Quantification of Neurocognitive Changes Before, During, and After Hyperbaric Oxygen Therapy in a Case of Fetal Alcohol Syndrome

Abstract

ABSTRACT. Fetal alcohol syndrome (FAS) is the most common nonhereditary cause of mental retardation, with deficits in general intellectual functioning, learning, memory, attention, and problem-solving. Presented here is the first case in which measured neurocognitive abilities were determined before, during, and after hyperbaric oxygen therapy in a case of FAS involving a teenage male patient. Memory, reaction time, and visual motor speed assessments were compared. After 40 hyperbaric treatments with 100% oxygen at 1.5 atmospheres absolute, the patient's performance in 6 of 6 categories of the computer-administered test battery improved. Word composite (verbal) scores improved from 55% to 73%, memory composite (visual) scores improved from 38% to 55%, reaction time composites improved from 1.03 to 0.53 seconds, impulse control composite scores improved from 8 to 5, and visual motor speed scores improved from 18.6 to 19.03. The patient's subjective symptoms diminished 94%. Six months after these treatments, the patient's verbal memory was maintained at 73% without any other interventions; impulsivity continued to improve, whereas other indices did not. Thirty-three additional treatments continued to improve test performance, with verbal memory at 95%, visual memory at 57%, and a 100% reduction of subjective symptoms. This patient, with 15-year-matured FAS, benefited from a short course of low-pressure hyperbaric oxygen therapy, sustained durable cognitive improvements, and continued to exhibit improvement with another short course of treatments. Pediatrics 2005;116:e586-e591. URL: www. pediatrics.org/cgi/doi/10.1542/peds.2004-2851; hyperbaric oxygen therapy, fetal alcohol syndrome.

Assessment-Guided Neurofeedback for Autistic Spectrum Disorder

“…HBOT involves the inhalation of 100% oxygen in a pressurized chamber, usually above one atmosphere absolute (ATA). It has been shown that HBOT can lead to improved functioning in various neurological populations that show cerebral hypoperfusion including stroke (Nighoghossian et al 1995), cerebral palsy (Montgomery et al 1999), chronically brain injured (Golden et al 2002), and even a teenage male with Fetal Alcohol Syndrome (Stoller 2005). Rossignol and Rossignol (2006) have suggested that the increased oxygen delivered by HBOT could counteract the hypoxia caused by hypoperfusion, and lead to a reduction in symptoms of autism.…”

Hyperbaric oxygen therapy may improve symptoms in autistic children

“…Many clinical applications of HBOT are at higher pressures (over 2.0 ATA) including treatment of decompression sickness, arterial gas embolism, carbon monoxide poisoning [10], amyotrophic lateral sclerosis [11], and complex regional pain syndrome [12]. However, HBOT has also been used at lower pressures (1.5 ATA or less) with clinical success in conditions including fetal alcohol syndrome [13] and ischemic brain injury [14]. HBOT at 1.5 ATA was utilized in a prospective trial of 168 patients with closed head trauma with a significant reduction in mortality (32% versus 17%) [15].…”

“…HBOT is generally considered safe [17] at oxygen pressures below 3.0 ATA and with treatment durations of less than 120 min [10,13,24]. The use of HBOT in children appears generally safe, even at pressures of 2.0 ATA for 2 hours per day for up to 40 sessions [25].…”

“…Stoller recently reported on one pediatric case of fetal alcohol syndrome, which is considered ''irreversible and incurable'' [13] and is characterized by cerebral hypoperfusion on SPECT studies [77]. Using HBOT at 1.5 ATA, the child had statistically significant improvements in verbal, memory, reaction time, impulse control, and visual motor scores [13]. In addition, Heuser et al [78] treated a four year old autistic child using lower pressure HBOT at 1.3 ATA and reported ''striking improvement in behavior including memory and cognitive functions'' after only ten sessions.…”

“…This finding is relevant because autism and hypoxic brain injuries are considered by many to be permanent conditions. However, new research is revealing that even long-standing brain disorders may be partially reversible [13,14]. Recently, stem cells have been isolated in the adult brain.…”