Autism "Treatments": HBOT -- Hyperbaric Oxygen Therapy Updated List

Almost two years ago, Do'C at Autism street assembled a list, Mild HBOT for Autism: A Brief Skeptical Guide

For readers who may be interested in a skeptical perspective with regards to “mild” hyperbaric oxygen therapy for autism, I’ve assembled a short list of links. These are articles that I’ve enjoyed reading, found interesting, or written myself.

 I've reorganized the list by date and included (a) relevant papers (b) some commentary

• Rossignol, D., & Rossignol, L. epub March 22, 2006 2006 Hyperbaric oxygen therapy may improve symptoms in autistic children. Medical Hypotheses 67:2 , 216-228.
• Do'C at Autism Street April 20, 2006 Autism HBOT: First Look Before you jump on the “Children With Oxygen-Deprived Brains” bandwagon and chase the claimed “healing power” of oxygen, there’s a lot worth looking into here.
  • The underlying science
  • Several clinical aspects
  • The marketing of HBOT
• Do'C at Autism Street April 24, 2006 What Say Dan, The DAN! Doc? In which Do'C  discovered a significant error in Rossignol & Rossignol's calculations.
• Do'C at Autism Street April 20, 2006 Nitpicking Sloppy Science More on errors in Rossignol & Rossignol's calculations.
• Rossignol DA. December 4 2006 Hyperbaric oxygen therapy might improve certain pathophysiological findings in autism. Medical Hypotheses. 2007;68(6):1208-27.
• Do'C at Autism Street July 6, 2007 Ridiculous Autism Treatment Statements - 1-- marketing claims from HBOT providers. "The oxygen level in the patient’s bloodstream is raised many times above normal? That’s incredible! It’s also very unlikely to be true."
• Do'C at Autism Street July 20 2006 Hyperbarics and Hypotheses
• Mike Stanton at Action for Autism September 9 2007 HBOT autism and the NHS
• Do'C at LeftBrain/RightBrain October 7 2007 When High Does Mean Low: Autism, mHBOT, and Dan Rossignol
• Prometheus at Photon in the Darkness: Nov 9 2007 HBOT: Is it just a bunch of hot air?

  it looks as though the “benefits” of HBOT are not due to increasing the oxygen content of the blood. And the jury is still out on what HBOT does to the blood flow, although it should be noted that the studies showing any changes were done at much higher pressures.

• Prometheus at Photon in the Darkness: November 16th, 2007 HBOT: Under Pressure

So, is there a chance that hyperbaric therapy might help autism? Perhaps, but not at the pressures attainable in the “soft chambers” used by most “alternative” autism practitioners.

If they really wanted to see the effects of pressure alone, the HBOT “researchers” could dilute the air in the “soft chamber” with an inert gas such as helium so that the partial pressures of nitrogen and oxygen remain the same as they are at sea level (or whatever the ambient pressure is). This would require (at sea level) a mix of 23% helium and 77% air. It would be a simple test (and safe - even breathing the mix at sea level pressure would not be dangerous, as it still contains 16% oxygen) and would finally put to rest any question about the need for (mildly) elevated pressure.

Unfortunately, the risks of using real hyperbaric therapy (not to mention the costs) outweigh the potential benefits (which are largely hypothetical and unproven), so a trial of real HBOT for autism is probably not in our future.

• Rossignol  et al.  November 16 2007  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.
• Peter Lipson Md at Science-Based Medicine October 14 2008 Is there no end to unscientific treatments for autism? Discussion of science behind HBOT, and
• Rossignol et al, March 13 2009  Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial BMC Pediatrics 2009,9:21doi:10.1186/1471-2431-9-21
• Lisa Jo Rudy at autism.About.com March 14 2009 Hyperbaric Oxygen as a Treatment for Autism: Let the Buyer Beware
• Jordan Lite at Scientific American News Blog March 13 2009 Can hyperbaric oxygen therapy help autistic kids?
• Steven Novella MD at Neurologica March 16 2009 Hyperbaric Oxygen for Autism
• Do'C at LeftBrain/RightBrain March 21, 2009 Autism, HBOT, and the new study by Rossignol et al. Discussion of study confounders, especially the effect of altitude of study centers on oxygen pressures, and other weaknesses.
• Nestor Lopez-Duran PhD at Child Psychology Research Blog March 27, 2009 Hyperbaric treatment for children with autism: First controlled clinical trials.
• Swift at James Randi Educational Foundation March 29 2009 Hyperbaric Oxygen for Autism? Not so fast
• Do'C at LeftBrain/RightBrain March 30 2009 Mild hyperbaric therapy for autism – Shh!…don’t say it’s expensive
• John Wills Lloyd at EBD Blog March 2009 Does Rossignol et al Show HBOT's Effective for Autism?
• Prometheus at LeftBrain/RightBrain: April 6 2009 More Hot Air about HBOT: this is a detailed analysis of Rossignol et al, 2009  
• John Wills Lloyd at EBD Blog November 2009 Reporter Falls for HBOT 
• Jepson et al (2010) August 3, 2010 Controlled Evaluation of the Effects of Hyperbaric Oxygen Therapy on the Behavior of 16 Children with Autism Spectrum Disorders. J Autism Dev Disord. 

Comments

[Barbara Boucher, OT, PhD, PT]

I really appreciate a summary on the fallacy of HBOT-effectiveness (oxymoron) for symptoms of autism, Liz. Thanks.

I was most convinced by viewing (via livestream) the session at the 2009 World Congress on Disabilities where Rossignal spoke and was questioned by a panel of scientists.

I would like to see more 'commentary' on each reference, by you. Annotation, please?

[Annie]

Thank you for putting this together - it's a helpful and interesting resource for people who may not have a whole lot of experience in the discussion or expertise in the relevant areas.

[Mild autism]

The ideal treatment plan coordinates therapies and interventions that target the core symptoms of autism: impaired social interaction, problems with verbal and nonverbal communication, and obsessive or repetitive routines and interests. Most professionals agree that the earlier the intervention, the better.