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Abdel-Rahman EA, Zaky EA, Aboulsaoud M, Elhossiny RM, Youssef WY, Mahmoud AM, Ali SS. Autism spectrum disorder (ASD)-associated mitochondrial deficits are revealed in children's platelets but unimproved by hyperbaric oxygen therapy. Free Radic Res 2021; 55:26-40. [PMID: 33402007 DOI: 10.1080/10715762.2020.1856376] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Mitochondrial and immune dysfunctions are often implicated in the aetiology of autism spectrum disorder (ASD). Here, we studied for the first time the relationship between ASD severity measures and mitochondrial respiratory rates in freshly isolated platelets as well as the activity of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX) in isolated neutrophils. We also verified the impact of hyperbaric oxygen therapy (HBOT) on mitochondrial and immune functions as well as on ASD severity measures. Blood samples were collected from three age-matched male groups (Control (Norm-N), autistic (Aut-N), and autistic + HBOT (Aut-H); N = 10 per group). Using high resolution respirometry, we found that routine basal respiration, complex I- and complex I + II-dependent oxidative phosphorylation rate were significantly impaired in Aut-N platelets. Similarly, deficits in immune response of neutrophils were evidenced through lower rates of oxygen consumption and reactive oxygen species (ROS) production by phagocytic NOX. ASD-related behavioural outcomes were found to moderately correlate with platelets' mitochondrial bioenergetic parameters as well as with NOX-mediated activity in neutrophils. HBOT was not able to improve mitochondrial dysfunctions or to counteract ASD-related behavioral deficits. Although HBOT improved one measure of the immune response; namely, NOX-mediated superoxide burst, this was not associated with significant changes in trends of recurrent infections between groups. Taken together, our data suggest that ASD-associated mitochondria and immune deficits are detectable in platelets and neutrophils. We also found no evidence that HBOT confers any significant improvement of ASD-associated physiological or behavioural phenotypes.
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Affiliation(s)
- Engy A Abdel-Rahman
- Center for Aging and Associated Diseases, Helmy Institute of Medical Sciences, Zewail City of Science and Technology, Giza, Egypt.,Basic Research Department, Children's Cancer Hospital, Cairo, Egypt.,Department of Pharmacology, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Eman A Zaky
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud Aboulsaoud
- Center for Aging and Associated Diseases, Helmy Institute of Medical Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Reham M Elhossiny
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Walaa Y Youssef
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ali M Mahmoud
- Center for Aging and Associated Diseases, Helmy Institute of Medical Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Sameh S Ali
- Center for Aging and Associated Diseases, Helmy Institute of Medical Sciences, Zewail City of Science and Technology, Giza, Egypt.,Basic Research Department, Children's Cancer Hospital, Cairo, Egypt
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Campisi L, Imran N, Nazeer A, Skokauskas N, Azeem MW. Autism spectrum disorder. Br Med Bull 2019; 127:91-100. [PMID: 30215678 DOI: 10.1093/bmb/ldy026] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 07/22/2018] [Indexed: 11/13/2022]
Abstract
Sources of data This article is based on key recent published literature including international guidelines and relevant reviews and meta-analyses. Authors have also supplemented this material with their own clinical experience. Areas of agreement There is an agreement that autism spectrum disorder (ASD) have a strong hereditary component. There is also a consensus that the reported prevalence estimates have increased in the last 5 years. There is strong support for using the broader spectrum disorder conceptualization of the DSM-5. Areas of controversy Higher public awareness of ASD has generated several controversial theories of causation. We review a number of environmental risk factors receiving media attention including: vaccines, mercury, heavy metal exposure and Selective Serotonin Uptake Inhibitors (SSRIs). Popular yet controversial treatment interventions are discussed. Early diagnostic screening tools are also addressed. Growing points There is increasing scientific interest in identifying biomarkers of autism with potential for early diagnosis, prognostic indicators and predictive treatment responses. We review evidence from genetics, neuroimaging and eye tracking as candidate biomarkers. Area timely for developing research Family studies point to a strong hereditary component in the aetiology of autism. However these studies have not established 100% concordance rates, suggesting a role for environmental factors. The gene-environment interplay has not received enough attention in scientific research. This represents an important new avenue for research in ASD.
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Affiliation(s)
- Lisa Campisi
- Department of Psychiatry, Sidra Medical and Research Center, Doha, Qatar
| | - Nazish Imran
- Child and Family Psychiatry Department, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | - Ahsan Nazeer
- Department of Psychiatry, Sidra Medical and Research Center, Doha, Qatar
| | - Norbert Skokauskas
- Centre for Child and Adolescent Mental Health and Child Protection, Faculty of Medicine, NTNU, Trondheim, Norway
| | - Muhammad Waqar Azeem
- Department of Psychiatry, Sidra Medical and Research Center, Doha, Qatar.,Weill Cornell Medicine-Qatar, Doha, Qatar
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Abstract
Abstract
Therapy with hyperbaric oxygen (HBOT) was first used in pediatrics in Russia in the 1920s (1927). At present, HBOT is used in children in similar indications as in adults, as well as in perinatal, neurologic and neuro-developmental conditions, even though there is only limited evidence of it offering any benefit for such conditions. The aim of this publication is to present current indications and risks of the use of HBOT in children.
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Lindly OJ, Thorburn S, Heisler K, Reyes NM, Zuckerman KE. Parents' Use of Complementary Health Approaches for Young Children with Autism Spectrum Disorder. J Autism Dev Disord 2018; 48:1803-1818. [PMID: 29243100 PMCID: PMC6431080 DOI: 10.1007/s10803-017-3432-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Knowledge of why parents use complementary health approaches (CHA) for children with autism spectrum disorder (ASD) is limited. We conducted a mixed methods study to better understand factors influencing parents' decision to use CHA for ASD. Parent-reported data about CHA use were collected on a probability sample of 352 young children with ASD in Denver, Colorado; Los Angeles, California; or Portland, Oregon. Follow-back interviews were conducted with 31 parents. CHA use was negatively associated with older child age and positively associated with parents' belief ASD has major consequences, living in Portland or Denver, and medication use. Nine themes help explain these results. Study findings may have utility for healthcare providers working with children with ASD and their families regarding CHA.
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Affiliation(s)
- Olivia J Lindly
- Department of General Academic Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 125 Nashua Street, Boston, MA, 02114, USA.
- Division of General Pediatrics, School of Medicine, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR, 97239, USA.
| | - Sheryl Thorburn
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, 401 Waldo Hall, Corvallis, OR, 97331, USA
| | - Karen Heisler
- Childhood Health Associates of Salem, Oregan, Salem, USA
| | - Nuri M Reyes
- Department of Psychiatry, School of Medicine, University of Colorado, 13121 E. 17th Avenue, 5th Floor, Aurora, CO, 80045, USA
| | - Katharine E Zuckerman
- Division of General Pediatrics, School of Medicine, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR, 97239, USA
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Lindly O, Thorburn S, Heisler K, Reyes N, Zuckerman K. Parent disclosure of complementary health approaches used for children with autism spectrum disorder: Barriers and facilitators. Complement Ther Med 2017; 35:47-52. [PMID: 29154066 PMCID: PMC5726576 DOI: 10.1016/j.ctim.2017.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 09/11/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Complementary health approaches (CHA) are widely used among children with autism spectrum disorder (ASD). As part of shared treatment decision-making, healthcare providers are encouraged to discuss CHA with parents of children with ASD. Yet prior research suggests that parents often do not disclose CHA used for children, and their reasons for nondisclosure are poorly understood. We, therefore, aimed to identify barriers and facilitators to parent disclosure of CHA used for children with ASD. DESIGN AND SETTING In-depth interviews were conducted with 31 parents who reported that they were currently using CHA for their child's ASD in Denver, Colorado or Portland, Oregon. RESULTS We used content analysis to identify six main themes indicating that the following factors play a role in disclosure: parents' drive to optimize their child's health, parent self-efficacy discussing CHA with healthcare providers, parent beliefs about the effectiveness of CHA, parent-provider relationship quality, provider attitudes and knowledge regarding CHA and ASD, and visit characteristics. CONCLUSIONS Study findings suggest that family and health system factors, together, influence parent disclosure of CHA used for children with ASD. Multifaceted intervention concurrently targeting the CHA-related knowledge, beliefs, and self-efficacy of parents whose children have been recently diagnosed with ASD, in addition to the CHA-related attitudes and knowledge of their healthcare providers may promote disclosure and shared treatment decision-making about the use of CHA.
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Affiliation(s)
- Olivia Lindly
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, 401 Waldo Hall, Corvallis, OR, 97331, United States; Division of General Pediatrics, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR, 97239, United States.
| | - Sheryl Thorburn
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, 401 Waldo Hall, Corvallis, OR, 97331, United States
| | - Karen Heisler
- Division of General Pediatrics, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR, 97239, United States
| | - Nuri Reyes
- Department of Pediatrics, University of Colorado School of Medicine, 13121 E. 17th Ave, Aurora, CO 80045 United States
| | - Katharine Zuckerman
- Division of General Pediatrics, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR, 97239, United States; School of Public Health, OHSU-PSU, 3181 SW Sam Jackson Park Road; Portland, OR 97239, United States
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Sakulchit T, Ladish C, Goldman RD. Hyperbaric oxygen therapy for children with autism spectrum disorder. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2017; 63:446-448. [PMID: 28615394 PMCID: PMC5471082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Question As autism spectrum disorder (ASD) is a multifactorial condition, with genetic and environmental risk factors contributing to children's unique presentation and symptom severity, a range of treatments have been suggested. Parents of children with ASD in my clinic are asking me about alternative therapies to improve their children's condition. One of those therapies is hyperbaric oxygen therapy (HBOT); commercial advertisement in the past has suggested good results with this approach. Should I recommend the use of HBOT for children with ASD? Answer Hyperbaric oxygen therapy provides a higher concentration of oxygen delivered in a chamber or tube containing higher than sea level atmospheric pressure. Case series and randomized controlled trials show no evidence to support the benefit of HBOT for children with ASD. Only 1 randomized controlled trial reported effectiveness of this treatment, and those results have yet to be repeated.
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Abstract
BACKGROUND The rising prevalence of autism spectrum disorder (ASD) has increased the need for evidence-based treatments to lessen the impact of symptoms. Presently, no therapies are available to effectively treat individuals with all of the symptoms of this disorder. It has been suggested that hyperbaric oxygen therapy may alleviate the biochemical dysfunction and clinical symptoms of ASD. OBJECTIVES To determine whether treatment with hyperbaric oxygen:1. improves core symptoms of ASD, including social communication problems and stereotypical and repetitive behaviors;2. improves noncore symptoms of ASD, such as challenging behaviors;3. improves comorbid states, such as depression and anxiety; and4. causes adverse effects. SEARCH METHODS On 10 December 2015, we searched CENTRAL, Ovid MEDLINE, Embase, and 15 other databases, four of which were Chinese language databases. We also searched multiple trial and research registers. SELECTION CRITERIA We selected randomized controlled trials (RCTs) and quasi-RCTs of any dose, duration, and frequency for hyperbaric oxygen therapy compared with no treatment or sham treatment for children and adults with ASD. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by The Cochrane Collaboration, in that three review authors independently selected studies, assessed them for risk of bias, and extracted relevant data. We also assessed the quality of the evidence by using the GRADE approach. MAIN RESULTS We included one trial with a total of 60 children with a diagnosis of ASD who randomly received hyperbaric oxygen therapy or a sham treatment. Using GRADE criteria, we rated the quality of the evidence as low because of the small sample size and wide confidence intervals (CIs). Other problems included selection bias and short duration or follow-up.Overall, study authors reported no improvement in social interaction and communication, behavioral problems, communication and linguistic abilities, or cognitive function. With regard to the safety of hyperbaric oxygen therapy (adverse events), they reported minor-grade ear barotrauma events. Investigators found significant differences between groups in total number of side effect events (Peto odds ratio (OR) 3.87, 95% CI 1.53 to 9.82) and in the number of children who experienced side effects (Peto OR 4.40, 95% CI 1.33 to 14.48). AUTHORS' CONCLUSIONS To date, there is no evidence that hyperbaric oxygen therapy improves core symptoms and associated symptoms of ASD. It is important to note that adverse effects (minor-grade ear barotrauma events) can occur. Given the absence of evidence of effectiveness and the limited biological plausibility and possible adverse effects, the need for future RCTs of hyperbaric oxygen therapy must be carefully considered.
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Affiliation(s)
- Tao Xiong
- West China Second University Hospital, Sichuan UniversityDepartment of PediatricsNo. 17, Section Three, Ren Min Nan Lu AvenueChengduSichuanChina610041
- Ministry of EducationKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan UniversityChengduSichuanChina
| | - Hongju Chen
- West China Second University Hospital, Sichuan UniversityDepartment of PediatricsNo. 17, Section Three, Ren Min Nan Lu AvenueChengduSichuanChina610041
- Ministry of EducationKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan UniversityChengduSichuanChina
| | - Rong Luo
- West China Second University Hospital, Sichuan UniversityDepartment of PediatricsNo. 17, Section Three, Ren Min Nan Lu AvenueChengduSichuanChina610041
- Ministry of EducationKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan UniversityChengduSichuanChina
| | - Dezhi Mu
- West China Second University Hospital, Sichuan UniversityDepartment of PediatricsNo. 17, Section Three, Ren Min Nan Lu AvenueChengduSichuanChina610041
- Ministry of EducationKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan UniversityChengduSichuanChina
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Integrative Approaches to Caring for Children with Autism. Curr Probl Pediatr Adolesc Health Care 2016; 46:195-201. [PMID: 26776326 DOI: 10.1016/j.cppeds.2015.12.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 12/04/2015] [Indexed: 01/20/2023]
Abstract
Parents commonly integrate complementary and alternative medical (CAM) treatments for autism spectrum disorder (ASD) with conventional care. The aims of this article are to (1) describe the most commonly used treatments, (2) assess their efficacy and safety, and (3) organize the information in practical format for practitioners. We organized treatment modalities into four categories: recommended, monitored, tolerated, and therapies that should be avoided. These four categories are based on a two by two table weighing a therapy׳s effectiveness and safety. To meet the threshold for "recommended," its effectiveness needed to be supported by two or more randomized, controlled trials. In addition to promoting an overall healthy lifestyle via nutrition, exercise, sleep, stress management, social support, and avoiding neurotoxins (healthy habits in a healthy habitat), the most promising therapies recommend are applied behavior analysis, parent-implemented training, melatonin supplements to improve sleep, supplements to correct deficiencies, and music therapy. Medications and restrictive diets may be helpful for some children, but use should be monitored given the risk of side effects. Most complementary therapies are safe, so they can be tolerated, but additional research is needed before they should be recommended. Given their risks, costs, and limited evidence of efficacy, chelation, secretin, and hyperbaric oxygen should be avoided.
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A head-to-head comparison of aripiprazole and risperidone for safety and treating autistic disorders, a randomized double blind clinical trial. Child Psychiatry Hum Dev 2015; 45:185-92. [PMID: 23801256 DOI: 10.1007/s10578-013-0390-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aripiprazole and risperidone are the only FDA approved medications for treating irritability in autistic disorder, however there are no head-to-head data comparing these agents. This is the first prospective randomized clinical trial comparing the safety and efficacy of these two medications in patients with autism spectrum disorders. Fifty nine children and adolescents with autism spectrum disorders were randomized to receive either aripiprazole or risperidone for 2 months. The primary outcome measure was change in Aberrant Behavior Checklist (ABC) scores. Adverse events were assessed. Aripiprazole as well as risperidone lowered ABC scores during 2 months. The rates of adverse effects were not significantly different between the two groups. The safety and efficacy of aripiprazole (mean dose 5.5 mg/day) and risperidone (mean dose 1.12 mg/day) were comparable. The choice between these two medications should be on the basis of clinical equipoise considering the patient's preference and clinical profile.
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Levy SE, Hyman SL. Complementary and alternative medicine treatments for children with autism spectrum disorders. Child Adolesc Psychiatr Clin N Am 2015; 24:117-43. [PMID: 25455579 DOI: 10.1016/j.chc.2014.09.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There are many treatments in current use for core and associated symptoms of autism spectrum disorders (ASD). This review discusses the complementary and alternative medical (CAM) treatments commonly added to conventional interventions for children with ASD, including natural products, mind and body practices, and other biomedical treatments. The article focuses on factors associated with use of CAM, the empirical evidence for the most frequently used treatments, and how clinicians work with families who choose CAM treatments. Some treatments have been ineffective, some have unacceptable potential side effects, and others require more study in depth.
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Affiliation(s)
- Susan E Levy
- Division of Developmental & Behavioral Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3550 Market Street, 3rd Floor, Philadelphia, PA 19104, USA.
| | - Susan L Hyman
- Neurodevelopmental and Behavioral Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
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Abstract
PURPOSE OF REVIEW To provide an updated overview of autism spectrum disorders (ASDs), with particular attention to the pediatrician's role in assessing and managing patients with ASDs. RECENT FINDINGS Clinical perspectives on ASDs continue to evolve. The prevalence of ASDs in the United States continues to rise, and pediatricians are being tasked with the responsibility for universal screening. Further changes in its epidemiology will undoubtedly result from anticipated changes in the diagnostic criteria put forth in the upcoming revision to the Diagnostic and Statistical Manual (5th edition). Although there have been considerable advances in identifying a genetic cause in many more cases, the cause remains elusive in most cases. Recent studies of concordant twins suggest there is a stronger environmental component than previously believed. Research suggests earlier diagnosis may be feasible in some cases, and a new treatment approach has been shown to be effective in very young children. Although there have not been any large-scale advances in the medical treatment, some isolated successes have been reported and other promising therapies are now being investigated. SUMMARY Clinical guidelines for ASDs are evolving, with updated diagnostic criteria expected and revised recommendations for evaluation also imminent. This article provides pediatricians with a clinical overview of ASD - with an emphasis on the clinical considerations relating to screening, evaluation, and management.
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Ghanizadeh A, Derakhshan N. N-acetylcysteine for treatment of autism, a case report. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2012; 17:985-7. [PMID: 23826003 PMCID: PMC3698662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 01/20/2012] [Accepted: 05/22/2012] [Indexed: 10/31/2022]
Abstract
There are a limited number of Food and Drug Administration (FDA)-approved medications for the treatment of autism. Meanwhile, oxidative stress and neuroinflammation are supposed to play a causative role in autism. N-acetylcysteine may provide cystine, a precursor for glutathione (GSH), which is an important antioxidant factor in the brain. We here report a child with autism, whose symptoms were markedly decreased after taking oral N-acetylcysteine 800 mg/day, in three divided doses. His social interaction was significantly increased. The score of social impairment on a visual analog scale decreased from 10 to 6 in the two-month trial. The aggressive behaviors decreased from 10 to 3. This case suggests that N-acetylcysteine may decrease some symptoms of autism.
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Affiliation(s)
- Ahmad Ghanizadeh
- Department of Psychiatry, Research Center for Psychiatry and Behavioral Sciences, Shiraz, Iran,Department of Psychiatry, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran,Address for correspondence: Dr. Ahmad Ghanizadeh, Department of Psychiatry, Research Center for Psychiatry and Behavioral, Sciences, Hafez Hospital, Shiraz, Iran. E-mail:
| | - Nima Derakhshan
- Department of Psychiatry, Research Center for Psychiatry and Behavioral Sciences, Shiraz, Iran
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Ghanizadeh A. Physical exercise and intermittent administration of lactulose may improve autism symptoms through hydrogen production. Med Gas Res 2012; 2:19. [PMID: 22846252 PMCID: PMC3464164 DOI: 10.1186/2045-9912-2-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 07/26/2012] [Indexed: 11/15/2022] Open
Abstract
Autism is neuro-developmental disorder. Oxidative stress is enhanced in some children with autism. Hydrogen is a gas with anti-oxidative effects suggested for treating or prevention of some medical problems. It is hypothesized that lactulose or hydrogen water may provide hydrogen to reduce oxidative stress in autism.
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Affiliation(s)
- Ahmad Ghanizadeh
- Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Rossignol DA, Bradstreet JJ, Van Dyke K, Schneider C, Freedenfeld SH, O'Hara N, Cave S, Buckley JA, Mumper EA, Frye RE. Hyperbaric oxygen treatment in autism spectrum disorders. Med Gas Res 2012; 2:16. [PMID: 22703610 PMCID: PMC3472266 DOI: 10.1186/2045-9912-2-16] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 05/19/2012] [Indexed: 01/21/2023] Open
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.
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Affiliation(s)
- Daniel A Rossignol
- Rossignol Medical Center, 3800 West Eau Gallie Blvd,, Melbourne, FL, 32934, USA.
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