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Hyperbaric oxygen treatment in autism spectrum disorders.

Rossignol DA, Bradstreet JJ, Van Dyke K, Schneider C, Freedenfeld SH, O'Hara N, Cave S, Buckley JA, Mumper EA, Frye RE - Med Gas Res (2012)

Bottom Line: Studies of children with ASD have found positive changes in physiology and/or behavior from HBOT.For example, several studies have reported that HBOT improved cerebral perfusion, decreased markers of inflammation and did not worsen oxidative stress markers in children with ASD.Many of the studies had limitations which may have contributed to inconsistent findings across studies, including the use of many different standardized and non-standardized instruments, making it difficult to directly compare the results of studies or to know if there are specific areas of behavior in which HBOT is most effective.

View Article: PubMed Central - HTML - PubMed

Affiliation: Rossignol Medical Center, 3800 West Eau Gallie Blvd,, Melbourne, FL, 32934, USA. rossignolmd@gmail.com.

ABSTRACT
Traditionally, hyperbaric oxygen treatment (HBOT) is indicated in several clinical disorders include decompression sickness, healing of problem wounds and arterial gas embolism. However, some investigators have used HBOT to treat individuals with autism spectrum disorders (ASD). A number of individuals with ASD possess certain physiological abnormalities that HBOT might ameliorate, including cerebral hypoperfusion, inflammation, mitochondrial dysfunction and oxidative stress. Studies of children with ASD have found positive changes in physiology and/or behavior from HBOT. For example, several studies have reported that HBOT improved cerebral perfusion, decreased markers of inflammation and did not worsen oxidative stress markers in children with ASD. Most studies of HBOT in children with ASD examined changes in behaviors and reported improvements in several behavioral domains although many of these studies were not controlled. Although the two trials employing a control group reported conflicting results, a recent systematic review noted several important distinctions between these trials. In the reviewed studies, HBOT had minimal adverse effects and was well tolerated. Studies which used a higher frequency of HBOT sessions (e.g., 10 sessions per week as opposed to 5 sessions per week) generally reported more significant improvements. Many of the studies had limitations which may have contributed to inconsistent findings across studies, including the use of many different standardized and non-standardized instruments, making it difficult to directly compare the results of studies or to know if there are specific areas of behavior in which HBOT is most effective. The variability in results between studies could also have been due to certain subgroups of children with ASD responding differently to HBOT. Most of the reviewed studies relied on changes in behavioral measurements, which may lag behind physiological changes. Additional studies enrolling children with ASD who have certain physiological abnormalities (such as inflammation, cerebral hypoperfusion, and mitochondrial dysfunction) and which measure changes in these physiological parameters would be helpful in further defining the effects of HBOT in ASD.

No MeSH data available.


Related in: MedlinePlus

SPECT scan images in a 12 year old boy with autism (a) before and (b) after 80 sessions of HBOT at 1.3 atm. Legend: minus 2 (green) to minus 4 (blue) standard deviations indicate the magnitude of regional hypofunctioning (hypoperfusion). White arrows indicate improvement in deeper cortical hypoperfusion patterns. Red arrows on sagittal slices show the midline cerebellum hypoperfusion and improvements after HBOT. Yellow arrows on the “underside” view show the temporal lobe hypoperfusion with improvements after HBOT. Pictures courtesy of J. Michael Uszler, MD. Credit: Permission for use of figure from Hyperbaric Oxygen for Neurological Disorders granted by Best Publishing Company, Palm Beach Gardens, FL.
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Figure 1: SPECT scan images in a 12 year old boy with autism (a) before and (b) after 80 sessions of HBOT at 1.3 atm. Legend: minus 2 (green) to minus 4 (blue) standard deviations indicate the magnitude of regional hypofunctioning (hypoperfusion). White arrows indicate improvement in deeper cortical hypoperfusion patterns. Red arrows on sagittal slices show the midline cerebellum hypoperfusion and improvements after HBOT. Yellow arrows on the “underside” view show the temporal lobe hypoperfusion with improvements after HBOT. Pictures courtesy of J. Michael Uszler, MD. Credit: Permission for use of figure from Hyperbaric Oxygen for Neurological Disorders granted by Best Publishing Company, Palm Beach Gardens, FL.

Mentions: It is possible that HBOT could improve cerebral perfusion in ASD. Several studies have reported significant improvements in cerebral perfusion with the use of HBOT at lower pressures (i.e., 1.3 to 1.5 atm), as measured by pre- and post-HBOT SPECT scans in several neurological conditions, including TBI and chronic brain injury [16,17,19,22]. In addition, cerebral perfusion has been shown to change in children with ASD after treatment with HBOT. For example, several case reports have demonstrated improvements in cerebral perfusion, as measured by pre- and post-treatment SPECT scans, with the use of HBOT at 1.3 atm/24% oxygen, including one child with ASD who received 1 hour of HBOT per day for 10 consecutive days [57] and two children with ASD who received 40–80 treatments [58]. Behavioral improvements were observed in these children as well.Figure 1a-b demonstrates the pre- and post-HBOT SPECT scans in one child from this latter case report [58].


Hyperbaric oxygen treatment in autism spectrum disorders.

Rossignol DA, Bradstreet JJ, Van Dyke K, Schneider C, Freedenfeld SH, O'Hara N, Cave S, Buckley JA, Mumper EA, Frye RE - Med Gas Res (2012)

SPECT scan images in a 12 year old boy with autism (a) before and (b) after 80 sessions of HBOT at 1.3 atm. Legend: minus 2 (green) to minus 4 (blue) standard deviations indicate the magnitude of regional hypofunctioning (hypoperfusion). White arrows indicate improvement in deeper cortical hypoperfusion patterns. Red arrows on sagittal slices show the midline cerebellum hypoperfusion and improvements after HBOT. Yellow arrows on the “underside” view show the temporal lobe hypoperfusion with improvements after HBOT. Pictures courtesy of J. Michael Uszler, MD. Credit: Permission for use of figure from Hyperbaric Oxygen for Neurological Disorders granted by Best Publishing Company, Palm Beach Gardens, FL.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3472266&req=5

Figure 1: SPECT scan images in a 12 year old boy with autism (a) before and (b) after 80 sessions of HBOT at 1.3 atm. Legend: minus 2 (green) to minus 4 (blue) standard deviations indicate the magnitude of regional hypofunctioning (hypoperfusion). White arrows indicate improvement in deeper cortical hypoperfusion patterns. Red arrows on sagittal slices show the midline cerebellum hypoperfusion and improvements after HBOT. Yellow arrows on the “underside” view show the temporal lobe hypoperfusion with improvements after HBOT. Pictures courtesy of J. Michael Uszler, MD. Credit: Permission for use of figure from Hyperbaric Oxygen for Neurological Disorders granted by Best Publishing Company, Palm Beach Gardens, FL.
Mentions: It is possible that HBOT could improve cerebral perfusion in ASD. Several studies have reported significant improvements in cerebral perfusion with the use of HBOT at lower pressures (i.e., 1.3 to 1.5 atm), as measured by pre- and post-HBOT SPECT scans in several neurological conditions, including TBI and chronic brain injury [16,17,19,22]. In addition, cerebral perfusion has been shown to change in children with ASD after treatment with HBOT. For example, several case reports have demonstrated improvements in cerebral perfusion, as measured by pre- and post-treatment SPECT scans, with the use of HBOT at 1.3 atm/24% oxygen, including one child with ASD who received 1 hour of HBOT per day for 10 consecutive days [57] and two children with ASD who received 40–80 treatments [58]. Behavioral improvements were observed in these children as well.Figure 1a-b demonstrates the pre- and post-HBOT SPECT scans in one child from this latter case report [58].

Bottom Line: Studies of children with ASD have found positive changes in physiology and/or behavior from HBOT.For example, several studies have reported that HBOT improved cerebral perfusion, decreased markers of inflammation and did not worsen oxidative stress markers in children with ASD.Many of the studies had limitations which may have contributed to inconsistent findings across studies, including the use of many different standardized and non-standardized instruments, making it difficult to directly compare the results of studies or to know if there are specific areas of behavior in which HBOT is most effective.

View Article: PubMed Central - HTML - PubMed

Affiliation: Rossignol Medical Center, 3800 West Eau Gallie Blvd,, Melbourne, FL, 32934, USA. rossignolmd@gmail.com.

ABSTRACT
Traditionally, hyperbaric oxygen treatment (HBOT) is indicated in several clinical disorders include decompression sickness, healing of problem wounds and arterial gas embolism. However, some investigators have used HBOT to treat individuals with autism spectrum disorders (ASD). A number of individuals with ASD possess certain physiological abnormalities that HBOT might ameliorate, including cerebral hypoperfusion, inflammation, mitochondrial dysfunction and oxidative stress. Studies of children with ASD have found positive changes in physiology and/or behavior from HBOT. For example, several studies have reported that HBOT improved cerebral perfusion, decreased markers of inflammation and did not worsen oxidative stress markers in children with ASD. Most studies of HBOT in children with ASD examined changes in behaviors and reported improvements in several behavioral domains although many of these studies were not controlled. Although the two trials employing a control group reported conflicting results, a recent systematic review noted several important distinctions between these trials. In the reviewed studies, HBOT had minimal adverse effects and was well tolerated. Studies which used a higher frequency of HBOT sessions (e.g., 10 sessions per week as opposed to 5 sessions per week) generally reported more significant improvements. Many of the studies had limitations which may have contributed to inconsistent findings across studies, including the use of many different standardized and non-standardized instruments, making it difficult to directly compare the results of studies or to know if there are specific areas of behavior in which HBOT is most effective. The variability in results between studies could also have been due to certain subgroups of children with ASD responding differently to HBOT. Most of the reviewed studies relied on changes in behavioral measurements, which may lag behind physiological changes. Additional studies enrolling children with ASD who have certain physiological abnormalities (such as inflammation, cerebral hypoperfusion, and mitochondrial dysfunction) and which measure changes in these physiological parameters would be helpful in further defining the effects of HBOT in ASD.

No MeSH data available.


Related in: MedlinePlus