Introduction
Autism is a disorder of the immune system with genetic predispositions. Both are affected by the individual’s ability to deal with environmental and toxic triggers which overwhelm a dysfunctional immune system. Studies documenting the mitochondrial dysfunction in the cells of autistic patients point to increased amount of oxidative stress in the cell. This prevents the mitochondria from doing the work required for normal metabolic function of the immune and central nervous systems.
Many studies have been done ranging from the ultra low (soft-chamber) pressures of 1.3 ATA to 1.7ATA in hard chambers where the patient receives 100% oxygen. Since it is difficult to standardize the patients to fit the same clinical picture the results of these studies have been questioned. However, on an individual patient basis, the clinical improvements as observed by physicians, parents and teachers and the changes seen on SPECT scans of the brain have demonstrated the positive effects of Hyperbaric Oxygen Therapy.
It is important to understand the other comorbid medical conditions that these patients on the autism spectrum have, e.g intestinal dysbiosis and inflammatory bowel scenarios, heavy metal and environmental toxicity, chronic seasonal allergy, gastroesophageal reflux disease and in some cases documented cerebral and cerebellar edema, are responding to the increased absorption of oxygen under hyperbaric pressure. The ultimate clinical response is that the patient improves as a result of vascular changes, improved mitochondrial detoxification pathways and increase in stem cell production. These changes can be maintained by intermittent repeated treatments.
It should be noted that other studies need to be done to document these changes on an individual and group basis.
Research
Hyperbaric Oxygen Therapy in Thai Autistic Children
J Med Assoc Thai. 2008 Aug;91(8):1232-8.
Chungpaibulpatana J, Sumpatanarax T, Thadakul N, Chantharatreerat C, Konkaew M, Aroonlimsawas M.
BACKGROUND: Hyperbaric oxygen therapy is a modern treatment in Thailand for nitrogen imbalance (i.e., decompression sickness syndrome or Caisson disease). Hyperbaric therapy can increase plasma oxygen to the tissues including the brain.
OBJECTIVE: To determine whether hyperbaric oxygen therapy is safe to use in children with autism, and whether it has a statistically significant effect on autistic symptoms. This is the first study of this type in Thailand.
MATERIAL AND METHOD: Thai Autistic children (n = 7) received hyperbaric therapy for 10 sessions, at 1.3 atmospheres. Assessment was done before and after treatment in five domains: Social development, Fine motor and Eye-hand coordination, Language development, Gross motor development, Self-help skills.
RESULTS: Improvement was shown in five domains with a significant level. Seventy-five percent of the children showed improvement while 25% did not seem to respond to the treatment.
CONCLUSION: Hyperbaric therapy is a new treatment for Thai autistic children. Many scientific studies have recently shown that the therapy could be an effective treatment for autistic children and could improve the major autistic symptoms.
The Effects of Hyperbaric Oxygen Therapy on Oxidative Stress, Inflammation, and Symptoms in Children with Autism: an Open-Label Pilot Study
BMC Pediatr. 2007 Nov 16;7:36.
Rossignol DA, Rossignol LW, James SJ, Melnyk S, Mumper E.
BACKGROUND: Recently, hyperbaric oxygen therapy has increased in popularity as a treatment for autism. Numerous studies document oxidative stress and inflammation in individuals with autism; both of these conditions have demonstrated improvement with the therapy, along with enhancement of neurological function and cognitive performance. In this study, children with autism were treated with hyperbaric oxygen therapy at atmospheric pressures and oxygen concentrations in current use for this condition. Changes in markers of oxidative stress and inflammation were measured. The children were evaluated to determine clinical effects and safety.
METHODS: Eighteen children with autism, ages 3-16 years, underwent 40 hyperbaric sessions of 45 minutes duration each at either 1.5 atmospheres (atm) and 100% oxygen, or at 1.3 atm and 24% oxygen. Measurements of C-reactive protein (CRP) and markers of oxidative stress, including plasma oxidized glutathione (GSSG), were assessed by fasting blood draws collected before and after the 40 treatments. Changes in clinical symptoms, as rated by parents, were also assessed. The children were closely monitored for potential adverse effects.
RESULTS: At the endpoint of 40 hyperbaric sessions, neither group demonstrated statistically significant changes in mean plasma GSSG levels, indicating intracellular oxidative stress appears unaffected by either regimen. A trend towards improvement in mean CRP was present in both groups; the largest improvements were observed in children with initially higher elevations in CRP. When all 18 children were pooled, a significant improvement in CRP was found (p = 0.021). Pre- and post-parental observations indicated statistically significant improvements in both groups, including motivation, speech, and cognitive awareness (p < 0.05). No major adverse events were observed.
CONCLUSION: In this prospective pilot study of children with autism, hyperbaric oxygen therapy at a maximum pressure of 1.5 atmospheres with up to 100% oxygen was safe and well tolerated. The therapy did not appreciably worsen oxidative stress and significantly decreased inflammation as measured by CRP levels. Parental observations support anecdotal accounts of improvement in several domains of autism. However, since this was an open-label study, definitive statements regarding the efficacy of the treatment for the treatment of individuals with autism must await results from double-blind, controlled trials.
Hyperbaric Oxygen Therapy may Improve Symptoms in Autistic Children
Med Hypotheses. 2006;67(2):216-28. Epub 2006 Mar 22
Rossignol DA, Rossignol LW
Autism is a neurodevelopmental disorder that currently affects as many as 1 out of 166 children in the United States. Recent research has discovered that some autistic individuals have decreased cerebral perfusion, evidence of neuroinflammation, and increased markers of oxidative stress. Multiple independent single photon emission computed tomography (SPECT) and positron emission tomography (PET) research studies have revealed hypoperfusion to several areas of the autistic brain, most notably the temporal regions and areas specifically related to language comprehension and auditory processing. Several studies show that diminished blood flow to these areas correlates with many of the clinical features associated with autism including repetitive, self-stimulatory and stereotypical behaviors, and impairments in communication, sensory perception, and social interaction. Hyperbaric oxygen therapy has been used with clinical success in several cerebral hypoperfusion syndromes including cerebral palsy, fetal alcohol syndrome, closed head injury, and stroke. Hyperbaric therapy can compensate for decreased blood flow by increasing the oxygen content of plasma and body tissues and can even normalize oxygen levels in ischemic tissue. In addition, animal studies have shown that hyperbaric therapy has potent anti-inflammatory effects and reduces oxidative stress. Furthermore, recent evidence demonstrates that hyperbaric oxygen therapy mobilizes stem cells from human bone marrow, which may aid recovery in neurodegenerative diseases. Based upon these findings, it is hypothesized that the therapy will improve symptoms in autistic individuals. A retrospective case series is presented that supports this hypothesis.
