Children with cerebral palsy get no benefit from
expensive high-pressure oxygen treatment, a highly touted alternative
therapy, new research has found.
A study published this week in The Lancet medical journal is the first to
properly investigate whether the technique improves the lives of children
with the incurable disability.
"This is one of a long succession of alleged treatments for cerebral
palsy that have come and gone, and this was by far the best researched,"
said Dr. Peter Rosenbaum, a cerebral palsy expert who was not involved in
the study.
Children given slightly pressurized air improved just as much as those
treated in high-pressure oxygen chambers, the study found.
Though most experts said they thought the findings proved high-pressure
treatment was useless, proponents said the improvement in the comparison
group means even slightly pressurized air helps.
Cerebral palsy is a collection of diverse syndromes characterized by
movement disorders and is caused by brain damage before, during or just
after birth. It affects two in every 1,000 babies in the industrialized
world, and is sometimes caused when not enough oxygen gets to the brain.
"The logic that we can repair brain impairment caused by oxygen
deprivation by supplying more oxygen after the damage has been done is just
crazy," said Rosenbaum, chair of the childhood research center at McMaster
University in Hamilton, Ontario.
"The underlying brain damage is permanent, and neither improves nor
worsens," Rosenbaum said.
Experts say that in the early years physiotherapy and drugs can help
children improve their motor function. As the child grows, the acquisition
of skills slows and therapy is geared toward preventing deterioration,
experts say.
High-pressure, or hyperbaric, oxygen is usually used to treat carbon
monoxide poisoning, some infectious diseases and to protect bones before
radiation therapy.
Its use in cerebral palsy has spread as testimonials of successful
treatment circulated among families of stricken children.
"It's hard to know the exact number, but there are many centers doing it.
It's a big business in the United States, and there are also centers in the
U.K. and Canada," said the study's leader, Dr. Jean-Paul Collet, a professor
of clinical research at McGill University in Montreal. "This is a classic
situation of people in a desperate situation. They are ready to try
anything."
Collet's study involved 111 children with cerebral palsy age 3 to 12.
Half were given high-pressure pure oxygen and half got air pressurized to
the lowest pressure that can be felt. Parents did not know which treatment
their children were getting.
The children got 40 daily sessions over eight weeks and were tested after
20 sessions, after their last treatment and three months later.
The two groups' test scores improved by the same amount and the changes
persisted three months after the treatment. The greatest improvements were
seen in the children who started with low scores.
Even the slightly pressurized air increased the concentration of oxygen
in the blood. The normal level is 100 milliliters of mercury. Slightly
pressurized air pushed that up to 148 milliliters, while the high-pressure
oxygen increased it to 1,230 milliliters.
Collet said the findings don't mean extra oxygen goes to the brain, but
that it can't be ruled out.
"An increase to 148 may be enough to have an effect on motor function,
but we'd have to compare improvements with (unpressurized) air to see if
that's the case," he said.
Collet said he believes the children improved because their brains were
stimulated by the excitement of getting into a pressure chamber.