|08-21-2001, 09:54 PM||#1|
Join Date: Jul 2001
Can Hyperbaric Oxygen Treat Neurological Conditions?
Can Hyperbaric Oxygen Treat Neurological Conditions?
Jon Rappoport, Medical Writer
The once-firm line between mainstream and alternative medicine continues to blur. New clinical anecdotes are emerging in the field of hyperbaric oxygen therapy (HBOT). Some physicians now use it to treat stroke, cerebral palsy (CP), and other neurological problems.
Are these physicians proceeding along untested ground?
During HBOT, the patient is exposed to 100% oxygen inside a sealed chamber. The sessions last 40-90 minutes. The goal is to saturate the patient's tissues with oxygen--to "feed" cells that may not be getting enough energy or that may not be working correctly.
Dr. Richard Neubauer uses HBOT. His most famous patient is Dr. Edward Teller, former science advisor to President Reagan and "father of the H-bomb." Teller, now 92, says, "Knowledge in the field of hyperbaric oxygen is incomplete. Large-scale studies should certainly be done. I had a serious stroke some years ago. I immediately received hyperbaric treatments. As far as I know, the remnants of the stroke passed away completely. My wife had lung problems. She, too, received hyperbaric oxygen. Her experience with this treatment was very good. I believe Dr. Neubauer is doing good work and is not sufficiently recognized."
Dr. Neubauer is a pioneer in the use of HBOT to treat neurological difficulties. "In the field of stroke," he says, "we are talking about two distinct treatment periods: the first 4 hours after the stroke, and then what we could call long-term late stroke. I know of one patient who made progress with HBOT 12 years after the initial stroke.
"If you can catch a stroke in the first 4 hours, you can, in many cases, recover the use of a significant number of brain cells which appear to be damaged."
Dr. Neubauer uses a SPECT (single photon emission computed tomography) scan, an imaging technology, to create before-and-after pictures of the patient's brain. "These images show that what we used to think of as dead or damaged brain cells, many of them, are actually in an idling or dormant state. They can literally be kick-started and awakened by flooding the area with oxygen," he says.
Dr. John Marler, of the National Institutes of Health, and director of clinical trials in the area of neurological diseases, does not share "premature opinions about HBOT. Hyperbaric oxygen is only an experimental treatment in the area of stroke, as well as in other neurological problems. These matters take many years to research, and it's worth the time to get it right. Accepting HBOT on the face of it is just not good medicine. We need large-scale controlled clinical trials. Anecdotal reports are not a substitute for real science."
There are no recent definitive studies, using large numbers of patients and a control group, which show the value of HBOT for neurological problems. Plans are underway to begin a clinical trial this summer using HBOT with stroke patients. One of the study's principal investigators will be Dr. Paul Harch of the LSU School of Medicine.
"In the last 10 years," Dr. Harch says, "I have seen hundreds of patients with some category of neurological brain problem or injury. About 90% of those patients make improvements to one degree or another with HBOT.
"I'll point to the centerfield fence and make a prediction here. In the future HBOT will become a foundation therapy for both acute and chronic neurological brain injury of just about any type."
"In some of these children, we end up seeing less spasticity, more coordination as judged by people closely involved in their lives."
"There is an HBOT study going on right now at Cornell University on childhood neurological injury," continues Dr. Harch. "There is another HBOT study on cerebral palsy underway at Fort Gordon, an army base in Augusta, Georgia. A primary breakthrough on HBOT is occurring. We are talking about using HBOT to treat cerebral palsy, divers with brain injuries, boxers with brain injuries, stroke victims, a few dozen different categories of neuropathology."
Dr. Ralph Potkin, who operates an HBOT facility in Beverly Hills, California, has had positive experience treating children with cerebral palsy. "In some of these children, we end up seeing less spasticity, more coordination as judged by people closely involved in their lives," he says.
Dr. Potkin treats "a variety of neurological patients. Some have had strokes; some have other degenerative conditions. There is a definite subset of all these patients who respond to HBOT, who improve."
When asked about his stroke patients, Dr. Potkin says, "My impression is that those who get better improve more in the area of intellectual function and less in motor coordination."
Cyndi Di Mauro's 6-year-old son Trent has cerebral palsy. Trent is a patient of Dr. Potkin. Di Mauro says he has had 120 HBOT sessions. "After the second session, we saw a large change. Trent had been able to move only 4 feet at a time with his walker. Suddenly he was going all around his school with the walker. The most major change has been in the cognitive area. Trent is now able to learn his ABCs. His vocabulary and articulation have improved. So has his peripheral vision."
In addition to plans to continue HBOT for her son, Di Mauro is organizing a foundation for children whose parents can't afford the cost of HBOT treatments (which are not covered by insurance).
How long might it be before the "experimental" tag is removed from HBOT in the treatment of stroke, cerebral palsy, and other degenerative neurological conditions?
At the UCLA Gonda Center for Wound Healing and Hyperbaric Medicine, Dr. Cornelius Scannell sounds a cautionary note. "The proven uses of HBOT include pre- and post- skin-graft sessions in the hyperbaric chamber. All the neurological applications of HBOT, such as stroke and cerebral palsy, are not on the list of conditions Medicare will pay for. They are off-protocol. That's because there isn't sufficient scientific evidence in the literature to support those uses. We must have more hard science, double-blind controlled studies. And we don't have that."
A British research-review group, Scope, agrees. Commenting on the efficacy of HBOT for cerebral palsy, the group states its position: "A number of leading neurologists believe there is no theoretical reason why HBO[T] should help children or adults with cerebral palsy. A lack of formal studies in this area would tend to reinforce that notion."
Meanwhile, a growing number of doctors and patients are more than willing to use HBOT for neurological conditions, especially when other treatments are not reversing these conditions.