Neuropsychological effects of hyperbaric oxygen therapy in cerebral palsy

Abstract

We conducted a double-blind placebo study to investigate the claim that hyperbaric oxygen treatment (HBO2) improves the cognitive status of children with cerebral palsy (CP). Of 111 children diagnosed with CP (aged 4 to 12 years), only 75 were suitable for neuropsychological testing, assessing attention, working memory, processing speed, and psychosocial functioning. The children received 40 sessions of HBO2 or sham treatment over a 2-month period. Children in the active treatment group were exposed for 1 hour to 100% oxygen at 1.75 atmospheres absolute (ATA), whereas those in the sham group received only air at 1.3 ATA. Children in both groups showed better self-control and significant improvements in auditory attention and visual working memory compared with the baseline. However, no statistical difference was found between the two treatments. Furthermore, the sham group improved significantly on eight dimensions of the Conners' Parent Rating Scale, whereas the active treatment group improved only on one dimension. Most of these positive changes persisted for 3 months. No improvements were observed in either group for verbal span, visual attention, or processing speed.

Systematic review of hyperbaric oxygen therapy for cerebral palsy: the state of the evidence

“…Secondary outcome measures, published separately, included neuropsychological tests, which also did not show a difference between the groups. 13 When the caregivers' viewpoint was assessed with the Pediatric Evaluation of Disabilities Inventory (PEDI), the control group had significantly better mobility and social functioning. 12 …”

Response to Letter by Helms et al

“…We agree that most treatment centers use either 2.0 or 2.4 ATA, but many practitioners who advocate the use of HBOT for neurological problems including stroke, strongly advocate lower pressures. 4,5,6 Because there is no sound evidence for a minimum effective pressure for any indication and the exclusion of studies using Ͻ2.0 ATA would leave us open to criticism from proponents of "low pressure" HBOT, we felt it was prudent to allow such studies to be included in the review. Our conclusions would not be substantially altered if those studies were excluded-there is no evidence of benefit from randomized clinical trials in this area.…”

Hyperbare-zuurstoftherapie bij kinderen met cerebrale parese

“…Om de werkzaamheid in de praktijk te onderzoeken is een aantal clinical trials en case studies uitgevoerd naar de effecten van de therapie bij patie¨nten met cerebrale parese (Montgomery et al, 1999;Collet et al, 2001;Hardy et al, 2002;Waalkes et al, 2002;Packard, 2000;Neubauer, 2001;Case Study Four, Neuberger, 2000). Deze studies hebben aangetoond dat deelname een positief effect heeft op het motorisch en cognitief functioneren van de patie¨nt.…”