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Shining light on the head: Photobiomodulation for brain disorders. BBA CLINICAL 2016; 6:113-124. [PMID: 27752476 PMCID: PMC5066074 DOI: 10.1016/j.bbacli.2016.09.002] [Citation(s) in RCA: 293] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 09/27/2016] [Accepted: 09/29/2016] [Indexed: 12/21/2022]
Abstract
Photobiomodulation (PBM) describes the use of red or near-infrared light to stimulate, heal, regenerate, and protect tissue that has either been injured, is degenerating, or else is at risk of dying. One of the organ systems of the human body that is most necessary to life, and whose optimum functioning is most worried about by humankind in general, is the brain. The brain suffers from many different disorders that can be classified into three broad groupings: traumatic events (stroke, traumatic brain injury, and global ischemia), degenerative diseases (dementia, Alzheimer's and Parkinson's), and psychiatric disorders (depression, anxiety, post traumatic stress disorder). There is some evidence that all these seemingly diverse conditions can be beneficially affected by applying light to the head. There is even the possibility that PBM could be used for cognitive enhancement in normal healthy people. In this transcranial PBM (tPBM) application, near-infrared (NIR) light is often applied to the forehead because of the better penetration (no hair, longer wavelength). Some workers have used lasers, but recently the introduction of inexpensive light emitting diode (LED) arrays has allowed the development of light emitting helmets or "brain caps". This review will cover the mechanisms of action of photobiomodulation to the brain, and summarize some of the key pre-clinical studies and clinical trials that have been undertaken for diverse brain disorders.
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Karimi M, Zangabad PS, Ghasemi A, Amiri M, Bahrami M, Malekzad H, Asl HG, Mahdieh Z, Bozorgomid M, Ghasemi A, Boyuk MRRT, Hamblin MR. Temperature-Responsive Smart Nanocarriers for Delivery Of Therapeutic Agents: Applications and Recent Advances. ACS APPLIED MATERIALS & INTERFACES 2016; 8:21107-33. [PMID: 27349465 PMCID: PMC5003094 DOI: 10.1021/acsami.6b00371] [Citation(s) in RCA: 240] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Smart drug delivery systems (DDSs) have attracted the attention of many scientists, as carriers that can be stimulated by changes in environmental parameters such as temperature, pH, light, electromagnetic fields, mechanical forces, etc. These smart nanocarriers can release their cargo on demand when their target is reached and the stimulus is applied. Using the techniques of nanotechnology, these nanocarriers can be tailored to be target-specific, and exhibit delayed or controlled release of drugs. Temperature-responsive nanocarriers are one of most important groups of smart nanoparticles (NPs) that have been investigated during the past decades. Temperature can either act as an external stimulus when heat is applied from the outside, or can be internal when pathological lesions have a naturally elevated termperature. A low critical solution temperature (LCST) is a special feature of some polymeric materials, and most of the temperature-responsive nanocarriers have been designed based on this feature. In this review, we attempt to summarize recent efforts to prepare innovative temperature-responsive nanocarriers and discuss their novel applications.
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Affiliation(s)
- Mahdi Karimi
- Department of Medical Nanotechnology, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
- Advanced Nanobiotechnology and Nanomedicine Research Group (ANNRG), Iran University of Medical Sciences, Tehran, Iran
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
| | - Parham Sahandi Zangabad
- Research Center for Pharmaceutical Nanotechnology (RCPN), Tabriz University of Medical Science (TUOMS), Tabriz, Iran
- Department of Materials Science and Engineering, Sharif University of Technology, Azadi Avenue, 14588 Tehran, Iran
- Advanced Nanobiotechnology and Nanomedicine Research Group (ANNRG), Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Ghasemi
- Department of Materials Science and Engineering, Sharif University of Technology, Azadi Avenue, 14588 Tehran, Iran
| | - Mohammad Amiri
- Department of Materials Science and Engineering, Sharif University of Technology, Azadi Avenue, 14588 Tehran, Iran
| | - Mohsen Bahrami
- Department of Materials Science and Engineering, Sharif University of Technology, Azadi Avenue, 14588 Tehran, Iran
| | - Hedieh Malekzad
- Advanced Nanobiotechnology and Nanomedicine Research Group (ANNRG), Iran University of Medical Sciences, Tehran, Iran
- Department of Chemistry, Kharazmi University of Tehran, Tehran, Iran
| | - Hadi Ghahramanzadeh Asl
- Department of Materials Science and Engineering, Sharif University of Technology, Azadi Avenue, 14588 Tehran, Iran
| | - Zahra Mahdieh
- Department of Biomedical and Pharmaceutical Sciences, Material Science and Engineering, University of Montana, Missoula, Montana 59812, United States
| | - Mahnaz Bozorgomid
- Department of Applied Chemistry, Central Branch of Islamic Azad University of Tehran, Tehran, Iran
| | - Amir Ghasemi
- Department of Materials Science and Engineering, Sharif University of Technology, Azadi Avenue, 14588 Tehran, Iran
- Advanced Nanobiotechnology and Nanomedicine Research Group (ANNRG), Iran University of Medical Sciences, Tehran, Iran
| | | | - Michael R. Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts 02115, United States
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts 02139, United States
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103
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Beirne K, Rozanowska M, Votruba M. Red Light Treatment in an Axotomy Model of Neurodegeneration. Photochem Photobiol 2016; 92:624-31. [DOI: 10.1111/php.12606] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 05/09/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Kathy Beirne
- School of Optometry and Vision Sciences; Cardiff University; Cardiff UK
- Cardiff Institute for Tissue Engineering and Repair; Cardiff University; Cardiff UK
| | - Malgorzata Rozanowska
- School of Optometry and Vision Sciences; Cardiff University; Cardiff UK
- Cardiff Institute for Tissue Engineering and Repair; Cardiff University; Cardiff UK
| | - Marcela Votruba
- School of Optometry and Vision Sciences; Cardiff University; Cardiff UK
- Cardiff Institute for Tissue Engineering and Repair; Cardiff University; Cardiff UK
- Cardiff Eye Unit; University Hospital of Wales; Cardiff UK
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104
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Cassano P, Petrie SR, Hamblin MR, Henderson TA, Iosifescu DV. Review of transcranial photobiomodulation for major depressive disorder: targeting brain metabolism, inflammation, oxidative stress, and neurogenesis. NEUROPHOTONICS 2016; 3:031404. [PMID: 26989758 PMCID: PMC4777909 DOI: 10.1117/1.nph.3.3.031404] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 02/02/2016] [Indexed: 05/02/2023]
Abstract
We examined the use of near-infrared and red radiation (photobiomodulation, PBM) for treating major depressive disorder (MDD). While still experimental, preliminary data on the use of PBM for brain disorders are promising. PBM is low-cost with potential for wide dissemination; further research on PBM is sorely needed. We found clinical and preclinical studies via PubMed search (2015), using the following keywords: "near-infrared radiation," "NIR," "low-level light therapy," "low-level laser therapy," or "LLLT" plus "depression." We chose clinically focused studies and excluded studies involving near-infrared spectroscopy. In addition, we used PubMed to find articles that examine the link between PBM and relevant biological processes including metabolism, inflammation, oxidative stress, and neurogenesis. Studies suggest the processes aforementioned are potentially effective targets for PBM to treat depression. There is also clinical preliminary evidence suggesting the efficacy of PBM in treating MDD, and comorbid anxiety disorders, suicidal ideation, and traumatic brain injury. Based on the data collected to date, PBM appears to be a promising treatment for depression that is safe and well-tolerated. However, large randomized controlled trials are still needed to establish the safety and effectiveness of this new treatment for MDD.
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Affiliation(s)
- Paolo Cassano
- Massachusetts General Hospital, Depression Clinical and Research Program, One Bowdoin Square, 6th Floor, Boston, Massachusetts 02114, United States
- Harvard Medical School, Department of Psychiatry, 401 Park Drive, Boston, Massachusetts 02215, United States
- Address all correspondence to: Paolo Cassano, E-mail:
| | - Samuel R. Petrie
- Massachusetts General Hospital, Depression Clinical and Research Program, One Bowdoin Square, 6th Floor, Boston, Massachusetts 02114, United States
| | - Michael R. Hamblin
- Massachusetts General Hospital, Wellman Center for Photomedicine, 50 Blossom Street, Boston, Massachusetts 02114, United States
- Harvard Medical School, Department of Dermatology, 55 Fruit Street, Boston, Massachusetts 02114, United States
- Harvard-MIT Division of Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, United States
| | - Theodore A. Henderson
- Synaptic Space, 3979 East Arapahoe Road, Littleton, Colorado 80122, United States
- Neuro-Laser Foundation, Suite 420, 215 South Wadsworth, Lakewood, Colorado 80226, United States
| | - Dan V. Iosifescu
- Mount Sinai Medical School, Mood and Anxiety Disorders Program, 1428 Madison Avenue, New York, New York 10029, United States
- Mount Sinai Medical School, Department of Psychiatry and Neuroscience, 1 Gustave L. Levy Place, New York, New York 10029, United States
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105
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Hwang J, Castelli DM, Gonzalez-Lima F. Cognitive enhancement by transcranial laser stimulation and acute aerobic exercise. Lasers Med Sci 2016; 31:1151-60. [DOI: 10.1007/s10103-016-1962-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 05/09/2016] [Indexed: 12/28/2022]
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106
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Henderson TA. Multi-watt near-infrared light therapy as a neuroregenerative treatment for traumatic brain injury. Neural Regen Res 2016; 11:563-5. [PMID: 27212912 PMCID: PMC4870908 DOI: 10.4103/1673-5374.180737] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Theodore A Henderson
- Neuro-Laser Foundation, The Synaptic Space, Neuro-Luminance, Centennial, CO, USA
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107
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de Freitas LF, Hamblin MR. Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy. IEEE JOURNAL OF SELECTED TOPICS IN QUANTUM ELECTRONICS : A PUBLICATION OF THE IEEE LASERS AND ELECTRO-OPTICS SOCIETY 2016; 22:7000417. [PMID: 28070154 PMCID: PMC5215870 DOI: 10.1109/jstqe.2016.2561201] [Citation(s) in RCA: 733] [Impact Index Per Article: 91.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Photobiomodulation (PBM) also known as low-level laser (or light) therapy (LLLT), has been known for almost 50 years but still has not gained widespread acceptance, largely due to uncertainty about the molecular, cellular, and tissular mechanisms of action. However, in recent years, much knowledge has been gained in this area, which will be summarized in this review. One of the most important chromophores is cytochrome c oxidase (unit IV in the mitochondrial respiratory chain), which contains both heme and copper centers and absorbs light into the near-infra-red region. The leading hypothesis is that the photons dissociate inhibitory nitric oxide from the enzyme, leading to an increase in electron transport, mitochondrial membrane potential and ATP production. Another hypothesis concerns light-sensitive ion channels that can be activated allowing calcium to enter the cell. After the initial photon absorption events, numerous signaling pathways are activated via reactive oxygen species, cyclic AMP, NO and Ca2+, leading to activation of transcription factors. These transcription factors can lead to increased expression of genes related to protein synthesis, cell migration and proliferation, anti-inflammatory signaling, anti-apoptotic proteins, antioxidant enzymes. Stem cells and progenitor cells appear to be particularly susceptible to LLLT.
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Affiliation(s)
- Lucas Freitas de Freitas
- Programa de Pós-Graduação
Interunidades Bioengenharia, University of São Paulo, São Carlos -
SP, Brazil
- Wellman Center for Photomedicine, Harvard Medical School,
Boston, MA 02114, USA
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Harvard Medical School,
Boston, MA 02114, USA
- Department of Dermatology, Harvard Medical School, Boston,
MA 02115, USA
- Harvard-MIT Division of Health Sciences and Technology,
Cambridge, MA 02139, USA
- Correspondence: Michael R Hamblin,
; Tel 1-617-726-6182
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108
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The dark art of light measurement: accurate radiometry for low-level light therapy. Lasers Med Sci 2016; 31:789-809. [PMID: 26964800 PMCID: PMC4851696 DOI: 10.1007/s10103-016-1914-y] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 02/16/2016] [Indexed: 12/15/2022]
Abstract
Lasers and light-emitting diodes are used for a range of biomedical applications with many studies reporting their beneficial effects. However, three main concerns exist regarding much of the low-level light therapy (LLLT) or photobiomodulation literature; (1) incomplete, inaccurate and unverified irradiation parameters, (2) miscalculation of ‘dose,’ and (3) the misuse of appropriate light property terminology. The aim of this systematic review was to assess where, and to what extent, these inadequacies exist and to provide an overview of ‘best practice’ in light measurement methods and importance of correct light measurement. A review of recent relevant literature was performed in PubMed using the terms LLLT and photobiomodulation (March 2014–March 2015) to investigate the contemporary information available in LLLT and photobiomodulation literature in terms of reporting light properties and irradiation parameters. A total of 74 articles formed the basis of this systematic review. Although most articles reported beneficial effects following LLLT, the majority contained no information in terms of how light was measured (73 %) and relied on manufacturer-stated values. For all papers reviewed, missing information for specific light parameters included wavelength (3 %), light source type (8 %), power (41 %), pulse frequency (52 %), beam area (40 %), irradiance (43 %), exposure time (16 %), radiant energy (74 %) and fluence (16 %). Frequent use of incorrect terminology was also observed within the reviewed literature. A poor understanding of photophysics is evident as a significant number of papers neglected to report or misreported important radiometric data. These errors affect repeatability and reliability of studies shared between scientists, manufacturers and clinicians and could degrade efficacy of patient treatments. Researchers need a physicist or appropriately skilled engineer on the team, and manuscript reviewers should reject papers that do not report beam measurement methods and all ten key parameters: wavelength, power, irradiation time, beam area (at the skin or culture surface; this is not necessarily the same size as the aperture), radiant energy, radiant exposure, pulse parameters, number of treatments, interval between treatments and anatomical location. Inclusion of these parameters will improve the information available to compare and contrast study outcomes and improve repeatability, reliability of studies.
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109
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Patel K, Sun D. Strategies targeting endogenous neurogenic cell response to improve recovery following traumatic brain injury. Brain Res 2016; 1640:104-113. [PMID: 26855258 DOI: 10.1016/j.brainres.2016.01.055] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/27/2016] [Accepted: 01/29/2016] [Indexed: 11/16/2022]
Abstract
Traumatic brain injury (TBI) affects over 1.7 million people in the United States alone and poses many clinical challenges due to the variability of the injuries and complexity of biochemical mechanisms involved. Thus far, there is still no effective therapy for TBI. Failure of preventative therapeutic strategies has led studies focusing on regenerative approaches. Recent studies have shown evidence that mature brains harbors multipotent neural stem cells capable of becoming mature neurons in the neurogenic regions. Following brain insults including TBI, the injured brain has increased level of neurogenic response in the subventricular zone and dentate gyrus of the hippocampus and this endogenous response is associated with cognitive function following injury. In this review, we highlight recent development and strategies aimed at targeting this endogenous cell response to enhance post-TBI functional recovery. This article is part of a Special Issue entitled SI:Brain injury and recovery.
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Affiliation(s)
- Kaushal Patel
- Department of Neurosurgery, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Dong Sun
- Department of Neurosurgery, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States.
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110
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Johnstone DM, Moro C, Stone J, Benabid AL, Mitrofanis J. Turning On Lights to Stop Neurodegeneration: The Potential of Near Infrared Light Therapy in Alzheimer's and Parkinson's Disease. Front Neurosci 2016; 9:500. [PMID: 26793049 PMCID: PMC4707222 DOI: 10.3389/fnins.2015.00500] [Citation(s) in RCA: 206] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/15/2015] [Indexed: 11/13/2022] Open
Abstract
Alzheimer's and Parkinson's disease are the two most common neurodegenerative disorders. They develop after a progressive death of many neurons in the brain. Although therapies are available to treat the signs and symptoms of both diseases, the progression of neuronal death remains relentless, and it has proved difficult to slow or stop. Hence, there is a need to develop neuroprotective or disease-modifying treatments that stabilize this degeneration. Red to infrared light therapy (λ = 600-1070 nm), and in particular light in the near infrared (NIr) range, is emerging as a safe and effective therapy that is capable of arresting neuronal death. Previous studies have used NIr to treat tissue stressed by hypoxia, toxic insult, genetic mutation and mitochondrial dysfunction with much success. Here we propose NIr therapy as a neuroprotective or disease-modifying treatment for Alzheimer's and Parkinson's patients.
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Affiliation(s)
| | - Cécile Moro
- University Grenoble Alpes, CEA, LETI, CLINATEC, MINATEC Campus Grenoble, France
| | - Jonathan Stone
- Department of Physiology, University of Sydney Sydney, NSW, Australia
| | - Alim-Louis Benabid
- University Grenoble Alpes, CEA, LETI, CLINATEC, MINATEC Campus Grenoble, France
| | - John Mitrofanis
- University Grenoble Alpes, CEA, LETI, CLINATEC, MINATEC Campus Grenoble, France
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111
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Naeser MA, Hamblin MR. Traumatic Brain Injury: A Major Medical Problem That Could Be Treated Using Transcranial, Red/Near-Infrared LED Photobiomodulation. Photomed Laser Surg 2015; 33:443-6. [PMID: 26280257 DOI: 10.1089/pho.2015.3986] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Margaret A Naeser
- 1 VA Boston Healthcare System , Boston, Massachusetts.,2 Department of Neurology, Boston University School of Medicine , Boston, Massachusetts
| | - Michael R Hamblin
- 3 Wellman Center for Photomedicine, Massachusetts General Hospital , Boston, Massachusetts.,4 Department of Dermatology, Harvard Medical School , Boston, Massachusetts.,5 Harvard-MIT Division of Health Sciences and Technology , Cambridge, Massachusetts
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112
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Lapchak PA, Boitano PD, Butte PV, Fisher DJ, Hölscher T, Ley EJ, Nuño M, Voie AH, Rajput PS. Transcranial Near-Infrared Laser Transmission (NILT) Profiles (800 nm): Systematic Comparison in Four Common Research Species. PLoS One 2015; 10:e0127580. [PMID: 26039354 PMCID: PMC4454538 DOI: 10.1371/journal.pone.0127580] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 04/16/2015] [Indexed: 12/14/2022] Open
Abstract
Background and Purpose Transcranial near-infrared laser therapy (TLT) is a promising and novel method to promote neuroprotection and clinical improvement in both acute and chronic neurodegenerative diseases such as acute ischemic stroke (AIS), traumatic brain injury (TBI), and Alzheimer’s disease (AD) patients based upon efficacy in translational animal models. However, there is limited information in the peer-reviewed literature pertaining to transcranial near-infrared laser transmission (NILT) profiles in various species. Thus, in the present study we systematically evaluated NILT characteristics through the skull of 4 different species: mouse, rat, rabbit and human. Results Using dehydrated skulls from 3 animal species, using a wavelength of 800nm and a surface power density of 700 mW/cm2, NILT decreased from 40.10% (mouse) to 21.24% (rat) to 11.36% (rabbit) as skull thickness measured at bregma increased from 0.44 mm in mouse to 0.83 mm in rat and then 2.11 mm in rabbit. NILT also significantly increased (p<0.05) when animal skulls were hydrated (i.e. compared to dehydrated); but there was no measurable change in thickness due to hydration. In human calvaria, where mean thickness ranged from 7.19 mm at bregma to 5.91 mm in the parietal skull, only 4.18% and 4.24% of applied near-infrared light was transmitted through the skull. There was a slight (9.2-13.4%), but insignificant effect of hydration state on NILT transmission of human skulls, but there was a significant positive correlation between NILT and thickness at bregma and parietal skull, in both hydrated and dehydrated states. Conclusion This is the first systematic study to demonstrate differential NILT through the skulls of 4 different species; with an inverse relationship between NILT and skull thickness. With animal skulls, transmission profiles are dependent upon the hydration state of the skull, with significantly greater penetration through hydrated skulls compared to dehydrated skulls. Using human skulls, we demonstrate a significant correlation between thickness and penetration, but there was no correlation with skull density. The results suggest that TLT should be optimized in animals using novel approaches incorporating human skull characteristics, because of significant variance of NILT profiles directly related to skull thickness.
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Affiliation(s)
- Paul A. Lapchak
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Department of Neurosurgery, Cedars-Sinai Medical center, Los Angeles, California, United States of America
- * E-mail:
| | - Paul D. Boitano
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Pramod V. Butte
- Department of Neurosurgery, Cedars-Sinai Medical center, Los Angeles, California, United States of America
| | - David J. Fisher
- BURL Concepts Inc., San Diego, California, United States of America
| | - Thilo Hölscher
- BURL Concepts Inc., San Diego, California, United States of America
| | - Eric J. Ley
- Department of Surgery, Cedars-Sinai Medical center, Los Angeles, California, United States of America
| | - Miriam Nuño
- Department of Neurosurgery, Cedars-Sinai Medical center, Los Angeles, California, United States of America
| | - Arne H. Voie
- BURL Concepts Inc., San Diego, California, United States of America
| | - Padmesh S. Rajput
- Department of Neurosurgery, Cedars-Sinai Medical center, Los Angeles, California, United States of America
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113
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Gonzalez-Lima F, Auchter A. Protection against neurodegeneration with low-dose methylene blue and near-infrared light. Front Cell Neurosci 2015; 9:179. [PMID: 26029050 PMCID: PMC4428125 DOI: 10.3389/fncel.2015.00179] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 04/24/2015] [Indexed: 12/21/2022] Open
Affiliation(s)
- F Gonzalez-Lima
- Department of Psychology and Institute for Neuroscience, University of Texas at Austin Austin, TX, USA
| | - Allison Auchter
- Department of Psychology and Institute for Neuroscience, University of Texas at Austin Austin, TX, USA
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114
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Morries LD, Cassano P, Henderson TA. Treatments for traumatic brain injury with emphasis on transcranial near-infrared laser phototherapy. Neuropsychiatr Dis Treat 2015; 11:2159-75. [PMID: 26347062 PMCID: PMC4550182 DOI: 10.2147/ndt.s65809] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Traumatic brain injury (TBI) is a growing health concern affecting civilians and military personnel. In this review, treatments for the chronic TBI patient are discussed, including pharmaceuticals, nutraceuticals, cognitive therapy, and hyperbaric oxygen therapy. All available literature suggests a marginal benefit with prolonged treatment courses. An emerging modality of treatment is near-infrared (NIR) light, which has benefit in animal models of stroke, spinal cord injury, optic nerve injury, and TBI, and in human trials for stroke and TBI. The extant literature is confounded by variable degrees of efficacy and a bewildering array of treatment parameters. Some data indicate that diodes emitting low-level NIR energy often have failed to demonstrate therapeutic efficacy, perhaps due to failing to deliver sufficient radiant energy to the necessary depth. As part of this review, we present a retrospective case series using high-power NIR laser phototherapy with a Class IV laser to treat TBI. We demonstrate greater clinical efficacy with higher fluence, in contrast to the bimodal model of efficacy previously proposed. In ten patients with chronic TBI (average time since injury 9.3 years) given ten treatments over the course of 2 months using a high-power NIR laser (13.2 W/0.89 cm(2) at 810 nm or 9 W/0.89 cm(2) at 810 nm and 980 nm), symptoms of headache, sleep disturbance, cognition, mood dysregulation, anxiety, and irritability improved. Symptoms were monitored by depression scales and a novel patient diary system specifically designed for this study. NIR light in the power range of 10-15 W at 810 nm and 980 nm can safely and effectively treat chronic symptoms of TBI. The clinical benefit and effects of infrared phototherapy on mitochondrial function and secondary molecular events are discussed in the context of adequate radiant energy penetration.
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Affiliation(s)
| | - Paolo Cassano
- Harvard Medical School, Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Theodore A Henderson
- Neuro-Laser Foundation, Lakewood, CO, USA ; The Synaptic Space, Centennial, CO, USA
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115
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Henderson TA, Morries LD. Near-infrared photonic energy penetration: can infrared phototherapy effectively reach the human brain? Neuropsychiatr Dis Treat 2015. [PMID: 26346298 DOI: 10.2147/ndt] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
Traumatic brain injury (TBI) is a growing health concern effecting civilians and military personnel. Research has yielded a better understanding of the pathophysiology of TBI, but effective treatments have not been forthcoming. Near-infrared light (NIR) has shown promise in animal models of both TBI and stroke. Yet, it remains unclear if sufficient photonic energy can be delivered to the human brain to yield a beneficial effect. This paper reviews the pathophysiology of TBI and elaborates the physiological effects of NIR in the context of this pathophysiology. Pertinent aspects of the physical properties of NIR, particularly in regards to its interactions with tissue, provide the background for understanding this critical issue of light penetration through tissue. Our recent tissue studies demonstrate no penetration of low level NIR energy through 2 mm of skin or 3 cm of skull and brain. However, at 10-15 W, 0.45%-2.90% of 810 nm light penetrated 3 cm of tissue. A 15 W 810 nm device (continuous or non-pulsed) NIR delivered 2.9% of the surface power density. Pulsing at 10 Hz reduced the dose of light delivered to the surface by 50%, but 2.4% of the surface energy reached the depth of 3 cm. Approximately 1.22% of the energy of 980 nm light at 10-15 W penetrated to 3 cm. These data are reviewed in the context of the literature on low-power NIR penetration, wherein less than half of 1% of the surface energy could reach a depth of 1 cm. NIR in the power range of 10-15 W at 810 and 980 nm can provide fluence within the range shown to be biologically beneficial at 3 cm depth. A companion paper reviews the clinical data on the treatment of patients with chronic TBI in the context of the current literature.
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Affiliation(s)
- Theodore A Henderson
- The Synaptic Space, Centennial, CO, USA ; Neuro-Laser Foundation, Lakewood, CO, USA
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116
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Henderson TA, Morries LD. Near-infrared photonic energy penetration: can infrared phototherapy effectively reach the human brain? Neuropsychiatr Dis Treat 2015; 11:2191-208. [PMID: 26346298 PMCID: PMC4552256 DOI: 10.2147/ndt.s78182] [Citation(s) in RCA: 227] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Traumatic brain injury (TBI) is a growing health concern effecting civilians and military personnel. Research has yielded a better understanding of the pathophysiology of TBI, but effective treatments have not been forthcoming. Near-infrared light (NIR) has shown promise in animal models of both TBI and stroke. Yet, it remains unclear if sufficient photonic energy can be delivered to the human brain to yield a beneficial effect. This paper reviews the pathophysiology of TBI and elaborates the physiological effects of NIR in the context of this pathophysiology. Pertinent aspects of the physical properties of NIR, particularly in regards to its interactions with tissue, provide the background for understanding this critical issue of light penetration through tissue. Our recent tissue studies demonstrate no penetration of low level NIR energy through 2 mm of skin or 3 cm of skull and brain. However, at 10-15 W, 0.45%-2.90% of 810 nm light penetrated 3 cm of tissue. A 15 W 810 nm device (continuous or non-pulsed) NIR delivered 2.9% of the surface power density. Pulsing at 10 Hz reduced the dose of light delivered to the surface by 50%, but 2.4% of the surface energy reached the depth of 3 cm. Approximately 1.22% of the energy of 980 nm light at 10-15 W penetrated to 3 cm. These data are reviewed in the context of the literature on low-power NIR penetration, wherein less than half of 1% of the surface energy could reach a depth of 1 cm. NIR in the power range of 10-15 W at 810 and 980 nm can provide fluence within the range shown to be biologically beneficial at 3 cm depth. A companion paper reviews the clinical data on the treatment of patients with chronic TBI in the context of the current literature.
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Affiliation(s)
- Theodore A Henderson
- The Synaptic Space, Centennial, CO, USA ; Neuro-Laser Foundation, Lakewood, CO, USA
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