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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

Coloring book pages from 17 year old girl with autism: (a) before beginning HBOT at 1.5 atm/100% oxygen; (b) after one week of HBOT (5 sessions at one hour each), she is beginning to create patches of color to fill in a space; (c) after 3 weeks of HBOT (about 15 hours of HBOT), she uses correct colors for Winnie the Pooh and Eyore, and the foliage except for the tree trunk; and (d) after 5 weeks of HBOT (20 hours of HBOT), she begins to respect borders and boundaries and even outlines the inner border with color. After 6 months, her coloring abilities remained stable. Pictures courtesy of Carol L. Henricks, MD. Credit: Permission for use of drawings granted by the Journal of American Physicians and Surgeons.
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Figure 3: Coloring book pages from 17 year old girl with autism: (a) before beginning HBOT at 1.5 atm/100% oxygen; (b) after one week of HBOT (5 sessions at one hour each), she is beginning to create patches of color to fill in a space; (c) after 3 weeks of HBOT (about 15 hours of HBOT), she uses correct colors for Winnie the Pooh and Eyore, and the foliage except for the tree trunk; and (d) after 5 weeks of HBOT (20 hours of HBOT), she begins to respect borders and boundaries and even outlines the inner border with color. After 6 months, her coloring abilities remained stable. Pictures courtesy of Carol L. Henricks, MD. Credit: Permission for use of drawings granted by the Journal of American Physicians and Surgeons.

Mentions: Several case studies have reported behavioral improvements in individuals with ASD from treatment with HBOT. The first published report of the use of HBOT in an individual with ASD was in 1994 [115]. In this report, treatment with HBOT resulted in improvements in mood and social interactions in a three year old child with ASD. The number of treatments and other HBOT parameters were not reported. In 2002, Heuser et al. reported a “striking improvement” in behavior, memory, social interaction, verbalizations and cognitive functioning in a 4 year old boy with ASD after HBOT treatment at 1.3 atm/24% oxygen for 10 consecutive days [57]. Another investigator observed significant objective improvements in coloring skills (seeFigure 3a-d) as well as speech and self-help skills in a 17 year old child with ASD using HBOT at 1.5 atm/100% oxygen for 20 sessions [116]. Burke noted improvements in 2 children with ASD using HBOT at 1.3 atm/28% oxygen, including improvements in communication, aggressiveness and social interaction [117]. Another report noted objective improvements in one child with ASD in handwriting (Figure 4a-b) after 40 treatments with HBOT at 1.3 atm/24% oxygen, as well as improvements in fine motor skills, bowel function, language and communication [58]. One investigator reported improvements in language, social interaction and overall cognition in a 3 year old boy with ASD using HBOT at 1.3 atm/24% oxygen for 40 treatments. This child also had chronic diarrhea and had the first normal bowel movement in his life with HBOT treatment [99]. In another report, 23 patients with ASD had various improvements in social interaction, language and repetitive behaviors with HBOT at 1.5 atm [47]. Finally, one prospective study of 20 children with ASD reported improvements in communication, social interaction and stereotypical behaviors after 20 HBOT sessions at 1.5 atm/100% oxygen [118].


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)

Coloring book pages from 17 year old girl with autism: (a) before beginning HBOT at 1.5 atm/100% oxygen; (b) after one week of HBOT (5 sessions at one hour each), she is beginning to create patches of color to fill in a space; (c) after 3 weeks of HBOT (about 15 hours of HBOT), she uses correct colors for Winnie the Pooh and Eyore, and the foliage except for the tree trunk; and (d) after 5 weeks of HBOT (20 hours of HBOT), she begins to respect borders and boundaries and even outlines the inner border with color. After 6 months, her coloring abilities remained stable. Pictures courtesy of Carol L. Henricks, MD. Credit: Permission for use of drawings granted by the Journal of American Physicians and Surgeons.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Coloring book pages from 17 year old girl with autism: (a) before beginning HBOT at 1.5 atm/100% oxygen; (b) after one week of HBOT (5 sessions at one hour each), she is beginning to create patches of color to fill in a space; (c) after 3 weeks of HBOT (about 15 hours of HBOT), she uses correct colors for Winnie the Pooh and Eyore, and the foliage except for the tree trunk; and (d) after 5 weeks of HBOT (20 hours of HBOT), she begins to respect borders and boundaries and even outlines the inner border with color. After 6 months, her coloring abilities remained stable. Pictures courtesy of Carol L. Henricks, MD. Credit: Permission for use of drawings granted by the Journal of American Physicians and Surgeons.
Mentions: Several case studies have reported behavioral improvements in individuals with ASD from treatment with HBOT. The first published report of the use of HBOT in an individual with ASD was in 1994 [115]. In this report, treatment with HBOT resulted in improvements in mood and social interactions in a three year old child with ASD. The number of treatments and other HBOT parameters were not reported. In 2002, Heuser et al. reported a “striking improvement” in behavior, memory, social interaction, verbalizations and cognitive functioning in a 4 year old boy with ASD after HBOT treatment at 1.3 atm/24% oxygen for 10 consecutive days [57]. Another investigator observed significant objective improvements in coloring skills (seeFigure 3a-d) as well as speech and self-help skills in a 17 year old child with ASD using HBOT at 1.5 atm/100% oxygen for 20 sessions [116]. Burke noted improvements in 2 children with ASD using HBOT at 1.3 atm/28% oxygen, including improvements in communication, aggressiveness and social interaction [117]. Another report noted objective improvements in one child with ASD in handwriting (Figure 4a-b) after 40 treatments with HBOT at 1.3 atm/24% oxygen, as well as improvements in fine motor skills, bowel function, language and communication [58]. One investigator reported improvements in language, social interaction and overall cognition in a 3 year old boy with ASD using HBOT at 1.3 atm/24% oxygen for 40 treatments. This child also had chronic diarrhea and had the first normal bowel movement in his life with HBOT treatment [99]. In another report, 23 patients with ASD had various improvements in social interaction, language and repetitive behaviors with HBOT at 1.5 atm [47]. Finally, one prospective study of 20 children with ASD reported improvements in communication, social interaction and stereotypical behaviors after 20 HBOT sessions at 1.5 atm/100% oxygen [118].

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