The effects od HBOT in the Children with Autism Spectrum Disorders


KINACI Cem¹, KINACI Serpilgul¹, ALAN Mustafa², ELBUKEN Emin³
¹Department of Nuclear Medicine, German Hospital-Camlica-Universal Hospitals Group, Istanbul, Turkey.
² Department of Aerospace Medicine, Baromed Hyperbaric Oxygen Theraphy Center, Ankara, Turkey.
³ Department of Underwater and Hyperbaric Medicine, 2001 Hyperbaric Oxygen Theraphy Center, Istanbul, Turkey

Background:
Autism is the most common disease of the Pervasive Developmental Disorders. There are many theories as to the cause of Autism Spectrum Disorders (ASD) such as abnormal cerebral blood flow to areas of the brain (1-7), high fevers, birth trauma, brain injury, infections, reactions to vaccines or lack of oxygen before, during or after delivery. Human genome can be affected by nutrition. There is an interplay between genes and environment. Genes can be turned on and off. Genetics, heavy metal burden, infectious agents are predisposing factors for ASD. Impaired detoxification, depletion of antioxidants, glutathione and metallothionein (oxidative stress), mineral deficiency, mitochondrial dysfunction, gastrointestinal dysfunction and immune system dysregulation are biochemical aftermath in ASD. Many cases of ASD today are, in fact, cases of gut-brain inflamation secondary to toxic heavy metal poisoning (8).

Materials/Methods:
We performed a retrospective review in search of 108 children with ASD (85 males, 23 females) between the ages 3-12, who had done basal and control SPECT scans between the years 2004-2007. We reviewed Dimercaptosuccinic acid (DMSA) provocated urine toxic metals profiles, Magnetic Resonance Imaging (MRI) results, brain perfusion Single-Photon Emission Computed Tomography (SPECT) Scans, special questionnaires of 108 children and Autism Treatment Evaluation Checklist (ATEC) done by parents (57 of) and clinicians / therapists (54 of) these children. They were all applied 50 sessions Hyperbaric Oxygen Theraphy (HBOT) for each patient at 1.5 ATA for 60 minutes/daily. We compared the results of SPECT scans before and after HBOT and ATEC.
A specialized tool, the SPECT scan, has been proven effective in this task and it is the primary tool to objectively measure the effectiveness of HBOT on patients (9-10).
As inert (dead) cells do not absorb the tracer at all, SPECT scanning can distinguish between living and dead (necrotic) tissue. SPECT scanning can also identify between recoverable brain cells (referred to as sleeping cells, idling neurons, or the ischemic penumbra).
This study showed behavioral, physical and brain perfusion changes secondary to brain inflamation and positive or negative effects of HBOT in children with ASD, who have high levels of toxic heavy metals.

Results/Discussion:
DMSA provocated urine toxic metals profile were done by first administering DMSA orally in appropriate dosage (30mg/kg) and then collected urine the following 6-9 hours.
All 108 cases had elevated or very elevated levels of lead, 61 of them had mercury and most of them were in company with some other toxic heavy metals such as nickel, aluminum, tin, thallium, arsenic, tungsten and uranium ( ). Before HBOT all of the patients were revealed focal areas of decreased perfusion in temporal lobe of the brain. We also detected decreased perfusion in 79 males and in 16 females at frontal lobes and in 54 males and in 12 females at other areas of the brain. By contrast all patients had normal MRI findings.
Most people are familiar with MRI scans, which are superb at depicting structural anatomy. However, neither is designed for or is capable of measuring the brain activity. We determined that, after HBOT, all patient’s SPECT scan findings were improved Perfusion changes were 82.40% (89 of 108) at temporal, were 85.26% (81 of 95) at frontal and were 75.75% (50 of 66) at the other areas ( ). On the other hand, there were significiant behavioral and physical changes in most of the patients On ATEC of 54 patients done by clinicians/therapists, we determined that, 79% improvement were at Speech/Language/ Communication, 85,5% improvement were at Sociability, 87% improvement were at Sensory/Cognitive Awareness and 75,2% improvement were at Health/Physical/Behavior.

Conclusions:
Benefits of HBOT are; angioneogenesis from the addition or removal of O2, increases in blood flow independent of new blood vessel formation, decreasing levels of inflammatory biochemicals, up-regulation of key antioxidant enzymes and decreasing oxidative stress, increased oxygenation to functioning mitochondria, increased production of new mitochondria, by-passing functionally impaired hemoglobin molecules secondary to abnormal porphyrin production, improvement of the immune system and the autoimmune system, decreasing the bacterial and yeast load systemically and in the gastrointestinal system, decreasing the viral load found systemically and the viral load in the gastrointestinal mucosa, increases in the production of stem cells in the bone marrow with transfer to the central nervous system, direct production of stem cells by certain areas in the brain, increased production and utilization of serotonin, the possibility that oxidation may help rid the body of petrochemicals (theoretical only), the possibility that oxidation may help rid the body of mercury and other heavy metals (theoretical only) (11). HBOT which now being used for children with ASD is to address the neuroinflammatory component of the disorder (12). There is emerging evidence of chronic blood-brain barrier dysfunction in these children. The use of high dosage oxygen is based on the latest research into its role in the control of inflammation (13).
Behavioral positive effects of HBOT were determined at speech, language, communication, sociability, sensory, cognitive awareness and some other health/ physical/ behavior Through these sessions it is important to make sure that the brains inactive cells develop to normal function by SPECT scanning. It can identify recoverable brain cells (idling neurons).
After HBOT, extensive perfusion improvements involving the brain were found in this study. SPECT scans may be more sensitive in reflecting the pathophysiology of autism than MRI (14-16).

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