4,194,304 (222) possible results
Why such a straightforward number?
Each press doubles the number of possible sequences
and no two sequences can produce the same result.
Why not?
Each press redoubles the additive/subtractive
effect of all previous presses, which have already
been redoubled by any intervening presses.
(The first press's effect has been doubled the most often.)
After that, the new +1 or -1 will only make half the difference
of the immediately preceding press.
This is equivalent to a 22-digit binary number.
The exact final result, $V\!$, equals a 23-bit binary number built from the
intermediate results $A$,$B$,...,$U$ of button presses $a$,$b$,...,$u$,
followed by one last button press, $v$.
\begin{array}{lrrllll}
\rm\llap{1st} ~press& a \;{=}\;{\pm}\!\: 1 & ~A ~~\rlap{=} ~& 2(1) + a & ~~\llap{=}~~~ \phantom{ 2( 2( } 2{+}a & ~~\llap{=}~~~ 2 + ~ a \\
\rm\llap{2st} ~press& b \;{=}\;{\pm}\!\: 1 & ~B ~~\rlap{=} ~&~ 2A ~ + b & ~~\llap{=}~~~ \phantom{ 2( } 2( 2{+}a )+b & ~~\llap{=}~~~ 4 + 2 a + ~ b \\
\rm\llap{3st} ~press& c \;{=}\;{\pm}\!\: 1 & ~C ~~\rlap{=} ~&~ 2B ~ + c & ~~\llap{=}~~~ 2( 2( 2{+}a )+b)+c & ~~\llap{=}~~~ 8 + 4 a + 2 b + c \\[-1ex]
\quad\vdots \\[-1ex]
\rm\llap{22nd}~press& v \;{=}\;{\pm}\!\: 1 & ~V ~~\rlap{=} ~&~ 2U ~ + v & ~~\llap{=}~~~ \rlap{ 2 ( \cdots 2 ( 2{+}a ) + \cdots ) + v } \\[1ex]
& & \rlap{=} ~&~ \rlap{ 2^{22} + 2^{21} a + 2^{20} b + \cdots + 2^0 v } \\[1ex]
& & \rlap{=} ~&~ \rlap{ 2^{22} \bigl( \frac12 {+} \frac a2 \bigr)
+ \, 2^{21} \bigl( \frac12 {+} \frac b2 \bigr) + \cdots
+ \, 2^1 \bigl( \frac12 {+} \frac v2 \bigr)
+ \, 2^0 ( 1 ) } \\[1ex]
& & \rlap{=} ~&~ \rlap{ 23 \;\!\textrm{-bit binary number} ~\mathit{abcdefghijklmnopqrstuv} \!\: 1_{\!\:2} } \\[-.5ex]
& & &~ \rlap{ \textrm{where the}~{-}\!\textrm{1s of}~ a,b,\dots,v ~\textrm{are replaced by 0}\!\:\textrm{s} }
\end{array}
Each of the 4,194,304 ($2^{22}$) possible sequences of 22 button presses
has a unique combination of values for $a$,$b$,$c$,...,$v$,
which produces a unique value for $V\!$
and happens to cover all of the 4,194,304 odd numbers
from 1 through 8,388,607 ($2^{23}{-}1$).
Sure enough, if every press were $\boxed{D-}$
then $V \! = 000\textrm{...}001_2 = 1$,
the same as doubling the original 1 and diminishing that
by 1 — producing no net
change — 22 times.
And if every press were $\boxed{D+}$
then $V \! = 11111111111111111111111_2$,
which amounts to $2{\times}1111111111111111111111_2 + 1$,
the same calculation as the 22nd and last repeated step of
doubling an intermediate result and adding 1 before the next step.