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3472 The Use of Hyperbaric Oxygen Therapy in Autism


Thursday, July 10, 2008: 4:00 PM-5:15 PM
Sarasota 1 (Gaylord Palms Resort & Convention Center)
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Some of the abnormal findings in autism, including cerebral inflammation, hypoperfusion, and hypoxia may be improved with hyperbaric oxygen therapy (HBOT). Several recent prospective studies on the use of HBOT in individuals with autism will be presented, including studies measuring markers of inflammation and oxidative stress before and after HBOT. Common improvements, side effects, and protocols will be discussed. Recently, hyperbaric oxygen therapy (HBOT) has increased in popularity as a treatment for autism.  HBOT involves inhaling up to 100% oxygen at a pressure greater than one atmosphere (atm) in a pressurized chamber.  In some studies, the use of oxygen appears to enhance neurological function.  For instance, in a double-blind, placebo-controlled, cross-over study, oxygen administration in healthy young adults, when compared to room air, was demonstrated to enhance cognitive performance, including improved performance on attention, reaction times, and word recall.  Additionally, in elderly patients, HBOT at 2.5 atm and 100% oxygen, when compared to a control group, improved cognitive function, including memory.  Numerous studies document oxidative stress and inflammation in individuals with autism; both of these conditions have demonstrated improvement with HBOT.

HBOT for children is generally regarded as safe, even at pressures of 2.0 atm for 2 hours per day.  Several studies have demonstrated clinical improvements in certain neurodevelopmental disorders using HBOT; these include traumatic brain injury, cerebral palsy, and fetal alcohol syndrome.  Based upon this research data, some investigators have begun using HBOT as a treatment in individuals with autism.

Review of the pathophysiology found in some autistic individuals in conjunction with the mechanisms of action of HBOT lead to the speculation that HBOT might produce clinical improvements in autistic individuals.  Several studies indicate that some individuals with autism manifest cerebral hypoperfusion, cerebral hypoxia, neuroinflammation, and gastrointestinal inflammation.  HBOT might ameliorate some of these problems because it has been demonstrated to improve cerebral hypoperfusion and hypoxia, and also decrease neuroinflammation and gastrointestinal inflammation.

HBOT represents an emerging and new therapeutic advance for some individuals with autism.  It is important that the scientific evidence for HBOT, including the studies performed to date, be presented and critiqued.  Since the application of HBOT in autism is neither well-established nor well-accepted, a discussion of the potential use of HBOT for this medical condition is essential.  This presentation will briefly review the problems found in autism that HBOT can ameliorate, such as cerebral hypoperfusion, hypoxia, and inflammation.  The effects of HBOT on oxidative stress will be reviewed; this is a pertinent discussion as some individuals with autism express increased levels of oxidative stress.  Common improvements and side effects seen with HBOT in individuals with autism will be discussed.  The presentation will also review the protocols for treating autistic individuals with HBOT.

Several prospective studies on the use of HBOT in autism will be reviewed.  One recently published study utilized HBOT ranging from 1.3 to 1.5 atm in 18 children with autism (ages 3 to 16).  Markers of inflammation and oxidative stress were measured before and after HBOT treatment.  At both pressures, markers of oxidative stress did not worsen.  Furthermore, a statistically significant decrease in inflammation was observed, and significant clinic improvements were found, including motivation, speech, and cognitive awareness.  No major adverse events were observed and the treatment was well-tolerated and safe.

A most recent study of 61 children with autism (ages 2 to 7) compared HBOT at 1.3 atm with a control group (1.03 atm).  Statistically significant clinical improvements were found as rated by blinded parents and physicians when the treatment group was compared to the control group.  No major adverse events were seen in the study.

Previous conferences: Undersea and Hyperbaric Medical Society, 5th International Symposium on Hyperbaric Medicine, American College for the Advancement of Medicine, DAN! conference, Autism One, National Autism Association, USAAA conference

 

Learning Objectives:

  • Review and understand the common problems found in autism such as cerebral hypoperfusion, hypoxia, inflammation, and oxidative stress
  • Understand the effects of hyperbaric oxygen therapy (HBOT) on these common problems
  • Understand the common improvements and side effects seen with HBOT in individuals with autism
  • Review and understand the protocols for treating autistic individuals with HBOT

Content Area: Medicine and Research

Presenter:

Daniel A. Rossignol, M.D., FAAFP
Physician
Rossignol Medical Center

Dan Rossignol, MD, FAAFP received his Doctorate of Medicine at the Medical College of Virginia and completed his residency in family medicine at the University of Virginia. Some of his clinical interests include the study of antioxidants, anti-inflammatory medications, and nutritional supplements in neurodevelopment disorders, including autism.