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Chacur M, Rocha IRC, Harland ME, Green-Fulgham SM, de Almeida SRY, Ciena AP, Watkins LR. Prevention and Reversal of Neuropathic Pain by Near-Infrared Photobiomodulation Therapy in Male and Female Rats. Physiol Behav 2024:114680. [PMID: 39187036 DOI: 10.1016/j.physbeh.2024.114680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 08/20/2024] [Accepted: 08/20/2024] [Indexed: 08/28/2024]
Abstract
Pathological nociception arising from peripheral nerve injury impacts quality of life. Current therapeutics are generally ineffective. However, photobiomodulation therapy (PBMT) has shown promise in addressing this issue. We aimed to assess the potential anti-allodynic effects of two PBMT protocols, each applied transcutaneously over the peripheral nerve injury. In addition to evaluating nociceptive behavior, we also conducted morphological analysis using electron microscopy (EM) to investigate potential ultrastructural changes at the cellular level. We sought to determine, using the chronic constriction injury (CCI) model, whether our parameters could alleviate established allodynia and/or dampen allodynia development. Adult male and female rats with CCI or sham were treated with PBMT (850-nm wavelength) for 2 minutes, 3 times a week over three or four weeks across three studies, where PBMT began either before or after CCI. Allodynia was assessed prior to surgery and across weeks and, at the conclusion of the third study, sciatic nerve was processed for EM and histomorphometrically evaluated. The results showed that PBMT before versus after CCI injury yielded similar behaviors, effectively decreasing allodynia. Interestingly, these positive effects of PBMT do not appear to be accounted by protection of the sciatic injury site, based on EM. CCI reliably decreased axon size and the number of myelinated axons present in both PBMT and control groups. While PBMT reduced the number of C-fibers in CCI samples, no improvement in any measure was observed in response to PBMT.
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Affiliation(s)
- Marucia Chacur
- Department of Psychology and Neuroscience, and the Center for Neuroscience, University of Colorado, Boulder, CO 80309, USA; Laboratory of Neuroanatomy Functional of Pain, Departamento de Anatomia, Institute of Biomedical Science, Universidade de Sao Paulo, 05508-900, Sao Paulo, Brazil.
| | - Igor R Correia Rocha
- Department of Psychology and Neuroscience, and the Center for Neuroscience, University of Colorado, Boulder, CO 80309, USA; Laboratory of Neuroanatomy Functional of Pain, Departamento de Anatomia, Institute of Biomedical Science, Universidade de Sao Paulo, 05508-900, Sao Paulo, Brazil
| | - Michael E Harland
- Department of Psychology and Neuroscience, and the Center for Neuroscience, University of Colorado, Boulder, CO 80309, USA
| | - Suzanne M Green-Fulgham
- Department of Psychology and Neuroscience, and the Center for Neuroscience, University of Colorado, Boulder, CO 80309, USA
| | - Sonia Regina Yokomizo de Almeida
- Laboratory of Neuroanatomy Functional of Pain, Departamento de Anatomia, Institute of Biomedical Science, Universidade de Sao Paulo, 05508-900, Sao Paulo, Brazil
| | - Adriano Polican Ciena
- Laboratory of Morphology and Physical Activity (LAMAF), Institute of Biosciences, Sao Paulo State University (UNESP), Rio Claro 13506-900, Sao Paulo, Brazil
| | - Linda R Watkins
- Department of Psychology and Neuroscience, and the Center for Neuroscience, University of Colorado, Boulder, CO 80309, USA
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Hou TW, Yang CC, Lai TH, Wu YH, Yang CP. Light Therapy in Chronic Migraine. Curr Pain Headache Rep 2024; 28:621-626. [PMID: 38865075 DOI: 10.1007/s11916-024-01258-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE OF REVIEW This review assesses the effectiveness and safety of light therapy, particularly green light therapy, as an emerging non-pharmacological treatment for chronic migraine (CM). It aims to highlight alternative or complementary approaches to traditional pharmacological remedies, focusing the need for diverse treatment options. RECENT FINDINGS Despite sensitivity to light being a defining feature of migraine, light therapy has shown promising signs in providing substantial symptom relief. Studies have provided insights into green light therapy's role in managing CM. These studies consistently demonstrate its efficacy in reducing the frequency, severity, and symptoms of migraines. Additional benefits observed include improvements in sleep quality and reductions in anxiety. Importantly, green light therapy has been associated with minimal side effects, indicating its potential as a suitable option for migraine sufferers. In addition to green light, other forms of light therapy, such as infrared polarized light, low-level laser therapy (LLLT), and intravascular irradiation of blood (ILIB), are also being explored with potential therapeutic effects. Light therapies, especially green light therapy, are recognized as promising, safe, and non-pharmacological interventions for treating CM. They have been shown to be effective in decreasing headache frequency and enhancing the overall quality of life. However, current studies, often limited by small sample sizes, prompt more extensive clinical trials to better understand the full impact of light therapies. The exploration of other light-based treatments, such as LLLT and ILIB, warrants further research to broaden the scope of effective migraine management strategies.
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Affiliation(s)
- Tsung-Wei Hou
- Department of Neurology, Taichung Veteran General Hospital, Taichung, Taiwan
| | - Cheng-Chia Yang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Tzu-Hsien Lai
- Department of Neurology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ying-Hui Wu
- Department of Family Medicine, Kuang-Tien General Hospital, Taichung, Taiwan.
| | - Chun-Pai Yang
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan.
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan.
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Limerick G, Christo DK, Tram J, Moheimani R, Manor J, Chakravarthy K, Karri J, Christo PJ. Complex Regional Pain Syndrome: Evidence-Based Advances in Concepts and Treatments. Curr Pain Headache Rep 2023; 27:269-298. [PMID: 37421541 DOI: 10.1007/s11916-023-01130-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE OF REVIEW This review presents the most current information about the epidemiology of complex regional pain syndrome (CRPS), classification and diagnostic criteria, childhood CRPS, subtypes, pathophysiology, conventional and less conventional treatments, and preventive strategies. RECENT FINDINGS CRPS is a painful disorder with multifactorial pathophysiology. The data describe sensitization of the central and peripheral nervous systems, inflammation, possible genetic factors, sympatho-afferent coupling, autoimmunity, and mental health factors as contributors to the syndrome. In addition to conventional subtypes (type I and type II), cluster analyses have uncovered other proposed subtypes. Prevalence of CRPS is approximately 1.2%, female gender is consistently associated with a higher risk of development, and substantial physical, emotional, and financial costs can result from the syndrome. Children with CRPS seem to benefit from multifaceted physical therapy leading to a high percentage of symptom-free patients. The best available evidence along with standard clinical practice supports pharmacological agents, physical and occupational therapy, sympathetic blocks for engaging physical restoration, steroids for acute CRPS, neuromodulation, ketamine, and intrathecal baclofen as therapeutic approaches. There are many emerging treatments that can be considered as a part of individualized, patient-centered care. Vitamin C may be preventive. CRPS can lead to progressively painful sensory and vascular changes, edema, limb weakness, and trophic disturbances, all of which substantially erode healthy living. Despite some progress in research, more comprehensive basic science investigation is needed to clarify the molecular mechanisms of the disease so that targeted treatments can be developed for better outcomes. Incorporating a variety of standard therapies with different modes of action may offer the most effective analgesia. Introducing less conventional approaches may also be helpful when traditional treatments fail to provide sufficient improvement.
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Affiliation(s)
- Gerard Limerick
- Division of Pain Medicine, Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Dana K Christo
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Jennifer Tram
- Department of Anesthesiology, University of California, San Diego, CA, USA
| | | | - John Manor
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, USA
| | | | - Jay Karri
- Division of Pain Medicine, Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
- Department of Orthopedic Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Paul J Christo
- Division of Pain Medicine, Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.
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Cheng K, Martin LF, Slepian MJ, Patwardhan AM, Ibrahim MM. Mechanisms and Pathways of Pain Photobiomodulation: A Narrative Review. THE JOURNAL OF PAIN 2021; 22:763-777. [PMID: 33636371 PMCID: PMC8277709 DOI: 10.1016/j.jpain.2021.02.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/26/2021] [Accepted: 02/09/2021] [Indexed: 12/14/2022]
Abstract
A growing body of evidence supports the modulation of pain by light exposure. As such, phototherapy is being increasingly utilized for the management of a variety of pain conditions. The modes of delivery, and hence applications of phototherapy, vary by wavelength, intensity, and route of exposure. As such, differing mechanisms of action exist depending upon those parameters. Cutaneous application of red light (660 nm) has been shown to reduce pain in neuropathies and complex regional pain syndrome-I, whereas visual application of the same wavelength of red light has been reported to exacerbate migraine headache in patients and lead to the development of functional pain in animal models. Interestingly visual exposure to green light can result in reduction in pain in variety of pain conditions such as migraine and fibromyalgia. Cutaneous application typically requires exposure on the order of minutes, whereas visual application requires exposure on the order of hours. Both routes of exposure elicit changes centrally in the brainstem and spinal cord, and peripherally in the dorsal root ganglia and nociceptors. The mechanisms of photobiomodulation of pain presented in this review provide a foundation in furtherance of exploration of the utility of phototherapy as a tool in the management of pain. PERSPECTIVE: This review synopsizes the pathways and mechanisms through which light modulates pain and the therapeutic utility of different colors and exposure modalities of light on pain. Recent advances in photobiomodulation provide a foundation for understanding this novel treatment for pain on which future translational and clinical studies can build upon.
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Affiliation(s)
- Kevin Cheng
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona
| | - Laurent F Martin
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona; Department of Anesthesiology, College of Medicine, University of Arizona, Tucson, Arizona
| | - Marvin J Slepian
- Department of Medicine, College of Medicine, University of Arizona, Tucson, Arizona; Department of Biomedical Engineering, University of Arizona, Tucson, Arizona; Sarver Heart Center, University of Arizona, Tucson, Arizona; Arizona Center for Accelerated Biomedical Innovation, University of Arizona, Tucson, Arizona
| | - Amol M Patwardhan
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona; Department of Anesthesiology, College of Medicine, University of Arizona, Tucson, Arizona; Department of Neurosurgery, College of Medicine, University of Arizona, Tucson, Arizona; Comprehensive Pain and Addiction Center, University of Arizona, Tucson, Arizona
| | - Mohab M Ibrahim
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona; Department of Anesthesiology, College of Medicine, University of Arizona, Tucson, Arizona; Department of Neurosurgery, College of Medicine, University of Arizona, Tucson, Arizona.
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Canever JB, Barbosa RI, Hendler KG, Neves LMSD, Kuriki HU, Júnior ASA, Fonseca MDCR, Marcolino AM. Effects of photobiomodulation on different application points and different phases of complex regional pain syndrome type I in the experimental model. Korean J Pain 2021; 34:250-261. [PMID: 34193632 PMCID: PMC8255157 DOI: 10.3344/kjp.2021.34.3.250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/17/2021] [Accepted: 04/17/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Complex regional pain syndrome type I (CRPS-I) consists of disorders caused by spontaneous pain or induced by some stimulus. The objective was to verify the effects of photobiomodulation (PBM) using 830 nm wavelength light at the affected paw and involved spinal cord segments during the warm or acute phase. METHODS Fifty-six mice were randomized into seven groups. Group (G) 1 was the placebo group; G2 and G3 were treated with PBM on the paw in the warm and acute phase, respectively; G4 and G5 treated with PBM on involved spinal cord segments in the warm and acute phase, respectively; G6 and G7 treated with PBM on paw and involved spinal cord segments in the warm and acute phase, respectively. Edema degree, thermal and mechanical hyperalgesia, skin temperature, and functional quality of gait (Sciatic Static Index [SSI] and Sciatic Functional Index [SFI]) were evaluated. RESULTS Edema was lower in G3 and G7, and these were the only groups to return to baseline values at the end of treatment. For thermal hyperalgesia only G3 and G5 returned to baseline values. Regarding mechanical hyperalgesia, the groups did not show significant differences. Thermography showed increased temperature in all groups on the seventh day. In SSI and SFI assessment, G3 and G7 showed lower values when compared to G1, respectively. CONCLUSIONS PBM irradiation in the acute phase and in the affected paw showed better results in reducing edema, thermal and mechanical hyperalgesia, and in improving gait quality, demonstrating efficacy in treatment of CRPS-I symptoms.
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Affiliation(s)
- Jaquelini Betta Canever
- Laboratory of Assesment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Center Araranguá, Federal University of Santa Catarina, Araranguá, Brazil
| | - Rafael Inácio Barbosa
- Laboratory of Assesment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Center Araranguá, Federal University of Santa Catarina, Araranguá, Brazil
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Brazil
| | - Ketlyn Germann Hendler
- Laboratory of Assesment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Center Araranguá, Federal University of Santa Catarina, Araranguá, Brazil
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Brazil
| | - Lais Mara Siqueira das Neves
- Laboratory of Assesment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Center Araranguá, Federal University of Santa Catarina, Araranguá, Brazil
- Postgraduate Program in Rehabilitation and Functional Performance of the Departament of Health Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Heloyse Uliam Kuriki
- Laboratory of Assesment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Center Araranguá, Federal University of Santa Catarina, Araranguá, Brazil
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Brazil
| | | | - Marisa de Cassia Registro Fonseca
- Postgraduate Program in Rehabilitation and Functional Performance of the Departament of Health Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Alexandre Márcio Marcolino
- Laboratory of Assesment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Center Araranguá, Federal University of Santa Catarina, Araranguá, Brazil
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Brazil
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