Hyperbaric Oxygen Therapy is a medical treatment that uses the administration of 100 % oxygen at controlled pressure (greater than sea level) for a prescribed amount of time usually 60 to 90 minutes.
HBOT is NOT to be confused with “hyperoxygenation”, which is breathing in oxygen in regular pressure (1 atmosphere) Inhaling large amounts of oxygen in regular pressure can be damaging to the brain. Under no circumstances should the child breathe high dose of oxygen from an oxygen tube. Pressure levels, Length of sessions, Numbers of sessions are individually adjusted after the childs needs. Protocols that are beneficiary for other diagnoses are not relevant for autistic children. Only specialists may treat with “Hyperbaric Oxygen Therapy”.
The treatment is done in submarine boat like chambers (hyperbaric chambers) that are on land.
By using pressure, SCUBA diving is simulated.
With the help of special masks and hoods
it is possible to breathe 100% oxygen.
During modern HBOT, the patient breathes pure, 100% oxygen under increased atmospheric pressure.
The air we normally breathe contains only 19-21% of this essential element;
Via HBOT, the concentration of pure oxygen dissolved into the bloodstream is dramatically increased with virtually no energy expenditure.
Without changing the temperature, when you increase the pressure, you can get more gas in solution
In addition to the blood, all body fluids (including the vital lymph and cerebrospinal fluids) are infused with the healing benefits of this molecular oxygen.
BENEFICIAL EFFECTS OF HBOT • Angioneogenesis from the addition of O2. • Angioneogenesis from the 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 • Bypassing functionally impaired hemoglobin molecules secondary to abnormal porphyrin production. • Improvement of the immune system and the autoimmune system.
BENEFICIAL EFFECTS OF HBOT • 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. • Increases 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).
Autism: Pathophysiology
Cerebral hypoperfusion Inflammation Cerebral Gastrointestinal Mitochondrial dysfunction Oxidative stress High intestinal counts of Clostridia
• Two independent studies have described bilateral temporal hypoperfusion in autistic children. • Significant negative correlation was observed between cerebral blood flow (rCBF) and Autism Diagnostic Interview-Revised (ADI-R) score in the left superior temporal gyrus. • The more severe the autistic syndrome, the more rCBF is low in this region, suggesting that left superior temporal hypoperfusion is related to autistic behavior severity.
Gendry Meresse et al., 2005 Ann Neurol 58:466-69
• Hypoperfusion of the prefrontal and left temporal areas worsened and became “quite profound” as the age of the child increased.
Wilcox et al., 2002 Neuropsychobiology 46(1):13-6
Selected areas of hypoperfusion in autism and clinical correlations
Area of Hypoperfusion
Clinical Correlation
Thalamus
Repetitive, self-stimulatory, and unusual behaviors [Starkstein, 2000]
Temporal lobes
Desire for sameness and social/communication impairments [Ohnishi, 2000]
Temporal lobes and amygdala
Impairments in processing facial expressions/emotions [Critchley, 2000]
Fusiform gyrus
Difficulty recognizing familiar faces [Pierce, 2004]
Wernicke’s and Brodmann’s areas
Decreased language development and auditory processing problems [Wilcox, 2002; Boddaert, 2002]
Temporal and Frontal lobes
Decreased IQ [Hashimoto, 2000]
Autism and Neuroinflammation P
G
A – Normal control cerebellum
B – Autistic brain with loss of Purkinje cell layer (P) and granular cell layer (G)
Vargas et al., 2005 Ann Neurol 57(1):67-81
Autism
Control
Connolly et al., 1999 J Pediatr 134:607-13
Autism and Gastrointestinal Inflammation
Autism and Gastrointestinal Inflammation
Andrew Wakefield,MBBS, FRCS, FRC Path Executive Director Thoughtful House, Texas
Andrew Wakefield,MBBS, FRCS, FRC Path Executive Director Thoughtful House, Texas
Andrew Wakefield,MBBS, FRCS, FRC Path Executive Director Thoughtful House, Texas
Andrew Wakefield,MBBS, FRCS, FRC Path Executive Director Thoughtful House, Texas
Andrew Wakefield,MBBS, FRCS, FRC Path Executive Director Thoughtful House, Texas
Andrew Wakefield,MBBS, FRCS, FRC Path Executive Director Thoughtful House, Texas
Autistic Enterocolitis
Takeshima et al., 1999 Am J Gastroenterol 94(11):3374-5
SPECT Scans shows increased perfusion in a 4 year old autistic child after 10 hyperbaric treatments at 1.3 atm and 24% oxygen
Before
After Mild HBO
Heuser et al., 2002 Best Publications, 109-15
Oxidative Stress and HBOT
Oxidative stress is caused by an imbalance of oxidants and antioxidants At pressures below 2.0 atm, HBOT can decrease oxidative stress by increasing anti-oxidant enzyme levels such as: Superoxide dismutase (SOD) Catalase Glutathione peroxidase Heme-oxygenase 1 Paraoxonase At pressures above 2.5 atm, the literature is conflicted and HBOT may actually increase oxidative stress
Superoxide Dismutase 59 children with autism Superoxide Dismutase with HBOT at 1.3 atm 60
40
20
0
Before HBOT
After 1 day of HBOT
After 32 days of HBOT
HBOT at 1.3 atm for 32 days
Glutathione Peroxidase 59 children with autism Glutathione Peroxidase with HBOT at 1.3 atm 6
4
2
0
Before HBOT
After 1 day of HBOT
After 32 days of HBOT
HBOT at 1.3 atm for 32 days
Catalase 59 children with autism Catalase with HBOT at 1.3 atm 300
200
100
0
Before HBOT
After 1 day of HBOT
After 32 days of HBOT
HBOT at 1.3 atm for 32 days
Rossignol and Rossignol, 2006 Med Hypotheses 67(2):216-28
HBOT Case Series
Six children, ages 2-7 1.3 atm and 28% oxygen for 40 sessions Scores calculated pre- and post-treatment for: Autism Treatment Evaluation Checklist (ATEC) Childhood Autism Rating Scale (CARS) Social Responsiveness Scale (SRS)
Rossignol and Rossignol, 2006 Med Hypotheses 67(2):216-28
Rossignol et al., 2007 BMC Pediatrics 7:36
Oxidized Glutathione Oxidized Glutathione Levels p = 0.557 0.3 0.26
0.27
p = 0.583
0.24
0.24 0.22 0.20
0.2
umol/L
Control Before After
0.1
0
1.3 atm
1.5 atm Pressure
p = 0.557
p = 0.583
Mean Changes in C-reactive protein CRP Levels 8
p = 0.123 6.10
mg/L
6
Before After
4
p = 0.084 2 0.70
0.64
0.27
0
1.3 atm
1.5 atm Pressure
p = 0.123
p = 0.084
p = 0.021 for all 18 children
Major Improvements (by %) Subscale
*p < 0.1, **p < 0.05
Social Withdrawal (ABC) Motivation (SRS) Health, Physical, Behavior (ATEC) Mannerisms (SRS) Sensory, Cognitive Awareness (ATEC) Speech, Language, Communication (ATEC) Cognition (SRS) Communication (SRS)
1.3 atm
1.5 atm
26.7* 25.5**
49.0** 34.1**
21.4**
4.2
21.2**
8.3
14.2**
23.9**
10.3**
17.3**
0 7.4**
16.4* 14.5*
Pilot Study Summary
HBOT at both 1.5 atm/100% oxygen and 1.3 atm/24% oxygen led to clinical improvements in children with autism and was safe HBOT at both pressures decreased an inflammatory marker (CRP) HBOT at both pressures did not appreciably worsen oxidative stress markers (as measured by oxidized glutathione) Limitations included open-label nature
• Thai Autistic children (n = 7) received HBOT (1.3 atm, 10 sessions) treatment. • Assessment was done before and after treatment in five domains: Social development, fine motor and eye-hand coordination, language development, gross motor development, self-help skills. • Results: Improvement was shown in five domains with a significant level. 75% of children showed improvement while 25% did not seem to respond to the treatment. Chungpaibulpatana et al., 2008 J Med Assoc Thai 91(8):1232-8
Dear Dr Kinaci Hyperbaric Oxygen Treatment for Autistic Children Thank you for your letters about this matter. I can confirm that the use of hyperbaric treatment which now being used for autistic children in the UK is to address the neuroinflammatory component of the disorder. There is emerging evidence of chronic bloodbrain 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. There is a very thorough review of this by Carl Nathan in Nature 2003 vol 422 675-676. Best wishes
Philip James
Professor of Hyperbaric Medicine
Effects of HBOT
Control Rat Brain
Hypoxia Ischemia
Hypoxia Ischemia + HBOT
Calvert et al., 2002
AUTISM
Cerebral Hypoperfusion
Neuroinflammation and GI inflammation
Excretion of Porphyrins
Oxidative Stress
Neurodegenerative Disease
Cerebral Hypoperfusion
Neuroinflammation and GI inflammation
Excretion of Porphyrins
Oxidative Stress
HBOT
Stem Cells
Neurodegenerative Disease
HYPERBARIC OXYGEN THERAPY INCREASES STEM CELLS BY EIGHT-FOLD • A scientific study completed at the University of Pennsylvania School of Medicine reports that HBOT is a safe and effective way to mobilize stem cells. • Stem cells, also called progenitor cells, are crucial to the repair of injured tissues and organs. • HBOT increase by eight-fold the number of circulating stem cells throughout the body.
• Healthy recovery of injured and diseased tissues is the ultimate goal and stem cells play an essential role.
Through these sessions we make sure that the brains inactive cells (idling neurons) develop to normal function. When the brain cells are able to utilize the molecules of oxygen in the air, the treatment is finished. To confirm this, a SPECT is done. (Dr.Neubauer & Dr.Harch’s Scan-Dive-Scan Protocol)
A specialized tool, the SPECT scan, (Single Photon Emission Computed Tomography) has been proven effective in this task and it is the primary tool to objectively measure the brain perfusion (function/metabolism) on patients.
Specifically, SPECT scanning show actual brain functioning, in visual terms.
It can help doctors to see how blood is flowing through different areas within a patient's brain, visualize brain metabolism, make a better diagnosis of his/her condition and a better planning on treatment
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
A SPECT scan can show brain areas implicated with specific clinical problems, such as the prefrontal cortex with impulsivity and the hippocampus with memory issues.
SPECT frequently uncovers unexpected findings that may be contributing to presenting problems, such as toxicity or brain trauma.
Before and after SPECT can also show the effects of prescribed medication to give guidance on how to adjust treatment.
33rd Annual Scientific Meeting of the
European Underwater and Baromedical Society on Diving & Hyperbaric Medicine September 8th - 15th, 2007 Sharm el-Sheikh, Sinai, Egypt
BRAIN PERFUSION CHANGES AFTER HYPERBARIC OXYGEN THERAPHY IN THE CHILDREN WITH AUTISM. KINACI Cem¹, ALAN Mustafa², HATIPOGLU Kadir³ ¹DAN! Practitioner and Nuclear Medicine Physician, IMC Hospital, Mersin, Turkey. ²Aerospace Medicine Physician, Baromed Hyperbaric Center, Ankara, Turkey. ³Diving Medicine and Pulmonary Disease Physician, Gulhane Military Medical Academy, TSK Rehabilitation Center, Ankara, Turkey.
Materials/Methods: This study shows the brain perfusion changes secondary to brain inflamation and effects of HBOT in 108 children with autism.
Conclusions: 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.
www.cemkinaci.com
Brain SPECT scan before HBOT (A.S. 7 YO Boy)
Brain SPECT scan after 90 sessions of HBOT
Brain SPECT scan BEFORE AND AFTER 90 SESSIONS OF HBOT
Brain SPECT scan before HBOT
Brain SPECT scan after HBOT
Brain SPECT scan before HBOT
Brain SPECT scan after HBOT
Brain SPECT scan before HBOT
Brain SPECT scan after HBOT
N.L.’S HANDWRITING BEFORE HBOT
N.L.’S HANDWRITING AFTER HBOT
HYPERBARIC OXYGENATION IN RESTORATION OF THE COGNITIVE FUNCTIONS IN CHILDREN Jovanovic Simic N.3, Terzic I .3, Jovanovic T.1, Brkic P.2, Mitrovic A.1 1Centre
for hyperbaric medicine, Belgrade, Serbia, 2 Institute of Medical Physiology,School of Medicine, University of Belgrade 3Institution Faculty of special education and rehabilitation, University of Belgrade, Belgrade, Serbia
Some examples from N.V, 5 year old boy HBO and Stimulative treatment for psychomotor development
Before HBO
Before HBO
Before HBO
After 10 HBO session and stimulative program for psychomotor reeducation
After 13 HBO session and stimulative program for psychomotor reeducation
After 20 HBO session and stimulative program for psychomotor reeducation
Some examples from N.V, 5 year old boy
Before HBO
Drawing before HBO
After 36 HBO session and stimulative program for psychomotor reeducation
Draw and color after 80 HBO session and stimulative program for psychomotor reeducation
www.oceanhbo.com www.harchhyperbarics.com
With “Hyperbaric Oxygen Therapy” it is possible to treat both brain and digestive system. This has been used since 1972 by Dr. Richard Neubauer/USA, with excellent results.
Anju Usman, TREATING AUTISM CONFERENCE FEB 2007 - UK
THANKS TO
My wife Serpilgul Kinaci
Autism Research Institute
Medical Academy for Pediatric Special Needs
CONTACT ADDRESS FOR CEM KINACI MD Grand Hospital Həsən Əliyev 38 AZ1033, Baku - AZERBAIJAN +99 412 599 1117 Oksimer HBOT Clinic Kazım Karabekir Mahallesi Türbe Caddesi Num:16/18 Daire A11, Karabağlar, Izmir - TURKEY +90 507 247 49 46 Unionhealth Terapijski Centar Dalmatinska 17, 11000, Beograd – SERBIA +381 1 3292 172 HBOT Clinic Aymed Tirana Rr.”Reshit Petrela” Kompleksi Usluga Kula e Xhamit, KL-1, Tirane – ALBANIA +355 6730 18627
[email protected]
