Are stem cells the latest Autism woo?

by endlesspsych

There is apparently a new “treatment” for ASD avaliable from the XCell centre in Dussledorf Germany – Stem Cell therapy.

Dusseldorf, Germany (PRWEB) October 1, 2009 — The XCell-Center has released interim results from 10 autism patients treated with autologous bone marrow stem cells. Overall, more than 70% improved following treatment. Patients reported improvements in cognition, behavior, language, socialization, coordination, motor skills and awareness. These results support the premise that patients with Autism can be treated safely and effectively with autologous stem cell therapy.

Which sounds fantastic doesn’t it? So fantastic one might be tempted to think it’s a little too good to be true perhaps? One part in particular rings alarm bells “Patients reported”… Of course it could just be poor reporting from a poor press release or some such but it seems to imply that self-reported measures are being used to determine the efficacy of a genetic treatment for autistic spectrum disorders. At the very least the following seems to confirm that suspicion…

My son’s behavior has improved; playing for an hour at a time, running, climbing, and exploring the playground as a normal, healthy child would,” commented the mother of a 6 year-old boy who was treated at the XCell-Center in May 2009. Better behavior was reported by every patient who experienced improvements following treatment.

…and also makes it seem that it’s not even the patients who are reporting the benefits but rather the parents themselves… Which we must consider opens up a whole can of worms regarding expectation effects.

Expectation effects in medicine are a kind of placebo response to treatment that can be demonstrated by comparing the pain relief giving properties of branded and non-branded pain killers. If you ask participants to place their hands in ice water for as long as they can giving one group brand X and another group a household name painkiller (when in fact both are the same pill) then those who think they are receiving the household name painkiller will be able to keep their hands in the ice water longer. This implies that as well as the pain relief provided by the active ingredients in the pill there is an additional placebo effect that increases branded pills effectiveness. Indeed there is a whole raft of research on such effects demonstrating that we think very large and very small pills help us more, injections are better than pills and that even some surgical procedures may work by placebo effect alone! It’s also worth noting that the more something costs the higher the placebo effect has been found to be.

It’s not too large a jump to consider that the supposed benefits  of stem cell therapy are in fact down to a form of expectation effect. Essentially the parents want their kids to be better, they shell out for a (presumably) expensive treatment at a private clinic and afterwards try to discern if there has been an effect. They want their kids to improve, they wouldn’t knowingly invest in some quack treatment and put their kid’s health at risk therefore they see what they want to see. They fall into a trap of confirmation bias and accentuate the positive – they remember more vividly before the treatment the negative behaviours associated with their child’s ASD and after the treatment they focus more on the positive. unconsciously wishing the treatment to have worked if you like.

I could be wrong but there are a number of fairly standard objective measures that can test some, if not all, of the following: “improvements in cognition, behavior, language, socialization, coordination, motor skills and awareness.”. I find it highly suspicious that there is no reference to any objective measures of improvement in many of the conditions listed on the XCell website (stroke, spinal injuries, multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), Parkinson’s and Alzheimer’s disease as well as arthritis, heart disease, eye disease, neuropathy and incontinence) indeed there appears to be a worrying trend towards suggesting stem cells as a panacea for all ills… Which as has been seen with acupuncture, homeopathy, chiropracty (spine wizards!) and the like is almost a sure sign of woo…

I don’t dispute that stem cell therapy may one day provide real and tangible benefits for a whole range of diseases and illnesses, perhaps even some of those mentioned above, indeed the US national institute of health lists 2758 trials of stem cells in treating various diseases. But I can’t escape the nagging feeling that the XCell centre, particularly in the case of ASD, is just the latest in a long line of well meaning but deluded practitioners drifting from woo to woo cure or huxters looking to exploit pseudoscience for their own gain. For one thing the idea of stem cells being injected to somehow fixing a broken brain doesn’t strike me as being a million miles away from ye olde anti-vax lunacy about mercury in vaccines destroying neural pathways…

I’m more then willing to be proven wrong however.