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Hyperbaric oxygen treatment in autism spectrum disorders

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Hyperbaric Oxygen Treatment In Autism Spectrum Disorders

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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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