In a repurposed laboratory at Harrisburg University of Science and Technology, a non-profit clinic has quietly become a destination for veterans and special operations personnel seeking relief from chronic traumatic brain injury and post-traumatic stress disorder. Since opening its doors in January 2025, the Aurelius Brain Health and Human Performance Program has treated more than sixty patients who traveled from twenty-five states and two countries to complete an accelerated nineteen-day protocol that places hyperbaric oxygen therapy at its center.
The clinic’s announcement this week marks a rare expansion of HBOT access specifically for veteran neurological and psychological conditions—uses that fall outside the therapy’s FDA-cleared indications and remain contentious within the military medical establishment.
A Three-Modality Approach
The Aurelius Protocol, described as patent-pending, combines three interventions delivered intensively over less than three weeks. Patients undergo hyperbaric oxygen therapy inside multiplace chambers manufactured by HPO.TECH, receiving 93–96 percent oxygen at 2.0 atmospheres absolute pressure through a built-in breathing system that synchronizes with their respiratory rhythm. Alongside the pressurized oxygen sessions, participants receive transcranial magnetic stimulation and structured physical training.
This multi-modal design reflects a growing trend in brain injury rehabilitation: the hypothesis that HBOT’s physiological effects—supersaturating plasma with oxygen to reach damaged or “idling” neural tissue—may synergize with neuromodulation and exercise to improve outcomes beyond what any single therapy achieves alone. The clinic’s founders, Anson Flake and Robert Ortenzio, come from rehabilitation and sports medicine backgrounds; Ortenzio co-founded Select Medical Corporation, one of the largest rehabilitation providers in the United States.
All treatment is provided without cost to patients, funded by private donors. The program maintains confidentiality for its participants, who include not only veterans but active-duty service members, special operations forces, and members of the intelligence community.
The Geography of Hope and Desperation
That patients are willing to travel from across the continental United States—and from overseas—to spend nineteen days in central Pennsylvania suggests something about the unmet need for TBI and PTSD interventions that conventional care has failed to satisfy. Many of the veterans treated at Aurelius carry diagnoses of chronic TBI, often from blast exposure during deployments, alongside comorbid PTSD and depression.
The clinic’s model represents one of several grassroots initiatives that have emerged where patients perceive gaps in federally provided care. Kentucky recently expanded state-funded HBOT access for veterans with PTSD through Centerpoint Health, and similar programs have operated in Texas and Florida. These state-level experiments exist in tension with the official positions of federal health agencies.
What the Evidence Actually Shows
The Aurelius Program’s outcomes have not been published in peer-reviewed literature, and the clinic has not announced plans for a randomized controlled trial. The sixty-patient cohort represents an observational experience rather than controlled evidence—valuable for generating hypotheses, but insufficient to establish efficacy.
For hyperbaric oxygen therapy specifically, the research landscape for TBI and PTSD remains deeply contested. The Department of Veterans Affairs and Department of Defense have funded multiple large trials, including the HOPPS study, which found no benefit of HBOT over sham compression for mild TBI and post-concussive symptoms. The Defense Health Agency’s Traumatic Brain Injury Center of Excellence summarized in a 2025 publication that “despite anecdotal reports of improvement, scientific evidence does not support the use of HBOT for TBI.”
Randomized trials from the Sagol Center at Tel Aviv University, led by Dr. Shai Efrati, have reported improvements in brain imaging and symptoms for TBI and fibromyalgia patients using specialized HBOT protocols. These studies, published in peer-reviewed journals, suggest that particular pressure and oxygen combinations may produce measurable neuroplastic changes. However, replication attempts have produced mixed results, and methodological debates—particularly around sham control design—continue to divide the research community.
The FDA’s Position: Not Cleared for Brain Injury or PTSD
The Food and Drug Administration has not approved or cleared hyperbaric oxygen therapy for traumatic brain injury, PTSD, depression, or any neurological or psychiatric condition. The agency’s cleared indications for HBOT remain limited to specific acute and chronic conditions: decompression sickness, carbon monoxide poisoning, gas gangrene, crush injuries, certain non-healing diabetic wounds, late radiation tissue injury, compromised skin grafts and flaps, and idiopathic sudden sensorineural hearing loss.
In its consumer guidance, the FDA explicitly warns against using HBOT for off-label conditions including Alzheimer’s disease, autism, stroke, multiple sclerosis, and brain injury—citing lack of sufficient evidence and potential safety risks. An August 2025 safety letter to healthcare providers further emphasized fire hazards, oxygen toxicity, and barotrauma risks associated with improper chamber operation.
This regulatory status has practical consequences for access. Medicare and most private insurers do not cover HBOT for TBI or PTSD, leaving patients to pay out-of-pocket or seek charitable programs like Aurelius. The VA has generally not authorized HBOT for these conditions outside of research protocols, though individual veterans may receive care through state-funded pilots or private clinics.
Safety in the Spotlight
The Aurelius Program uses hospital-grade multiplace chambers—rigid pressure vessels capable of treating multiple patients simultaneously under direct medical supervision. This distinguishes the program from the proliferating “mild hyperbaric” or soft-shell chamber industry, where lower pressures and non-medical oxygen concentrators have raised safety concerns.
At 2.0 ATA with concentrated oxygen delivery, the Aurelius protocol operates at pressures and oxygen levels consistent with established hyperbaric medicine. The clinic reports using HPO.TECH’s ATLANTIS and MEDITERRANEAN chamber systems, which are designed for clinical environments rather than wellness centers or home use.
Still, hyperbaric oxygen therapy carries inherent risks regardless of equipment quality. Barotrauma to ears, sinuses, or lungs can occur during pressure changes. Oxygen toxicity seizures, while rare, are a documented complication of high-pressure oxygen exposure. Fire safety requires strict protocols: the 2025 FDA safety communication noted injuries and deaths associated with chamber fires when proper precautions were not followed.
The Path Forward: Evidence or Access?
The Aurelius Clinic’s expansion highlights a fundamental tension in veteran healthcare: the gap between patient demand for HBOT and the evidence standards required for institutional adoption. For veterans who report improvement after completing the protocol, the distinction between “anecdotal” and “proven” may matter less than restored sleep, reduced headaches, or stabilized mood. For health systems responsible for millions of patients, the absence of definitive trial data—and the HOPPS trial’s negative result—remains determinative.
The clinic’s founders have indicated plans to continue scaling the program, potentially treating additional cohorts through 2026 and beyond. Whether this observational experience translates into publishable outcomes data, or whether the program remains a donor-funded alternative outside the mainstream, may determine its long-term influence on veteran care policy.
For now, Aurelius represents one point in a scattered landscape of HBOT access for veterans—part of a patient-driven movement that has outpaced regulatory approval and institutional consensus, but has not yet produced the definitive evidence that might bridge the divide.
HBOToday Editorial publishes evidence-based reporting on hyperbaric oxygen therapy research, regulation, and clinical practice. We have no financial relationship with Aurelius Clinic, HPO.TECH, or any hyperbaric equipment manufacturer.