

[0111] οDouble decision

[0112] οContinuous attention

[0113] οDistributive attention

[0114] οSelective attention

[0115] οReasoning

[0116] ο Auditory processing

[0117] Memory scores and / or information processing speed scores are determined before and after the treatment period by a cognitive assessment tool (eg, Neurotrax, BrainHQ, or any other suitable assessment tool).

[0118] Example 2: Cognitive Training Comparison Scheme 2

[0119] Cognitive training is performed during exposure to a hyperbaric, oxygen-rich environment with the goal of improving and / or enhancing cognitive abilities. The synergistic effect of cognitive training during hyperbaric oxygen therapy (HBOT) was evaluated by comparing cognitive training during the HBOT phase with and without HBOT.

[0120] Subjects to be treated are patients aged 40-55 years with brain injury (stroke / TBI). Screening (inclusion criteria) of subjects - at least 1 standard deviation (SD) below the mean in at least one cognitive domain, as measured using a computerized cognitive assessment (e.g. Neurotrax or any other suitable assessment tool).

[0121] Two groups of 5 patients were tested in the following groups:

[0122] 1. Group 1: HBOT and intracavitary cognitive training (60 cycles, e.g., 1 cycle per day for 60 days)

[0123] 2. Group 2 (Control 1): HBOT and extra-chamber cognitive training (60 daily cycles)

[0124] 3. Group 3 (Control 2): ​​Cognitive training task only (60 daily cycles), or both groups performed 40-60 sessions of cognitive training without HBOT before being divided into Group 1 and Group 2.

[0125] Treatment parameters:

[0126] Pressure in chamber: 2ATA

[0127] Oxygen level: 100%

[0128] Total time: 120 minutes per treatment cycle

[0129] Oxygen clean time: 90 minutes per cycle

[0130] · Oxygen-enriched environment administered via mask

[0131] Total number of cycles: 60

[0132] Number of cycles per week: 5

[0133] Decompression rate: 1m / min

[0134] Pressurization rate: 1m / min

[0135] Air breaks: 5 minutes of air breaks between every 20 minutes of oxygen-enriched environment administration (21% oxygen)

[0136] Duration of cognitive training tasks: 20 minutes per cycle

[0137] Exemplary cognitive training

[0138] οMemory (verbal, nonverbal, immediate, delayed)

[0139] οInformation processing speed

[0140] Memory scores and / or information processing speed scores are determined before and after the treatment cycle by BRAINHQ (every 5 cycles) and by Neurotrax (after 60 cycles) or by any other suitable assessment tool.

Claims

1. A system for improving cognitive performance of a subject by treating the subject through one or more treatment cycles, each treatment cycle comprising exposing the subject to hyperbaric conditions and an oxygen-enriched environment and performing at least one cognitive training task during the exposure, the system comprising: at least one hyperbaric chamber configured to surround at least one subject and apply hyperbaric conditions thereto, at least one controlled oxygen administration unit, the at least one controlled oxygen administration unit allowing the creation of an oxygen-rich environment within the chamber and / or configured to administer the oxygen-rich environment to the subject, and at least one cognitive training tool within the chamber, the at least one cognitive training tool being configured to allow the subject to perform at least one cognitive training task, the at least one cognitive training tool comprising a dedicated device or tool configured for the subject to interact with the at least one cognitive training tool during the cognitive training, and The system is configured to provide an assessment of cognitive performance during the treatment period by providing a current assessment score of the subject during the treatment period. 2 . The system of claim 1 , further comprising at least one physical training tool within the chamber, the physical training tool configured to allow the subject to perform at least one physical training task.

3. The system according to claim 1 further comprising at least one monitoring unit for monitoring at least one physical parameter of the subject.

4. The system of claim 1, further comprising at least one controller for operating and controlling the system.

5. The system of claim 1, wherein the chamber is configured to enclose two or more subjects.

6. The system of claim 5, wherein the at least one controllable oxygen administration unit is configured to administer a controlled oxygen-enriched environment to each subject.

7. The system of claim 6, wherein the at least one controllable oxygen administration unit is configured to administer a different oxygen-enriched environment to each subject.

8. The system of claim 5, wherein the at least one cognitive training tool is configured to allow each subject to independently perform at least one cognitive training task.

9. The system of claim 8, wherein the at least one cognitive training tool is configured to allow each subject to perform a different cognitive training task.

10. The system of claim 1, wherein the chamber further comprises at least one pressurized sub-chamber, at least one training sub-chamber, and at least one decompression sub-chamber, the pressurized sub-chamber, the training sub-chamber, and the decompression sub-chamber being interconnected to allow the subject to transfer therebetween.

11. The system of claim 10, wherein the at least one pressurized sub-chamber, the at least one training sub-chamber, and the at least one decompression sub-chamber are integral to one another.

12. The system of claim 1, wherein the system is configured to apply one or more treatment cycles, each treatment cycle comprising exposing the subject to hyperbaric conditions and an oxygen-enriched environment and performing at least one cognitive training task during the exposure.

13. The system of claim 12, wherein the treatment conditions are the same in each treatment cycle.

14. The system of claim 12, wherein the treatment conditions vary from treatment cycle to treatment cycle.

15. The system of claim 1, further comprising means for assessing the subject's cognitive performance prior to the exposure to obtain a first score, assessing the subject's cognitive performance after the exposure to obtain a second score, and comparing the first score and the second score to obtain an assessment score for the subject.

16. The system of claim 1, wherein the at least one cognitive training task is one or more tasks selected from the group consisting of: verbal memory tasks, nonverbal memory tasks, immediate memory tasks, delayed memory tasks, information processing speed tasks, attention tasks, executive function tasks, motor tasks, visual perception tasks, multitasking, visual-spatial tasks, verbal tasks, navigation tasks, intelligence tasks, working memory tasks, task switching, response inhibition tasks, psychomotor speed tasks, verbal function tasks, reaction time, double decision, continuous attention, divided attention, selective attention, working memory, long-term memory, reasoning, auditory processing, and combinations thereof.

17. The system of claim 16, wherein the speech function task is fluency / naming / vocabulary.

18. The system of claim 1, wherein the subject has a history of brain injury.

19. The system of claim 18, wherein the brain injury is selected from the group consisting of stroke, traumatic brain injury (TBI), ischemia, hypoxia, injury due to metabolic disorders, injury due to toxic exposure, and infection.

20. The system of claim 1, wherein the subject suffers from a neurodegenerative disease, dementia or mild cognitive impairment, aging-related cognitive decline, cerebral palsy, or abnormal development.

21. The system of claim 1, wherein the subject is a healthy subject.

22. The system of claim 1, wherein the at least one controllable oxygen administration unit is configured to administer the oxygen-enriched environment during defined time periods, with lower oxygen levels being administered at intervals between the defined time periods during the treatment cycle.

23. The system of claim 22, wherein the administration of a lower oxygen level during the interval is ambient air or oxygen level of about 21% by volume.

24. A system for improving cognitive performance of a subject by treating the subject through one or more treatment cycles, each treatment cycle comprising exposing the subject to hyperbaric conditions and an oxygen-enriched environment and performing at least one cognitive training task during the exposure, the system comprising: at least one hyperbaric chamber configured to surround at least one subject and apply hyperbaric conditions thereto, at least one controllable oxygen administration unit allowing the formation of an oxygen-rich environment within the chamber and / or configured to administer the oxygen-rich environment to the subject, wherein the at least one controllable oxygen administration unit is configured to administer the oxygen-rich environment during defined time periods with intervals between the defined time periods during the treatment cycle to administer lower oxygen levels, and at least one cognitive training tool within the chamber, the at least one cognitive training tool being configured to allow the subject to perform at least one cognitive training task, the at least one cognitive training tool being configured for the subject to interact with the at least one cognitive training tool during the cognitive training, The system is configured to provide an assessment of cognitive performance during the treatment period by providing a current assessment score of the subject during the treatment period.

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