Hyperbaric oxygen therapy may improve symptoms in autistic children
Section snippets
Overview of autism
Autism is a neurodevelopmental disorder currently affecting as many as 1 out of 166 children in the United States [1] that is characterized by impairments in social interaction, difficulty with communication, and restrictive and repetitive behaviors [2]. It affects children from all socioeconomic and ethnic backgrounds [3]. Autism was considered a rare condition before the 1990’s with a prevalence of approximately 1 in 2500 children [4]. However, according to the US Department of Developmental
Hypothesis
Multiple studies have revealed that autism is a neurodegenerative disease characterized by cerebral hypoperfusion, neuroinflammation, and increased oxidative stress. HBOT helps overcome hypoperfusion, has potent anti-inflammatory effects and reduces oxidative stress. Furthermore, HBOT mobilizes stems cells from human bone marrow. Therefore, HBOT will improve symptoms of autism.
Evidence of decreased cerebral blood flow in autism and possible mechanisms of hypoperfusion
Even in the presence of normal magnetic resonance imaging (MRI) findings, focal areas of decreased cerebral blood flow occur in children with autism [26]. Multiple independent single photon emission computed tomography (SPECT) and positron emission tomography (PET) research studies have demonstrated hypoperfusion to several areas of the autistic brain, most notably the temporal lobes [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39]. Several studies show that
Evidence of neuroinflammation in autism
Recent studies reveal that autism is characterized by neuroinflammation. Autopsy brain samples of autistic patients demonstrate an active neuroinflammatory process in the middle frontal gryus, anterior cingulate gryus, and cerebellar hemispheres including increased microglial and astroglial activation and increased proinflammatory cytokines. Furthermore, cerebrospinal fluid obtained from living autistic patients also “showed a prominent proinflammatory profile” [49]. Previous studies of
Evidence of increased oxidative stress in autism
Recent studies have shown that autistic children have evidence of increased oxidative stress including lower serum glutathione levels [100]. Sogut et al. [101] demonstrated that autistic children had increased red blood cell nitric oxide, which is a known reactive free radical and is toxic to the brain [101]. James et al. [100] recently showed that total serum glutathione levels were 46% lower and oxidized glutathione was 72% higher in autistic children when compared to neurotypical controls.
Improving stem cell mobilization in autism
Recently, HBOT at 2.0 ATA and 100% oxygen for 2 h was shown to mobilize stem/progenitor cells from the bone marrow of humans. Elevations were found in the number of colony-forming cells as demonstrated by an increase in the number of CD34+ cells by almost 2-fold [126]. This finding is relevant because autism and hypoxic brain injuries are considered by many to be permanent conditions. However, new research is revealing that even long-standing brain disorders may be partially reversible [13], [14]
Testing the hypothesis
There is a strong possibility that HBOT could play an integral role in improving brain disorders associated with hypoxia, hypoperfusion, inflammation, and/or oxidative stress, including autism, through the improvement of oxygen supply, decreased inflammation and oxidative stress, and/or the recruitment of new stem cells (see Table 1). This in turn should lead to improved clinical outcomes. Some physicians have begun using HBOT in autistic children and anecdotal reports indicate that HBOT has
Acknowledgments
The authors thank the following for reviewing this manuscript and offering advice: Dr. John Battiston, Dr. Bentley Calhoun, Mr. Michael Haynes, Dr. Elizabeth Mumper, Dr. David Slawson, and Dr. Kyle Van Dyke. Written consent was obtained from the children’s parent(s) for publication of case series data. The authors have two autistic sons who participated in the case series.
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