History of Hyperbaric Oxygen and Multiple Sclerosis
Many MS sufferers find the disease’s chronic nature, unpredictable flare-ups, and remissions difficult to live with. Unfortunately, the unpredictable nature of the disease makes such patients vulnerable to quack (and often expensive) treatments. Those practicing such questionable therapies can seize on remission phases as evidence to claim that the MS treatment is working, or is even a cure. And after paying for treatments, when symptoms return, MS patients are understandably disappointed and hurt.
But Hyperbaric Oxygen Therapy is not a quack treatment. And although it doesn’t help all those who suffer with MS, it does help many. To understand why some doctors still remain skeptical about HBOT’s ability to reduce MS symptoms, it’s first important to understand the scientific method, the gold standard for proving any medical therapy’s effectiveness and safety.
The Scientific Method
Medical studies employing the scientific method are:
- Randomized: treated and untreated groups have similar characteristics, but study participants are selected randomly
- Double-blind: neither the treating doctor nor the participants know which participants receive treatment and which receive a placebo (inactive material taking the place of a drug, vaccine or other treatment)
- Placebo-controlled: a placebo is given to one group of participants, while the treatment being tested is given to another group
This extensive type of research often costs millions of dollars, especially with long term studies. Hyperbaric oxygen therapy isn’t a patentable drug with the potential to return billions of dollars to pharmaceutical companies and their shareholders. Because of that, no companies have the incentive to complete the HOBT studies that the FDA would require in order to approve it for treating MS. And although the FDA has approved HBOT’s use as safe and effective for 14 medical conditions, multiple scleroses remains listed on the agency’s website as an off-label use. Consequently, no US medical insurers will cover hyperbaric oxygen therapy for MS. Nevertheless, studies have employed and continue to employ the scientific method to accurately gauge HBOT’s benefits to those suffering from the disabling disease.
Early Hyperbaric Studies
During the 1970s, researchers from four European countries described several benefits they’d noticed while treating MS patients with hyperbaric oxygen. In 1975, Dr. Richard Neubauer, a world-wide authority on HBOT, used the therapy to treat an MS patient suffering from bone inflammation (osteomyelitis) at Fort Lauderdale’s Ocean Medical Center. In addition to bringing down the inflammation, HBOT had an unanticipated benefit: the patients’ other MS symptoms improved. That led to a number of double-blind scientific studies.
Without successful treatment, 80 percent of those suffering with MS have progressive and deteriorating symptoms. Using both double-blind and longitudinal clinical studies, Dr. Neubauer administered individually-adjusted, hyperbaric oxygen therapy at low pressure (1.3 to 1.5 atmospheres) to his patients with MS. And although 20 to 30 percent of these patients continued to deteriorate, between 70 and 80 percent didn’t just stabilize – both their tissue damage and symptoms improved!
Between 1980 and 1982, Drs. B. H. Fischer, M. Marks, and T. Reich at New York University Medical Center completed the first randomized, double-blind, placebo-controlled trial of HBOT for 40 patients who had suffered with MS for 11 years or more. The researchers divided the patients randomly into two groups of 20. The experimental group breathed pure oxygen during 90-minute treatments once per day for 20 days, and the control group was given a mixture of 10% oxygen and 90% nitrogen over the same period. Three patients in the experiment group dropped out of the study prior to completion.
The researchers published their findings in the New England Journal of Medicine in 1983. Twelve out of 17 (70%) of the study’s participants who had HBOT improved, with just two showing deterioration at their one-year follow-up. The patients who were least severely affected with MS saw the best results. By comparison, of the patients who got the oxygen-nitrogen mix, only one patient in 20 (5%) saw any improvement.
By 1984, Dr. Neubauer and others had studied the impact of HBOT on over 10,000 MS patients in fourteen countries. Of these patients, 70 percent improved both brain, bladder and bowel function and their muscle spasticity declined. Twenty-five percent of the patients had measurable improvements. Forty-five percent of the patients also reported feeling better. At one hyperbaric medicine conference, Dr. Neubauer stated that 600 MS patients he had treated with HBOT experienced substantial objective improvement. He also noted that periodic HBOT boosters reduced both deterioration and the frequency of relapse.
In 1986, Neubauer and Kagan demonstrated that 11 out of 35 MS patients’ lesions disappeared after just one hour of hyperbaric oxygen therapy. At three separate international conferences, Neubauer, Kagan and Gottlieb presented research showing that MRI tests had confirmed a statistically significant reduction in both the number and size of lesions in MS patients who had HBOT, versus those who did not.
Researchers worldwide have seen positive results for MS patients. In one 1986 Japanese placebo-controlled, double blind study, Dr. Tl Yamada and his colleagues reported that all the patients they treated with HBOT had a substantial decrease in the number of relapses. In 1990, Oriani and fellow researchers in Palermo, Italy tested 44 MS patients with low Kurtzke disability scores (KDS). The 22 participants treated with HBOT weekly for one year experienced significant improvements over the 22 who had no treatment.
In Paris, France, Pallotta and other researchers followed 22 MS patients for 8 years. Each participant received an initial course of 20 HBOT treatments. Only 11 patients continued in treatments, receiving HBOT twice in every 20 days. Those having prolonged treatments experienced a dramatic decrease in relapses, whereas those who only had the initial course of treatment found their relapses gradually increased again. This conclusively established the importance of continuing HBOT treatments. The patients who saw such dramatic improvements established a non-profit called The Federation of Multiple Sclerosis Treatment Centers, which now has multi-place HBOT facilities throughout the United Kingdom.
Another study tested hyperbaric oxygen’s impact on the T and B lymphocytes of patients who had suffered MS for an average of nine or more years. (T and B lymphocytes refers to two types of critical white blood cells in the immune system – thyroid cells and bone cells, each playing different roles in helping the body fight off invaders.) Ninety percent of the patients tested showed an adjustment in their immune responses following HBOT treatments. The study served to reconfirm earlier successes using hyperbaric pressures at 1.5 ATA or below for longer treatment times and also suggested that higher pressures could negatively impact the immune system.
When the blood-brain barrier sustains injury, brain tissues swell and impede O2 delivery, leading to loss of function. Hyperbaric oxygen therapy pushes oxygen deep into areas that the circulatory system can’t reach. This permits the blood-brain-barrier and its underlying tissues to heal and restores the nervous system’s ability to accurately relay messages. How effective HBOT can be for MS depends on whether injured cells have truly died or whether the cells remain dormant, but viable. Treating MS with hyperbaric oxygen therapy early on will produce the best results, while the brain’s potential to restore lost function is the greatest. Even though HBOT cannot help everyone with MS, it’s important to remember that even chronic MS patients have experienced dramatic improvements.
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