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Nairuz T, Sangwoo-Cho, Lee JH. Photobiomodulation Therapy on Brain: Pioneering an Innovative Approach to Revolutionize Cognitive Dynamics. Cells 2024; 13:966. [PMID: 38891098 PMCID: PMC11171912 DOI: 10.3390/cells13110966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 05/30/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Photobiomodulation (PBM) therapy on the brain employs red to near-infrared (NIR) light to treat various neurological and psychological disorders. The mechanism involves the activation of cytochrome c oxidase in the mitochondrial respiratory chain, thereby enhancing ATP synthesis. Additionally, light absorption by ion channels triggers the release of calcium ions, instigating the activation of transcription factors and subsequent gene expression. This cascade of events not only augments neuronal metabolic capacity but also orchestrates anti-oxidant, anti-inflammatory, and anti-apoptotic responses, fostering neurogenesis and synaptogenesis. It shows promise for treating conditions like dementia, stroke, brain trauma, Parkinson's disease, and depression, even enhancing cognitive functions in healthy individuals and eliciting growing interest within the medical community. However, delivering sufficient light to the brain through transcranial approaches poses a significant challenge due to its limited penetration into tissue, prompting an exploration of alternative delivery methods such as intracranial and intranasal approaches. This comprehensive review aims to explore the mechanisms through which PBM exerts its effects on the brain and provide a summary of notable preclinical investigations and clinical trials conducted on various brain disorders, highlighting PBM's potential as a therapeutic modality capable of effectively impeding disease progression within the organism-a task often elusive with conventional pharmacological interventions.
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Affiliation(s)
| | | | - Jong-Ha Lee
- Department of Biomedical Engineering, Keimyung University, Daegu 42601, Republic of Korea; (T.N.); (S.-C.)
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Johnson PK, Fino PC, Wilde EA, Hovenden ES, Russell HA, Velez C, Pelo R, Morris AJ, Kreter N, Read EN, Keleher F, Esopenko C, Lindsey HM, Newsome MR, Thayn D, McCabe C, Mullen CM, Davidson LE, Liebel SW, Carr L, Tate DF. The Effect of Intranasal Plus Transcranial Photobiomodulation on Neuromuscular Control in Individuals with Repetitive Head Acceleration Events. Photobiomodul Photomed Laser Surg 2024; 42:404-413. [PMID: 38848287 DOI: 10.1089/pho.2023.0178] [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] [Indexed: 06/09/2024] Open
Abstract
Objective: This proof-of-concept study was to investigate the relationship between photobiomodulation (PBM) and neuromuscular control. Background: The effects of concussion and repetitive head acceleration events (RHAEs) are associated with decreased motor control and balance. Simultaneous intranasal and transcranial PBM (itPBM) is emerging as a possible treatment for cognitive and psychological sequelae of brain injury with evidence of remote effects on other body systems. Methods: In total, 43 (39 male) participants, age 18-69 years (mean, 49.5; SD, 14.45), with a self-reported history of concussive and/or RHAE and complaints of their related effects (e.g., mood dysregulation, impaired cognition, and poor sleep quality), completed baseline and posttreatment motor assessments including clinical reaction time, grip strength, grooved pegboard, and the Mini Balance Evaluation Systems Test (MiniBEST). In the 8-week interim, participants self-administered itPBM treatments by wearing a headset comprising four near-infrared light-emitting diodes (LED) and a near-infrared LED nasal clip. Results: Posttreatment group averages in reaction time, MiniBEST reactive control subscores, and bilateral grip strength significantly improved with effect sizes of g = 0.75, g = 0.63, g = 0.22 (dominant hand), and g = 0.34 (nondominant hand), respectively. Conclusion: This study provides a framework for more robust studies and suggests that itPBM may serve as a noninvasive solution for improved neuromuscular health.
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Affiliation(s)
- Paula K Johnson
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
- Office of Research, Rocky Mountain University of Health Professions, Provo, Utah, USA
| | - Peter C Fino
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| | - Elisabeth A Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Elizabeth S Hovenden
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Hilary A Russell
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Carmen Velez
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Ryan Pelo
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - Amanda J Morris
- Department of Kinesiology, Sacramento State University, Sacramento, California, USA
| | - Nicholas Kreter
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| | - Emma N Read
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Finian Keleher
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Carrie Esopenko
- Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Hannah M Lindsey
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Mary R Newsome
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
- H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Dayna Thayn
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Courtney McCabe
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Christine M Mullen
- Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah, USA
| | - Lance E Davidson
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Spencer W Liebel
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
| | - Lawrence Carr
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - David F Tate
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen VA Medical Center, Salt Lake City, Utah, USA
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Karr JE, Iverson GL, Boudreau N, Zafonte R. Treatment of chronic symptoms following mild traumatic brain injury with transcranial LED: a sham run-in pilot study of photobiomodulation therapy. Brain Inj 2024; 38:425-435. [PMID: 38329020 DOI: 10.1080/02699052.2024.2309258] [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] [Received: 04/25/2022] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
PRIMARY OBJECTIVE We evaluated whether photobiomodulation with red/near infrared light applied transcranially via light emitting diodes (LED) was associated with reduced symptoms and improved cognitive functioning in patients with chronic symptoms following mild traumatic brain injury. RESEARCH DESIGN Participants (3 men, 6 women; 22-61 years-old) underwent a 6-week intervention involving 18 40-minute transcranial LED treatment sessions. METHODS AND PROCEDURES Reliable change indices were calculated for 10 neuropsychological test scores and 3 self-report questionnaires of subjective cognition, post-concussion symptoms, and depression at baseline and following treatment. Questionnaires were also administered after 2-week sham and at 1-month and 2-month follow-ups. MAIN OUTCOME AND RESULTS Only 2 participants improved on neuropsychological testing. On questionnaires, 4 reported improved cognition, 5 reported improved post-concussion symptoms, and 3 reported improved depression. Significant improvement in 2 or more domains was reported by 4 participants and mostly maintained at both follow-ups. CONCLUSIONS Most participants did not improve on neuropsychological testing. A minority self-reported improvement in symptoms, potentially explained by the intervention, psychiatric medication changes, placebo effects, or other factors. Selecting participants with different clinical characteristics, and dosing and delivery system changes, may produce different results. A study design accounting for placebo effects appears warranted in future trials.
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Affiliation(s)
- Justin E Karr
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and the Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, Massachusetts, USA
- MassGeneral Hospital for Children Sports Concussion Program, Boston, Massachusetts, USA
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, Massachusetts, USA
| | - Nancy Boudreau
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Schoen Adams Research Institute at Spaulding Rehabilitation, Massachusetts General Hospital, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
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Taylor AM, Mannix R, Zafonte RD, Whalen MJ, Meehan WP. A Randomized, Double-Blind, Placebo-Controlled Clinical Trial Evaluating Transcranial Photobiomodulation as Treatment for Concussion. Med Sci Sports Exerc 2024; 56:822-827. [PMID: 38109202 DOI: 10.1249/mss.0000000000003364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
INTRODUCTION Literature indicating that transcranial photobiomodulation (tPBM) may enable the brain to recover normal function after concussion, resulting in symptoms reduction, and improved cognitive function after concussion is limited by small sample sizes and lack of controls. METHODS We conducted a randomized, double-blind, placebo-controlled trial examining the effect of 6 wk of tPBM in patients 11 yr or older who received care for persistent postconcussion symptoms between September 2012 and December 2015. Our primary outcome measure was the mean difference in Postconcussion Symptom Scale total score and the raw Immediate Postconcussion Assessment and Cognitive Testing composite scores between study entry and treatment completion. Participants received two, 10-min sessions either with tPBM units or via two placebo units, three times per week. We screened for potential confounding variables using univariable analyses. We entered covariables that differed between the two groups on univariable screening into a regression analysis. We considered adjusted odds ratio that did not cross one statistically significant. RESULTS Forty-eight participants completed the study. Most were female (63%), and a majority sustained their injury during sports or exercise (71%). Despite randomization, those that received tPBM therapy reported a greater number of previous concussions. After adjusting for the effect of previous concussions and multiple comparisons, there were no significant differences between tPBM and placebo groups at 3 or 6 wk of treatment. CONCLUSIONS Despite showing promise in previous investigations, our study did not show benefit to tPBM over placebo therapy in patients experiencing persistent postconcussion symptoms. Further investigation is needed to determine if varying the dose or timing alters the efficacy of tPBM after concussion.
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Affiliation(s)
| | | | - Ralph D Zafonte
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA
| | - Michael J Whalen
- Division of Critical Care Medicine, Department of Pediatrics, Massachusetts General Hospital, Boston, MA
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Fradkin Y, De Taboada L, Naeser M, Saltmarche A, Snyder W, Steingold E. Transcranial photobiomodulation in children aged 2-6 years: a randomized sham-controlled clinical trial assessing safety, efficacy, and impact on autism spectrum disorder symptoms and brain electrophysiology. Front Neurol 2024; 15:1221193. [PMID: 38737349 PMCID: PMC11086174 DOI: 10.3389/fneur.2024.1221193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 03/11/2024] [Indexed: 05/14/2024] Open
Abstract
Background Small pilot studies have suggested that transcranial photobiomodulation (tPBM) could help reduce symptoms of neurological conditions, such as depression, traumatic brain injury, and autism spectrum disorder (ASD). Objective To examine the impact of tPBM on the symptoms of ASD in children aged two to six years. Method We conducted a randomized, sham-controlled clinical trial involving thirty children aged two to six years with a prior diagnosis of ASD. We delivered pulses of near-infrared light (40 Hz, 850 nm) noninvasively to selected brain areas twice a week for eight weeks, using an investigational medical device designed for this purpose (Cognilum™, JelikaLite Corp., New York, United States). We used the Childhood Autism Rating Scale (CARS, 2nd Edition) to assess and compare the ASD symptoms of participants before and after the treatment course. We collected electroencephalogram (EEG) data during each session from those participants who tolerated wearing the EEG cap. Results The difference in the change in CARS scores between the two groups was 7.23 (95% CI 2.357 to 12.107, p = 0.011). Seventeen of the thirty participants completed at least two EEGs and time-dependent trends were detected. In addition, an interaction between Active versus Sham and Scaled Time was observed in delta power (Coefficient = 7.521, 95% CI -0.517 to 15.559, p = 0.07) and theta power (Coefficient = -8.287, 95% CI -17.199 to 0.626, p = 0.07), indicating a potential trend towards a greater reduction in delta power and an increase in theta power over time with treatment in the Active group, compared to the Sham group. Furthermore, there was a significant difference in the condition (Treatment vs. Sham) in the power of theta waves (net_theta) (Coefficient = 9.547, 95% CI 0.027 to 19.067, p = 0.049). No moderate or severe side effects or adverse effects were reported or observed during the trial. Conclusion These results indicate that tPBM may be a safe and effective treatment for ASD and should be studied in more depth in larger studies.Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT04660552, identifier NCT04660552.
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Affiliation(s)
- Yuliy Fradkin
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, United States
| | | | - Margaret Naeser
- Chobanian and Avedisian School of Medicine, Boston University, Boston, MA, United States
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Bicknell B, Liebert A, Herkes G. Parkinson's Disease and Photobiomodulation: Potential for Treatment. J Pers Med 2024; 14:112. [PMID: 38276234 PMCID: PMC10819946 DOI: 10.3390/jpm14010112] [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: 11/21/2023] [Revised: 01/07/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Parkinson's disease is the second most common neurodegenerative disease and is increasing in incidence. The combination of motor and non-motor symptoms makes this a devastating disease for people with Parkinson's disease and their care givers. Parkinson's disease is characterised by mitochondrial dysfunction and neuronal death in the substantia nigra, a reduction in dopamine, accumulation of α-synuclein aggregates and neuroinflammation. The microbiome-gut-brain axis is also important in Parkinson's disease, involved in the spread of inflammation and aggregated α-synuclein. The mainstay of Parkinson's disease treatment is dopamine replacement therapy, which can reduce some of the motor signs. There is a need for additional treatment options to supplement available medications. Photobiomodulation (PBM) is a form of light therapy that has been shown to have multiple clinical benefits due to its enhancement of the mitochondrial electron transport chain and the subsequent increase in mitochondrial membrane potential and ATP production. PBM also modulates cellular signalling and has been shown to reduce inflammation. Clinically, PBM has been used for decades to improve wound healing, treat pain, reduce swelling and heal deep tissues. Pre-clinical experiments have indicated that PBM has the potential to improve the clinical signs of Parkinson's disease and to provide neuroprotection. This effect is seen whether the PBM is directed to the head of the animal or to other parts of the body (remotely). A small number of clinical trials has given weight to the possibility that using PBM can improve both motor and non-motor clinical signs and symptoms of Parkinson's disease and may potentially slow its progression.
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Affiliation(s)
- Brian Bicknell
- NICM Health Research Institute, University of Western Sydney, Westmead 2145, Australia;
| | - Ann Liebert
- NICM Health Research Institute, University of Western Sydney, Westmead 2145, Australia;
- Sydney Adventist Hospital, Wahroonga 2076, Australia
- Faculty of medicine and Health, Sydney University, Camperdown 2050, Australia
| | - Geoffrey Herkes
- Neurologist, Sydney Adventist Hospital, Wahroonga 2076, Australia;
- College of Health and Medicine, Australian National University, Canberra 2600, Australia
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Gao Y, An R, Huang X, Liu W, Yang C, Wan Q. Effectiveness of photobiomodulation for people with age-related cognitive impairment: a systematic review and meta-analysis. Lasers Med Sci 2023; 38:237. [PMID: 37843594 DOI: 10.1007/s10103-023-03899-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/27/2023] [Indexed: 10/17/2023]
Abstract
The increasing incident of age-related cognitive impairment worldwide and the lack of pharmaceutical treatments emphasizes the value of non-pharmaceutical therapy. Emerging evidence suggested photobiomodulation (PBM) is a popular intervention to brain disorder; however, it remains unclear the efficacy of PBM for patients with age-related cognitive impairment. The purpose of this systematic review is to compare the different parameters used in PBM, analyze the beneficial effects of PBM as a potential therapy for age-related cognitive impairment. Five electronic database, PubMed, Web of Science, Cochrane Library, CINAHL, and PsycINFO, were systematically searched from inception to November 2021. Relevant randomized controlled trials (RCTs) were screened and assessed for risk of bias. Eleven RCTs evaluating PBM interventions were included. The systematic review and meta-analysis has been registered in PROSPERO(CRD42022374562). Results showed that PBM had a significant moderated effect on global cognition function (SMD=0.51, 95% CI [0.162, 0.864], p=0.004). We found that multiple wavelength PBM (SMD=0.648, 95% CI [0.220, 1.075], p=0.003) had significant effects while single wavelength PBM was non-significant (SMD=0.385, 95% CI [-0.168, 0.987], p=0.172). Laser effect (SMD=0.682, 95% CI [0.37, 0,994], p<0.001) was larger than LED effect (SMD=0.582, 95% CI [0.269, 0.895], p<0.001). PBM in clinical setting (SMD=0.468, 95% CI [0.050, 0.887], p=0.028) had significant effect, but there was no significant effect of home-used PBM (SMD=0.616, 95% CI [-0.121, 1.354], p=0.101). The pool effect of multi-modality PBM (SMD=0.720, 95% CI [0.027, 1.414], p=0.040) was significantly higher in the studies of transcranial irradiation (SMD=0.616, 95% CI [-0.121, 1.354], p=0.010). Cumulative irradiation time was a moderator between the PBM and cognitive function improvement. Photobiomodulation have the potential to improve cognitive function in aging adults. Cumulative irradiation duration, light source, device type, penetration modality, and intervention site can affect the effectiveness of PBM intervention.
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Affiliation(s)
- Yajing Gao
- School of Nursing, Peking University, Beijing, China
| | - Ran An
- School of Nursing, Peking University, Beijing, China
| | - Xiuxiu Huang
- School of Nursing, Peking University, Beijing, China
| | | | | | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China.
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Bowen R, Arany PR. Use of either transcranial or whole-body photobiomodulation treatments improves COVID-19 brain fog. JOURNAL OF BIOPHOTONICS 2023; 16:e202200391. [PMID: 37018063 DOI: 10.1002/jbio.202200391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
There is increasing recognition of post-COVID-19 sequelae involving chronic fatigue and brain fog, for which photobiomodulation (PBM) therapy has been utilized. This open-label, pilot, human clinical study examined the efficacy of two PBM devices, for example, a helmet (1070 nm) for transcranial (tPBM) and a light bed (660 and 850 nm) for whole body (wbPBM), over a 4-week period, with 12 treatments for two separate groups (n = 7 per group). Subjects were evaluated with a neuropsychological test battery, including the Montreal Cognitive Assessment (MoCA), the digit symbol substitution test (DSST), the trail-making tests A and B, the physical reaction time (PRT), and a quantitative electroencephalography system (WAVi), both pre- and post- the treatment series. Each device for PBM delivery was associated with significant improvements in cognitive tests (p < 0.05 and beyond). Changes in WAVi supported the findings. This study outlines the benefits of utilizing PBM therapy (transcranial or whole-body) to help treat long-COVID brain fog.
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Affiliation(s)
- Robert Bowen
- Shepherd University, Shepherdstown, West Virginia, USA
- West Virginia University, Martinsburg, West Virginia, USA
| | - Praveen R Arany
- Shepherd University, Shepherdstown, West Virginia, USA
- University at Buffalo, Buffalo, New York, USA
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Bossuyt FM, Bogdanova Y, Kingsley KT, Bergquist TF, Kolakowsky-Hayner SA, Omar Z, Popova ES, Tobita M, Constantinidou F. Evolution of rehabilitation services in response to a global pandemic: reflection on opportunities and challenges ahead. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1173558. [PMID: 37255738 PMCID: PMC10226080 DOI: 10.3389/fresc.2023.1173558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/21/2023] [Indexed: 06/01/2023]
Abstract
The rapidly evolving COVID-19 public health emergency has disrupted and challenged traditional healthcare, rehabilitation services, and treatment delivery worldwide. This perspective paper aimed to unite experiences and perspectives from an international group of rehabilitation providers while reflecting on the lessons learned from the challenges and opportunities raised during the COVID-19 pandemic. We discuss the global appreciation for rehabilitation services and changes in access to healthcare, including virtual, home-based rehabilitation, and long-term care rehabilitation. We illustrate lessons learned by highlighting successful rehabilitation approaches from the US, Belgium, and Japan.
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Affiliation(s)
- Fransiska M. Bossuyt
- Neuro-musculoskeletal Functioning and Mobility Group, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Yelena Bogdanova
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
- Physical Medicine & Rehabilitation, VA Boston Healthcare System, Boston, MA, United States
| | - Kristine T. Kingsley
- Institute of Emotional and Cognitive Wellness, New York, NY, United States
- Department of Psychology, Teachers College, Columbia University, New York, NY, United States
| | - Thomas F. Bergquist
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States
| | | | - Zaliha Binti Omar
- Department of Rehabilitation Medicine, University Malaya, Kuala Lumpur, Malaysia
- Department of Rehabilitation Medicine 1, Fujita Health University, Aichi, Japan
| | - Evguenia S. Popova
- Department of Occupational Therapy, Rush University, Chicago, IL, United States
| | - Mari Tobita
- Rancho Los Amigos National Rehabilitation Center, Downey, CA, United States
- Rancho Research Institute, Downey, CA, United States
| | - Fofi Constantinidou
- Center for Applied Neuroscience & Department of Psychology, University of Cyprus, Nicosia, Cyprus
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Estrada-Rojas K, Cedeño Ortiz NP. Increased Improvement in Speech-Language Skills After Transcranial Photobiomodulation Plus Speech-Language Therapy, Compared to Speech-Language Therapy Alone: Case Report with Aphasia. Photobiomodul Photomed Laser Surg 2023; 41:234-240. [PMID: 36999917 PMCID: PMC10171962 DOI: 10.1089/photob.2022.0024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 01/27/2023] [Indexed: 04/01/2023] Open
Abstract
Objective: This is a case report showing that transcranial photobiomodulation (tPBM) combined with traditional, speech-language therapy improved and accelerated the results from speech-language therapy, in a stroke person with aphasia (PWA). Background: tPBM is a safe, noninvasive technique using red and near-infrared light to improve the metabolism of cells. tPBM helps by promoting neuromodulation, while decreasing neuroinflammation and promoting vasodilation. Several studies have shown that tPBM can help individuals with stroke or traumatic brain injury achieve significant cognitive improvements. Methods: A 38-year-old female, who sustained an ischemic stroke on the left side of the brain, received two, 5-month series of treatments. The first series of treatments included traditional speech-language therapy, for the first 5 months poststroke. The second series of treatments included tPBM in combination with speech-language therapy, for the next 5 months. The tPBM treatments included application of red (630 and 660 nm) and near-infrared (850 nm) wavelengths of photons applied to left hemisphere scalp areas. The major cortical language areas were subjacent to the scalp placements along the line of the Sylvian fissure. At each session, first a light-emitting diode (LED) cluster head with red (630 and 660 nm) and near-infrared (850 nm) wavelengths, with an irradiance (power density) of 200 mW/cm2, a beam size of 4.9 cm2, and a fluence (energy density) of 12 J/cm2 per minute, was applied to the left side of the scalp/brain, along the Sylvian fissure for 60 sec at each at the following eight, language network target areas: frontal pole, prefrontal cortex, and inferior frontal gyrus (Broca's area); supramarginal gyrus and angular gyrus in the parietal lobe; inferior motor/sensory cortex (mouth area); and posterior superior temporal gyrus (Wernicke's area) and superior temporal sulcus in the temporal lobe, for a total of 8 min. Second, for the next 20 min (1200 sec), simultaneous with speech-language therapy, an LED PBM helmet was applied to the scalp/head. This helmet contained 256 separate LED lights, near-infrared (810 nm) wavelength, 60 mW power per LED light, total power, 15 W; energy, 72 Joules; fluence, 28.8 J/cm2; and irradiance, 24 mW/cm2. Results and conclusions: During the initial, 5-month treatment series with traditional speech-language therapy only, there was little to no improvement in dysarthria and expressive language. During the second, 5-month treatment series, however, with tPBM applied first, to the left hemisphere only, and second, to both hemispheres during each session plus simultaneous speech-language therapy, there was marked improvement in the dysarthria and expressive language. After the first 5-month series, this PWA had utilized a slow rate of speech with a production of ∼25 to 30 words-per-minute during conversations and spontaneous speech. Utterance length was only 4-6 words with simple, grammatical structure. After the second, 5-month series of treatment combining tPBM plus speech-language therapy, the rate of speech increased to 80+ words-per-minute and utterance length was increased to 9-10 words, with more complex grammatical structure.
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Affiliation(s)
- Karla Estrada-Rojas
- The American Speech-Language Hearing Association (ASHA), Speech-Language Pathology and Audiology, Rockville, Maryland, USA; member of Sociedad Internacional del Uso de Equipos en Fonoaudiología (SIEFO), Speech-Therapy, Pereira, Risaralda, Colombia
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Bell A, Hewins B, Bishop C, Fortin A, Wang J, Creamer JL, Collen J, Werner JK. Traumatic Brain Injury, Sleep, and Melatonin-Intrinsic Changes with Therapeutic Potential. Clocks Sleep 2023; 5:177-203. [PMID: 37092428 PMCID: PMC10123665 DOI: 10.3390/clockssleep5020016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
Traumatic brain injury (TBI) is one of the most prevalent causes of morbidity in the United States and is associated with numerous chronic sequelae long after the point of injury. One of the most common long-term complaints in patients with TBI is sleep dysfunction. It is reported that alterations in melatonin follow TBI and may be linked with various sleep and circadian disorders directly (via cellular signaling) or indirectly (via free radicals and inflammatory signaling). Work over the past two decades has contributed to our understanding of the role of melatonin as a sleep regulator and neuroprotective anti-inflammatory agent. Although there is increasing interest in the treatment of insomnia following TBI, a lack of standardization and rigor in melatonin research has left behind a trail of non-generalizable data and ambiguous treatment recommendations. This narrative review describes the underlying biochemical properties of melatonin as they are relevant to TBI. We also discuss potential benefits and a path forward regarding the therapeutic management of TBI with melatonin treatment, including its role as a neuroprotectant, a somnogen, and a modulator of the circadian rhythm.
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Affiliation(s)
- Allen Bell
- Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
| | - Bryson Hewins
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
| | - Courtney Bishop
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
| | - Amanda Fortin
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
| | - Jonathan Wang
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
| | | | - Jacob Collen
- Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
| | - J. Kent Werner
- Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
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12
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Naeser MA, Martin PI, Ho MD, Krengel MH, Bogdanova Y, Knight JA, Hamblin MR, Fedoruk AE, Poole LG, Cheng C, Koo B. Transcranial Photobiomodulation Treatment: Significant Improvements in Four Ex-Football Players with Possible Chronic Traumatic Encephalopathy. J Alzheimers Dis Rep 2023; 7:77-105. [PMID: 36777329 PMCID: PMC9912826 DOI: 10.3233/adr-220022] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 11/19/2022] [Indexed: 12/28/2022] Open
Abstract
Background Chronic traumatic encephalopathy, diagnosed postmortem (hyperphosphorylated tau), is preceded by traumatic encephalopathy syndrome with worsening cognition and behavior/mood disturbances, over years. Transcranial photobiomodulation (tPBM) may promote improvements by increasing ATP in compromised/stressed cells and increasing local blood, lymphatic vessel vasodilation. Objective Aim 1: Examine cognition, behavior/mood changes Post-tPBM. Aim 2: MRI changes - resting-state functional-connectivity MRI: salience, central executive, default mode networks (SN, CEN, DMN); magnetic resonance spectroscopy, cingulate cortex. Methods Four ex-players with traumatic encephalopathy syndrome/possible chronic traumatic encephalopathy, playing 11- 16 years, received In-office, red/near-infrared tPBM to scalp, 3x/week for 6 weeks. Two had cavum septum pellucidum. Results The three younger cases (ages 55, 57, 65) improved 2 SD (p < 0.05) on three to six neuropsychological tests/subtests at 1 week or 1 month Post-tPBM, compared to Pre-Treatment, while the older case (age 74) improved by 1.5 SD on three tests. There was significant improvement at 1 month on post-traumatic stress disorder (PTSD), depression, pain, and sleep. One case discontinued narcotic pain medications and had reduced tinnitus. The possible placebo effect is unknown. At 2 months Post-tPBM, two cases regressed. Then, home tPBM was applied to only cortical nodes, DMN (12 weeks); again, significant improvements were seen. Significant correlations for increased SN functional connectivity (FC) over time, with executive function, attention, PTSD, pain, and sleep; and CEN FC, with verbal learning/memory, depression. Increased n-acetyl-aspartate (NAA) (oxygen consumption, mitochondria) was present in anterior cingulate cortex (ACC), parallel to less pain and PTSD. Conclusion After tPBM, these ex-football players improved. Significant correlations of increased SN FC and CEN FC with specific cognitive tests and behavior/mood ratings, plus increased NAA in ACC support beneficial effects from tPBM.
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Affiliation(s)
- Margaret A. Naeser
- VA Boston Healthcare System, Jamaica Plain Campus, Boston, MA, USA,Department of Neurology, Boston University School of Medicine, Boston, MA, USA,Correspondence to: Margaret A. Naeser, PhD, VA Boston Healthcare System (12A), Jamaica Plain Campus, 150 So. Huntington Ave., Boston, MA 02130 USA. E-mail:
| | - Paula I. Martin
- VA Boston Healthcare System, Jamaica Plain Campus, Boston, MA, USA,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Michael D. Ho
- VA Boston Healthcare System, Jamaica Plain Campus, Boston, MA, USA
| | - Maxine H. Krengel
- VA Boston Healthcare System, Jamaica Plain Campus, Boston, MA, USA,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Yelena Bogdanova
- VA Boston Healthcare System, Jamaica Plain Campus, Boston, MA, USA,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Jeffrey A. Knight
- VA Boston Healthcare System, Jamaica Plain Campus, Boston, MA, USA,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA,National Center for PTSD - Behavioral Sciences Division, VA Boston Healthcare System, Boston, MA, USA
| | - Michael R. Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa,Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Luke G. Poole
- VA Boston Healthcare System, Jamaica Plain Campus, Boston, MA, USA
| | - ChiaHsin Cheng
- Department of Anatomy & Neurobiology, Bio-imaging Informatics Lab, Boston University School of Medicine, Boston, MA, USA
| | - BangBon Koo
- Department of Anatomy & Neurobiology, Bio-imaging Informatics Lab, Boston University School of Medicine, Boston, MA, USA
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13
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Stevens AR, Hadis M, Milward M, Ahmed Z, Belli A, Palin W, Davies DJ. Photobiomodulation in Acute Traumatic Brain Injury: A Systematic Review and Meta-Analysis. J Neurotrauma 2023; 40:210-227. [PMID: 35698294 DOI: 10.1089/neu.2022.0140] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Photobiomodulation (PBM) is a therapeutic modality that has gained increasing interest in neuroscience applications, including acute traumatic brain injury (TBI). Its proposed mechanisms for therapeutic effect when delivered to the injured brain include antiapoptotic and anti-inflammatory effects. This systematic review summarizes the available evidence for the value of PBM in improving outcomes in acute TBI and presents a meta-analysis of the pre-clinical evidence for neurological severity score (NSS) and lesion size in animal models of TBI. A systematic review of the literature was performed, with searches and data extraction performed independently in duplicate by two authors. Eighteen published articles were identified for inclusion: seventeen pre-clinical studies of in vivo animal models and one clinical study in human patients. The available human study supports safety and feasibility of PBM in acute moderate TBI. For pre-clinical studies, meta-analysis for NSS and lesion size were found to favor intervention versus control. Subgroup analysis based on PBM parameter variables for these outcomes was performed. Favorable parameters were identified as: wavelengths in the region of 665 nm and 810 nm; time to first administration of PBM ≤4 h; total number of daily treatments ≤3. No differences were identified between pulsed and continuous wave modes or energy delivery. Mechanistic substudies within included in vivo studies are presented and were found to support hypotheses of antiapoptotic, anti-inflammatory, and pro-proliferative effects, and a modulation of cellular metabolism. This systematic review provides substantial meta-analysis evidence of the benefits of PBM on functional and histological outcomes of TBI in in vivo mammalian models. Study design and PBM parameters should be closely considered for future human clinical studies.
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Affiliation(s)
- Andrew Robert Stevens
- Department of Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, and University of Birmingham, Edgbaston, Birmingham, United Kingdom.,NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham, Birmingham, United Kingdom.,Phototherapy Research Group, School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - Mohammed Hadis
- Phototherapy Research Group, School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - Michael Milward
- Phototherapy Research Group, School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - Zubair Ahmed
- Department of Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, and University of Birmingham, Edgbaston, Birmingham, United Kingdom.,NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham, Birmingham, United Kingdom.,Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Antonio Belli
- Department of Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, and University of Birmingham, Edgbaston, Birmingham, United Kingdom.,NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham, Birmingham, United Kingdom.,Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - William Palin
- Phototherapy Research Group, School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - David James Davies
- Department of Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, and University of Birmingham, Edgbaston, Birmingham, United Kingdom.,NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham, Birmingham, United Kingdom.,Phototherapy Research Group, School of Dentistry, University of Birmingham, Birmingham, United Kingdom.,Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
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14
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Liebert A, Capon W, Pang V, Vila D, Bicknell B, McLachlan C, Kiat H. Photophysical Mechanisms of Photobiomodulation Therapy as Precision Medicine. Biomedicines 2023; 11:biomedicines11020237. [PMID: 36830774 PMCID: PMC9953702 DOI: 10.3390/biomedicines11020237] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Despite a significant focus on the photochemical and photoelectrical mechanisms underlying photobiomodulation (PBM), its complex functions are yet to be fully elucidated. To date, there has been limited attention to the photophysical aspects of PBM. One effect of photobiomodulation relates to the non-visual phototransduction pathway, which involves mechanotransduction and modulation to cytoskeletal structures, biophotonic signaling, and micro-oscillatory cellular interactions. Herein, we propose a number of mechanisms of PBM that do not depend on cytochrome c oxidase. These include the photophysical aspects of PBM and the interactions with biophotons and mechanotransductive processes. These hypotheses are contingent on the effect of light on ion channels and the cytoskeleton, the production of biophotons, and the properties of light and biological molecules. Specifically, the processes we review are supported by the resonant recognition model (RRM). This previous research demonstrated that protein micro-oscillations act as a signature of their function that can be activated by resonant wavelengths of light. We extend this work by exploring the local oscillatory interactions of proteins and light because they may affect global body circuits and could explain the observed effect of PBM on neuro-cortical electroencephalogram (EEG) oscillations. In particular, since dysrhythmic gamma oscillations are associated with neurodegenerative diseases and pain syndromes, including migraine with aura and fibromyalgia, we suggest that transcranial PBM should target diseases where patients are affected by impaired neural oscillations and aberrant brain wave patterns. This review also highlights examples of disorders potentially treatable with precise wavelengths of light by mimicking protein activity in other tissues, such as the liver, with, for example, Crigler-Najjar syndrome and conditions involving the dysregulation of the cytoskeleton. PBM as a novel therapeutic modality may thus behave as "precision medicine" for the treatment of various neurological diseases and other morbidities. The perspectives presented herein offer a new understanding of the photophysical effects of PBM, which is important when considering the relevance of PBM therapy (PBMt) in clinical applications, including the treatment of diseases and the optimization of health outcomes and performance.
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Affiliation(s)
- Ann Liebert
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
- Adventist Hospital Group, Wahroonga 2076, Australia
- NICM Health Research Institute, Western Sydney University, Westmead 2145, Australia
- Correspondence:
| | - William Capon
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
| | - Vincent Pang
- NICM Health Research Institute, Western Sydney University, Westmead 2145, Australia
| | - Damien Vila
- Faculty of Medicine of Montpellier-Nîmes, University of Montpellier, 34090 Montpellier, France
| | - Brian Bicknell
- NICM Health Research Institute, Western Sydney University, Westmead 2145, Australia
| | - Craig McLachlan
- Faculty of Health, Torrens University, Adelaide 5000, Australia
| | - Hosen Kiat
- NICM Health Research Institute, Western Sydney University, Westmead 2145, Australia
- Faculty of Health, Torrens University, Adelaide 5000, Australia
- Cardiac Health Institute, Sydney 2121, Australia
- ANU College of Health and Medicine, Australian National University, Canberra 2600, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park 2109, Australia
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15
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Cheung MC, Lee TL, Sze SL, Chan AS. Photobiomodulation improves frontal lobe cognitive functions and mental health of older adults with non-amnestic mild cognitive impairment: Case studies. Front Psychol 2023; 13:1095111. [PMID: 36704674 PMCID: PMC9871821 DOI: 10.3389/fpsyg.2022.1095111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction This study investigated the effects of transcranial photobiomodulation (tPBM) on improving the frontal lobe cognitive functions and mental health of older adults. Methods Three older adults with mild cognitive impairment (MCI) of the non-amnestic type received 18-session tPBM stimulation for 9 weeks and were assessed with neuropsychological tests of memory and executive functions and standardized questionnaires on depressive and anxiety symptoms, global cognitive functions, and daily functioning abilities before and after tPBM stimulation. Results At baseline, their intrusion and/or perseveration errors in a verbal memory test and a fluency test, as measures of the frontal lobe cognitive functions, were in the borderline to severely impaired range at baseline. After tPBM stimulation, the three older adults showed various levels of improvement in their frontal lobe cognitive functions. One older adult's intrusion and perseveration errors improved from the <1st-2nd percentile (moderately to severely impaired range) to the 41st-69th percentile (average range), another older adult's intrusion errors improved from the 11th percentile to the 83rd percentile, and the third older adult's intrusion errors improved from the 5th percentile to the 56th percentile. Moreover, improvements in their anxiety and/or depressive symptoms were also observed. One older adult's depressive and anxiety symptoms improved from the severe range at baseline to the mild range after the intervention. The other two older adults' depressive symptoms improved from the mild range at baseline to the normal range after the intervention. Discussion These findings provide preliminary support for the potential of tPBM to improve the frontal lobe cognitive functions and mental health of older adults with MCI. Given the small sample size of only three older adults and the absence of a placebo control group, larger randomized controlled studies are needed to confirm its potential.
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Affiliation(s)
- Mei-Chun Cheung
- Department of Social Work, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China,Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Tsz-Lok Lee
- Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China,Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Sophia L. Sze
- Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China,Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Agnes S. Chan
- Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China,Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China,*Correspondence: Agnes S. Chan, ✉
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16
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Boosting psychological change: Combining non-invasive brain stimulation with psychotherapy. Neurosci Biobehav Rev 2022; 142:104867. [PMID: 36122739 DOI: 10.1016/j.neubiorev.2022.104867] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 09/01/2022] [Accepted: 09/07/2022] [Indexed: 11/21/2022]
Abstract
Mental health disorders and substance use disorders are a leading cause of morbidity and mortality worldwide, and one of the most important challenges for public health systems. While evidence-based psychotherapy is generally pursued to address mental health challenges, psychological change is often hampered by non-adherence to treatments, relapses, and practical barriers (e.g., time, cost). In recent decades, Non-invasive brain stimulation (NIBS) techniques have emerged as promising tools to directly target dysfunctional neural circuitry and promote long-lasting plastic changes. While the therapeutic efficacy of NIBS protocols for mental illnesses has been established, neuromodulatory interventions might also be employed to support the processes activated by psychotherapy. Indeed, combining psychotherapy with NIBS might help tailor the treatment to the patient's unique characteristics and therapeutic goal, and would allow more direct control of the neuronal changes induced by therapy. Herein, we overview emerging evidence on the use of NIBS to enhance the psychotherapeutic effect, while highlighting the next steps in advancing clinical and research methods toward personalized intervention approaches.
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17
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Hamblin MR. Could Photobiomodulation Treat Autism Spectrum Disorder? Photobiomodul Photomed Laser Surg 2022; 40:367-369. [PMID: 35613405 DOI: 10.1089/photob.2022.0051] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
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18
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Rowe RK, Griesbach GS. Immune-endocrine interactions in the pathophysiology of sleep-wake disturbances following traumatic brain injury: A narrative review. Brain Res Bull 2022; 185:117-128. [DOI: 10.1016/j.brainresbull.2022.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 04/26/2022] [Accepted: 04/30/2022] [Indexed: 12/16/2022]
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19
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Shao S, Guo T, Li F, Zhao Z, Li J, Wang X. Experimental study on the therapeutic effect of BDNF gene-carrying nanoparticles on traumatic brain injury. APPLIED NANOSCIENCE 2022. [DOI: 10.1007/s13204-022-02405-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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20
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Ceranoglu TA, Cassano P, Hoskova B, Green A, Dallenbach N, DiSalvo M, Biederman J, Joshi G. Transcranial Photobiomodulation in Adults with High-Functioning Autism Spectrum Disorder: Positive Findings from a Proof-of-Concept Study. Photobiomodul Photomed Laser Surg 2022; 40:4-12. [PMID: 34941429 DOI: 10.1089/photob.2020.4986] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To assess the efficacy and safety of transcranial photobiomodulation (tPBM) in adults with autism spectrum disorder (ASD). Methods: Adults with high-functioning-ASD, between 18 and 59 years of age, were enrolled to receive twice a week tPBM for 8 weeks in an open-label single group design. ASD symptom severity was assessed at baseline, midpoint, and end-point, by clinician-, self-, and informant-rated measures. Treatment response was defined as a ≥30% reduction in Social Responsiveness Scale-2nd Edition (SRS-2) total score and ASD Clinical Global Impression-Improvement score ≤2. Any possible adverse events were recorded at each visit. Paired-samples t-test analyses were performed. Results: Eleven participants were enrolled, and 10 participants (9 males; 30.0 ± 11.9 years) completed the study. One participant withdrew consent before baseline. All 10 completers were included in efficacy and safety analyses. Five participants (50%) met responder criteria at end-point. Overall, 8-week tPBM was associated with significant reduction in SRS-2 total scores at end-point (SRS-2: -30.6 ± 23, p < 0.001) particularly in Social Awareness (-3.0 ± 1.9, p < 0.001), Social Communication (-10.3 ± 6, p < 0.001), Social Motivation (-5.0 ± 2.4, p < 0.001), and Restricted/Repetitive Behaviors (-7.4 ± 4.1, p < 0.001). There were statistically significant improvements at end-point in Global Assessment of Functioning scores (+12.8 ± 4.2, p < 0.001) and Quality of Life Enjoyment and Satisfaction Questionnaire scores (+6.0 ± 7.9, p = 0.02). Three participants experienced transient, mild side effects (insomnia, headache, and warmth at treatment application site). No adverse events required changes in tPBM protocol. Adherence rate was 98%. Conclusions: tPBM is a safe and feasible treatment approach that has the potential to treat core features of ASD. Further research is necessary and warranted. ClinicalTrials.gov Identifier: NCT03724552.
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Affiliation(s)
- Tolga Atilla Ceranoglu
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Paolo Cassano
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Barbora Hoskova
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Allison Green
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nina Dallenbach
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Maura DiSalvo
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Joseph Biederman
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Gagan Joshi
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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21
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Huang LD. Brighten the Future: Photobiomodulation and Optogenetics. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:36-44. [PMID: 35746943 PMCID: PMC9063588 DOI: 10.1176/appi.focus.20210025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Safe, noninvasive, and effective treatments for brain conditions are everyone's dream. Low-level light therapy (LLLT) based on the photobiomodulation (PBM) phenomenon has recently been adopted in practice, with solid scientific evidence. Optogenetics provides high spatiotemporal resolution to precisely switch on and off a particular circuitry in the brain. However, there are currently no human trials of optogenetics on the human brain. These two approaches-PBM and optogenetics-are promising photonic treatments that target the brain using completely different technologies. PBM is based on the mitochondrial reaction to the photons for up- or downregulation on the cytochrome c oxidase synthase in cellular respiration. It is safe, noninvasive, and good for long-term treatments, with wide applications using light wavelengths ranging from 650 nm to ≈1,100 nm, the red to near-infrared range. Optogenetics is based on the expression of engineered opsins on targeted tissues through viral vectors. The opsins are engineered to be sensors, actuators, or switches and could be precisely controlled by light wavelength ranging from 450 nm to ≈650 nm, the visible light range. The penetration of visible light is limited, and thus the photons cannot be applied directly outside the head without surgical means to create a physical window. PBM using near-infrared light could reach deeper tissues for light directly applied outside the head. Detailed scientific foundations and the state of the art for both technologies are reviewed. Ongoing developments are discussed to provide insight for future research and applications.
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22
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Belova AN, Israelyan YA, Sushin VO, Shabanova MA, Rezenova AM. [Transcranial photobiomodulation in therapy of neurodegenerative diseases of the brain: theoretical background and clinical effectiveness]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2022; 98:61-67. [PMID: 34965698 DOI: 10.17116/kurort20219806161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Transcranial photobiomodulation (tPBM) is a form of light therapy that uses monochromatic visible and infrared light from non-ionizing radiation sources (lasers, LEDs) placed on the scalp, forehead, or intranasally to project light directly to target areas of the brain. Accumulated experimental and clinical data indicate the safety and potential efficacy of tPBM in some central nervous system diseases.This article briefly reviews the general concepts of tPBM, the results of experimental and clinical studies on the efficacy of tPBM in Alzheimer's disease, Parkinson's disease, and brain stroke. The possible mechanisms of the tPBM therapeutic effect and the need to choose optimal exposure parameters are discussed. Although the evidence base regarding the efficacy of tPBM in neurodegenerative and vascular brain diseases is still insufficient, analysis of the published data justifies considering tPBM as a promising method of adjuvant therapy for some central nervous system diseases.
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Affiliation(s)
- A N Belova
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Yu A Israelyan
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - V O Sushin
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - M A Shabanova
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - A M Rezenova
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
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Perez Garcia G, Perez GM, Otero-Pagan A, Abutarboush R, Kawoos U, De Gasperi R, Gama Sosa MA, Pryor D, Hof PR, Cook DG, Gandy S, Ahlers ST, Elder GA. Transcranial Laser Therapy Does Not Improve Cognitive and Post-Traumatic Stress Disorder-Related Behavioral Traits in Rats Exposed to Repetitive Low-Level Blast Injury. Neurotrauma Rep 2021; 2:548-563. [PMID: 34901948 PMCID: PMC8655798 DOI: 10.1089/neur.2021.0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Many military veterans who experienced blast-related traumatic brain injuries (TBIs) in the conflicts in Iraq and Afghanistan suffer from chronic cognitive and mental health problems, including post-traumatic stress disorder (PTSD). Transcranial laser therapy (TLT) uses low-power lasers emitting light in the far- to near-infrared ranges. Beneficial effects of TLT have been reported in neurological and mental-health-related disorders in humans and animal models, including TBI. Rats exposed to repetitive low-level blast develop chronic cognitive and PTSD-related behavioral traits. We tested whether TLT treatment could reverse these traits. Rats received a 74.5-kPa blast or sham exposures delivered one per day for 3 consecutive days. Beginning at 34 weeks after blast exposure, the following groups of rats were treated with active or sham TLT: 1) Sham-exposed rats (n = 12) were treated with sham TLT; 2) blast-exposed rats (n = 13) were treated with sham TLT; and 3) blast-exposed rats (n = 14) were treated with active TLT. Rats received 5 min of TLT five times per week for 6 weeks (wavelength, 808 nm; power of irradiance, 240 mW). At the end of treatment, rats were tested in tasks found previously to be most informative (novel object recognition, novel object localization, contextual/cued fear conditioning, elevated zero maze, and light/dark emergence). TLT did not improve blast-related effects in any of these tests, and blast-exposed rats were worse after TLT in some anxiety-related measures. Based on these findings, TLT does not appear to be a promising treatment for the chronic cognitive and mental health problems that follow blast injury.
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Affiliation(s)
- Georgina Perez Garcia
- Research and Development Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Gissel M. Perez
- Research and Development Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, New York, USA
| | - Alena Otero-Pagan
- Research and Development Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, New York, USA
| | - Rania Abutarboush
- Department of Neurotrauma, Naval Medical Research Center, Silver Spring, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Usmah Kawoos
- Department of Neurotrauma, Naval Medical Research Center, Silver Spring, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Rita De Gasperi
- Research and Development Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Miguel A. Gama Sosa
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- General Medical Research Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, New York, USA
| | - Dylan Pryor
- Research and Development Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, New York, USA
| | - Patrick R. Hof
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Geriatrics and Palliative Care, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Mount Sinai Alzheimer's Disease Research Center and Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - David G. Cook
- Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Sam Gandy
- Research and Development Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Mount Sinai Alzheimer's Disease Research Center and Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Barbara and Maurice A. Deane Center for Wellness and Cognitive Health and the Mount Sinai NFL Neurological Care Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Stephen T. Ahlers
- Department of Neurotrauma, Naval Medical Research Center, Silver Spring, Maryland, USA
| | - Gregory A. Elder
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Mount Sinai Alzheimer's Disease Research Center and Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Neurology Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, New York, USA
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Blum B, Kaushal S, Khan S, Kim JH, Alvarez Villalba CL. Melatonin in Traumatic Brain Injury and Cognition. Cureus 2021; 13:e17776. [PMID: 34659987 PMCID: PMC8494149 DOI: 10.7759/cureus.17776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 12/20/2022] Open
Abstract
Traumatic brain injury (TBI) is a leading cause of long-term disability and mortality in young adults. The devastating effects of TBI on emotion regulation, executive functioning, and cognition have been well-established, and recent research links TBI as a risk factor for neurodegenerative diseases such as Alzheimer’s disease. Despite an increased focus on the long-term cognitive dysfunction associated with TBI, research into potential treatments has not yet generated consistent successful results in human subjects. Many foundational studies have analyzed the cellular and molecular events involved in the inflammatory and healing processes following TBI, enhancing our understanding of the mechanisms that may contribute to the progression of dementia and cognitive decline in these patients. In this review, we will discuss the emergent research on melatonin within the framework of neuroinflammation and oxidative stress resulting from TBI and possibly preventing further sequelae such as Alzheimer’s disease. A literature review was conducted using standard search strategies to query the PubMed database. The following search terms were used with qualifiers of various combinations: TBI, traumatic brain injury, melatonin, treatment, dementia, Alzheimer’s, cognition, and neurodegeneration. Selected studies included meta-analyses, literature reviews, and randomized controlled trials (RCT) that evaluated melatonin’s role as a potential therapy to prevent post-TBI neurodegeneration, specifically the development of dementia and deficits in memory and cognition. Three independent reviewers assessed all articles for eligibility. After assessment for eligibility, 11 total studies were included. Much of the available data on melatonin in TBI has highlighted its significant neuroprotective and antiinflammatory effects, which can be significant in fighting against the neuroinflammatory processes indicated in neurodegeneration. In animal models, immunohistochemistry and histopathology have allowed researchers to study measures of cell injury such as inflammatory cytokines, edema, and markers of oxidative stress. Though the effects of melatonin in TBI appear to be mediated through mostly indirect mechanisms on inflammatory processes, some research has explored potential mechanisms that could be specific to melatonin. Animal model studies support that melatonin treatment after TBI significantly improves cognition and behavioral outcomes. However, clinical studies with human subjects are scarce. Beyond the apparent general antiinflammatory and antioxidant actions of melatonin, a review of the evidence identified some preliminary research that has suggested the significance of melatonin receptors specifically in TBI. While there is some evidence to suggest that melatonin is able to reduce post-TBI cognitive decline as measured by subject performance on memory tasks, there is a lack of longitudinal data on whether melatonin decreases the risk of developing dementia after TBI. Considering melatonin therapy’s promising preclinical data, favorable safety profile, and accessibility, further studies are warranted to assess the effects of melatonin as a post-TBI therapy on human subjects.
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Affiliation(s)
- Brian Blum
- Psychiatry, Aventura Hospital and Medical Center, Aventura, USA
| | - Shivani Kaushal
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, USA
| | - Sara Khan
- Psychiatry, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, USA
| | - Jae H Kim
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, USA
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25
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Caldieraro MA, Laufer-Silva T, Cassano P. Dosimetry and Clinical Efficacy of Transcranial Photobiomodulation for Major Depression Disorder: Could they Guide Dosimetry for Alzheimer's Disease? J Alzheimers Dis 2021; 83:1453-1469. [PMID: 34487045 DOI: 10.3233/jad-210586] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is prevalent and has significant impact on individuals and society. Cognitive symptoms are frequent in MDD and insufficiently treated by antidepressant medications. Transcranial photobiomodulation (t-PBM) is a novel device therapy which shows promise as an antidepressant and pro-cognitive treatment. To date, despite the encouraging results, the optimal stimulation parameters of t-PBM to treat MDD are not established, and clinical studies are very heterogeneous in terms of these parameters. While the literature provides guidance on the appropriate fluence to achieve therapeutic results, little is known on the other parameters. OBJECTIVE To evaluate the relationship between different parameters and the antidepressant effect of t-PBM. METHODS We reviewed clinical studies on MDD and on depressive symptoms comorbid with other diseases. We calculated the standardized effect size of the change in symptoms severity before and after t-PBM and we performed a descriptive analysis of the reviewed papers. RESULTS The greatest effect sizes for the antidepressant effect were found in studies using pulse-wave t-PBM with high peak irradiance (but low average irradiance) over large skin surface. One well-designed and sufficiently powered, double-blind, sham-controlled trial indicated that t-PBM with low irradiance over a small skin surface is ineffective to treat depression. CONCLUSION The use of t-PBM for Alzheimer's disease and for dementia is still at its inception; these dosimetry lessons from the use of t-PBM for depression might serve as guidance.
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Affiliation(s)
- Marco Antonio Caldieraro
- Centro de Pesquisa Experimental (CPE) e Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre -RS, Brasil.,Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Psiquiatria e Medicina Legal, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Porto Alegre -RS, Brasil
| | - Tatiana Laufer-Silva
- Centro de Pesquisa Experimental (CPE) e Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre -RS, Brasil.,Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Psiquiatria e Medicina Legal, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Porto Alegre -RS, Brasil
| | - Paolo Cassano
- Harvard Medical School, Boston, MA, USA.,MGH Division of Neuropsychiatry, Massachusetts General Hospital, Boston, MA, USA
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Méndez M, Fidalgo C, Arias JL, Arias N. Methylene blue and photobiomodulation recover cognitive impairment in hepatic encephalopathy through different effects on cytochrome c-oxidase. Behav Brain Res 2021; 403:113164. [PMID: 33549685 DOI: 10.1016/j.bbr.2021.113164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/02/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
Mitochondrial dysfunction plays a central role in hepatic encephalopathy (HE), due to changes in enzyme cytochrome c-oxidase (CCO), causing a decline in brain metabolism. We used an HE animal model and applied intracranial administration of methylene blue (MB) and transcranial photobiomodulation (PBM), both targeting CCO, to determine their differential effects on recovering cognition. Five groups of rats were used: sham-operated group + saline (SHAM + SAL, n = 6), hepatic encephalopathy + SAL (HE + SAL, n = 7), SHAM + methylene blue (SHAM + MB, n = 7), HE + MB (n = 7), HE + PBM (n = 7). PBM animals were exposed transcranially to 670 +/- 10 nm LED light at a dose of 9 J/cm2 once a day for 7 days, and the MB and SAL groups were injected with 2.2 μg/0.5 μL in the accumbens. Cognitive dysfunction was evaluated on a striatal stimulus-response task using the Morris water maze. Our results showed cognitive improvement in the HE group when treated with MB. This improvement was accompanied by a decrease in CCO activity in the prefrontal cortex, dorsal striatum, and dorsal hippocampus. When comparing MB and PBM, we found that, although both treatments effectively improved the HE-memory deficit, there was a differential effect on CCO. A general decrease in CCO activity was found in the prefrontal and entorhinal cortices, dorsal striatum, and hippocampus when PBM, compared to MB, was applied. Our results suggest that mitochondrial dysfunction and brain metabolic decline in HE might involve CCO alteration and can be improved by administering MB and PBM.
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Affiliation(s)
- Marta Méndez
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad de Oviedo, Plaza Feijoo s/n, Oviedo, 33003, Spain; INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain
| | - Camino Fidalgo
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain; Departamento de Psicología y Sociología, IIS Aragón, Universidad de Zaragoza, Ciudad Escolar s/n, Teruel, 44003, Spain
| | - Jorge L Arias
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad de Oviedo, Plaza Feijoo s/n, Oviedo, 33003, Spain; INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain
| | - Natalia Arias
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain; UK Dementia Research Institute, Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.
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27
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Martin PI, Chao L, Krengel MH, Ho MD, Yee M, Lew R, Knight J, Hamblin MR, Naeser MA. Transcranial Photobiomodulation to Improve Cognition in Gulf War Illness. Front Neurol 2021; 11:574386. [PMID: 33551948 PMCID: PMC7859640 DOI: 10.3389/fneur.2020.574386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/09/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction: Approximately 25-30% of veterans deployed to Kuwait, 1990-91, report persistent multi-symptom Gulf War Illness (GWI) likely from neurotoxicant exposures. Photobiomodulation (PBM) in red/near-infrared (NIR) wavelengths is a safe, non-invasive modality shown to help repair hypoxic/stressed cells. Red/NIR wavelengths are absorbed by cytochrome C oxidase in mitochondria, releasing nitric oxide (increasing local vasodilation), and increasing adenosine tri-phosphate production. We investigated whether PBM applied transcranially could improve cognition, and health symptoms in GWI. Materials and Methods: Forty-eight (40 M) participants completed this blinded, randomized, sham-controlled trial using Sham or Real, red/NIR light-emitting diodes (LED) applied transcranially. Fifteen, half-hour transcranial LED (tLED) treatments were twice a week (7.5 weeks, in-office). Goggles worn by participant and assistant maintained blinding for visible red. Pre-/Post- testing was at Entry, 1 week and 1 month post- 15th treatment. Primary outcome measures were neuropsychological (NP) tests; secondary outcomes, Psychosocial Questionnaires, including PTSD. Results: Primary Analyses (all participants), showed improvement for Real vs. Sham, for Digit Span Forwards (p < 0.01); and a trend for Trails 4, Number/Letter Sequencing (p < 0.10). For secondary outcomes, Real group reported more improvement on the SF-36V Plus, Physical Component Score (p < 0.08). Secondary Analyses included only subjects scoring below norm (50%ile) at Entry, on specific NP test/s. Real and Sham improved at 1 week after 15th treatment; however, at 1 month, only those receiving Real improved further: Digit Span Total, Forwards and Backwards; Trails 4, Number/Letter Sequencing; California Verbal Learning Test-II, long delay free recall; Continuous Performance Test-II, False Alarm Rate; and Color-Word Interference, Stroop, Trial 3, Inhibition; Sham group worsened, toward Entry values. Only those with more post-traumatic stress disorder (PTSD) symptomatology at Entry, receiving Real, continued to have additional PTSD reduction at 1 month; Sham regressed. Conclusion: This study was underpowered (n = 48), with large heterogeneity at Entry. This likely contributed to significance or trend to significance, for only two of the NP tests (Digit Span Forwards; Trails 4, Number/Letter Sequencing) and only one general health measure, the SF-36V Plus, Physical Component Score. More subjects receiving Real, self-reported increased concentration, relaxation and sleep. Controlled studies with newer, transcranial LED home treatment devices are warranted; this is expected to increase enrollment. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT01782378.
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Affiliation(s)
- Paula I. Martin
- VA Boston Healthcare System, Boston, MA, United States
- Department of Neurology, School of Medicine, Boston University, Boston, MA, United States
| | - Linda Chao
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Maxine H. Krengel
- VA Boston Healthcare System, Boston, MA, United States
- Department of Neurology, School of Medicine, Boston University, Boston, MA, United States
| | - Michael D. Ho
- VA Boston Healthcare System, Boston, MA, United States
| | - Megan Yee
- VA Boston Healthcare System, Boston, MA, United States
| | - Robert Lew
- VA Boston Healthcare System, Boston, MA, United States
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, United States
| | - Jeffrey Knight
- VA Boston Healthcare System, National Center for Posttraumatic Stress Disorder, Boston, MA, United States
| | - Michael R. Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, United States
- Laser Research Center, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Margaret A. Naeser
- VA Boston Healthcare System, Boston, MA, United States
- Department of Neurology, School of Medicine, Boston University, Boston, MA, United States
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28
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You J, Bragin A, Liu H, Li L. Preclinical studies of transcranial photobiomodulation in the neurological diseases. TRANSLATIONAL BIOPHOTONICS 2021. [DOI: 10.1002/tbio.202000024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Jing You
- Department of Biomedical Engineering University of North Texas Denton Texas USA
| | - Anatol Bragin
- Department of Neurology University of California Los Angeles Los Angeles California USA
- Brain Research Institute University of California Los Angeles Los Angeles California USA
| | - Hanli Liu
- Department of Bioengineering University of Texas at Arlington Arlington Texas USA
| | - Lin Li
- Department of Biomedical Engineering University of North Texas Denton Texas USA
- Department of Neurology University of California Los Angeles Los Angeles California USA
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29
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Does photobiomodulation influence the resting-state brain networks in young human subjects? Exp Brain Res 2020; 239:435-449. [PMID: 33211136 DOI: 10.1007/s00221-020-05981-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/04/2020] [Indexed: 01/01/2023]
Abstract
Using fMRI (functional magnetic resonance imaging), we explored the effect of transcranial photobiomodulation on four major resting-state brain networks, namely the sensorimotor, salience, default mode and central executive networks, in normal young subjects. We used a vielight transcranial device (810 nm) and compared the scans in 20 subjects (mean age 30.0 ± 2.8 years) after active- and sham-photobiomodulation sessions. Four sets of analysis-independent components, network connectivity, infra-slow oscillatory power and arterial spin labelling-were undertaken. Our results showed that when comparing pre- with post-active and pre- with post-sham photobiomodulation scans, there were no substantial differences in activity across any of the four resting-state networks examined, indicating no clear photobiomodulation effect. When taken together with previous findings, we suggest that the impact of photobiomodulation becomes much clearer only after brain circuitry is altered, for example, after a neurone undergoes some change in its equilibrium or homeostasis, either during pathology or ageing, or during a change in functional activity when individuals are engaged in a specific task (e.g. evoked brain activity).
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30
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Photobiomodulation as a promising new tool in the management of psychological disorders: A systematic review. Neurosci Biobehav Rev 2020; 119:242-254. [PMID: 33069687 DOI: 10.1016/j.neubiorev.2020.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/21/2020] [Accepted: 10/09/2020] [Indexed: 12/18/2022]
Abstract
Photobiomodulation is a brain modulation technique that has become a promising treatment for multiple pathologies. This systematic review collects studies up to 2019 about the beneficial effects of photobiomodulation as a therapy for treating psychological disorders and a tool for modulating cognitive processes. This technique is mostly used for the treatment of depression and stress, as well as to study its effects on psychological variables in healthy subjects. Despite the lack of parameters used, photobiomodulation seems to achieve enough brain penetration to produce beneficial effects in healthy subjects and patients with multiple pathologies. The best parameters are the wavelengths of 810 nm for the treatment of depression and 1064 nm for cognitive enhancement, along with a scalp irradiance of 250 mW/cm2 and a scalp yield of 60 J/cm2. It weekly application on the bilateral prefrontal area and the default mode network seems to be ideal for the maintenance of the effects. Photobiomodulation could be used as an effective and safe therapy for the treatment of multiple psychological pathologies.
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Black CE, Zhou E, DeAngelo CM, Asante I, Louie SG, Petasis NA, Humayun MS. Cyanine Nanocages Activated by Near-Infrared Light for the Targeted Treatment of Traumatic Brain Injury. Front Chem 2020; 8:769. [PMID: 33062635 PMCID: PMC7489144 DOI: 10.3389/fchem.2020.00769] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/23/2020] [Indexed: 01/03/2023] Open
Abstract
Traumatic brain injury (TBI) is a common and prevalent condition that affects large numbers of people across a range of ages. Individuals engaging in physical activities and victims of accidents are at a higher risk for TBI. There is a lack of available treatment specifically for TBI. Given the difficulty to determine its precise location in the brain, TBI remains difficult to fully diagnose or treat. Herein, we disclose a novel strategy for directing therapeutic agents to TBI sites, without the need to determine the precise location of the TBI activity in the brain. This novel approach is based on the use of a cyanine dye nanocage carrying Gabapentin, a known TBI therapeutic agent. Upon exposure of the cyanine nanocage to near-infrared light, the local release of Gabapentin is triggered, selectively at the TBI-affected site.
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Affiliation(s)
- Caroline E Black
- Department of Chemistry, University of Southern California, Los Angeles, CA, United States
| | - Eugene Zhou
- School of Pharmacy, University of Southern California, Los Angeles, CA, United States
| | - Caitlin M DeAngelo
- Department of Chemistry, University of Southern California, Los Angeles, CA, United States
| | - Isaac Asante
- School of Pharmacy, University of Southern California, Los Angeles, CA, United States
| | - Stan G Louie
- School of Pharmacy, University of Southern California, Los Angeles, CA, United States.,Ginsburg Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, CA, United States
| | - Nicos A Petasis
- Department of Chemistry, University of Southern California, Los Angeles, CA, United States.,School of Pharmacy, University of Southern California, Los Angeles, CA, United States.,Ginsburg Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, CA, United States
| | - Mark S Humayun
- Ginsburg Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, CA, United States.,Keck School of Medicine, Viterbi School of Engineering, and Roski Eye Institute, University of Southern California, Los Angeles, CA, United States
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32
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Arias JL, Mendez M, Martínez JÁ, Arias N. Differential effects of photobiomodulation interval schedules on brain cytochrome c-oxidase and proto-oncogene expression. NEUROPHOTONICS 2020; 7:045011. [PMID: 33313338 PMCID: PMC7723391 DOI: 10.1117/1.nph.7.4.045011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/28/2020] [Indexed: 06/12/2023]
Abstract
Significance: Transcranial photobiomodulation (PBM) is a noninvasive neuromodulation technique capable of producing changes in the mitochondrial cytochrome c-oxidase (CCO) activity of neurons. Although the application of PBM in clinical practice and as a neurophysiological tool is increasing, less is known about how different treatment time intervals may result in different outcomes. Aim: We evaluated the effects of different PBM treatment intervals on brain metabolic activity through the CCO and proto-oncogene expression (c-Fos). Approach: We studied PBM effects on brain CCO and c-Fos expression in three groups of animals: Control (CN, n = 8 ), long interval PBM treatment (LI, n = 5 ), and short interval PBM treatment (SI, n = 5 ). Results: Increased CCO activity in the LI group, compared to the SI and CN groups, was found in the prefrontal cortices, dorsal and ventral striatum, and hippocampus. Regarding c-Fos expression, we found a significant increase in the SI group compared to LI and CN, whereas LI showed increased c-Fos expression compared to CN in the cingulate and infralimbic cortices. Conclusions: We show the effectiveness of different PBM interval schedules in increasing brain metabolic activity or proto-oncogene expression.
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Affiliation(s)
- Jorge L. Arias
- University of Oviedo, Neuroscience Laboratory, Department of Psychology, Oviedo, Spain
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain
| | - Marta Mendez
- University of Oviedo, Neuroscience Laboratory, Department of Psychology, Oviedo, Spain
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain
| | - Juan Ángel Martínez
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain
- University of Oviedo, Escuela Politécnica de Gijón, Departamento Ingeniería Eléctrica, Electrónica, Computadores y Sistemas, Gijón, Spain
| | - Natalia Arias
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain
- Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King´s College London, Department of Basic and Clinical Neuroscience, London, United Kingdom
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33
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Chao LL. Improvements in Gulf War Illness Symptoms After Near-Infrared Transcranial and Intranasal Photobiomodulation: Two Case Reports. Mil Med 2020; 184:e568-e574. [PMID: 30916762 DOI: 10.1093/milmed/usz037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 01/29/2019] [Accepted: 02/12/2019] [Indexed: 12/25/2022] Open
Abstract
At least one-fourth of US veterans who served in the 1990-1991 Gulf War (GW) are affected by the chronic symptomatic illness known as Gulf War illness (GWI). This condition typically includes some combination of fatigue, headaches, cognitive dysfunction, musculoskeletal pain, and respiratory, gastrointestinal and dermatologic complaints. To date, effective treatments for GWI have been elusive. Photobiomodulation (PBM) describes the non-pharmacological, non-thermal use of light to stimulate, heal, and protect tissue that has either been injured, is degenerating, or else is at risk of dying. Significant benefits have been reported following application of transcranial PBM to humans with acute stoke, traumatic brain injury (TBI), and dementia. This report describes the first documentation of improved GWI symptoms in two GW veterans following 12 weeks of PBM treatments.
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Affiliation(s)
- Linda L Chao
- Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, 4150 Clement Street (114M), San Francisco, CA 94121.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA 94143
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Mocciaro E, Grant A, Esenaliev RO, Petrov IY, Petrov Y, Sell SL, Hausser NL, Guptarak J, Bishop E, Parsley MA, Bolding IJ, Johnson KM, Lidstone M, Prough DS, Micci MA. Non-Invasive Transcranial Nano-Pulsed Laser Therapy Ameliorates Cognitive Function and Prevents Aberrant Migration of Neural Progenitor Cells in the Hippocampus of Rats Subjected to Traumatic Brain Injury. J Neurotrauma 2020; 37:1108-1123. [DOI: 10.1089/neu.2019.6534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Emanuele Mocciaro
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas
| | - Auston Grant
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas
| | - Rinat O. Esenaliev
- Department of Neuroscience and Cell Biology, University of Texas Medical Branch, Galveston, Texas
- Center for Biomedical Engineering, University of Texas Medical Branch, Galveston, Texas
| | - Irene Y. Petrov
- Center for Biomedical Engineering, University of Texas Medical Branch, Galveston, Texas
| | - Yuriy Petrov
- Center for Biomedical Engineering, University of Texas Medical Branch, Galveston, Texas
| | - Stacy L. Sell
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas
| | - Nicole L Hausser
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas
| | - Jutatip Guptarak
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas
| | - Elizabeth Bishop
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas
| | - Margaret A. Parsley
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas
| | - Ian J. Bolding
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas
| | - Kathia M. Johnson
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas
| | - Maxwell Lidstone
- College of Natural Sciences, University of Texas at Austin, Austin, Texas
| | - Donald S. Prough
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas
| | - Maria-Adelaide Micci
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas
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Pruitt T, Wang X, Wu A, Kallioniemi E, Husain MM, Liu H. Transcranial Photobiomodulation (tPBM) With 1,064-nm Laser to Improve Cerebral Metabolism of the Human Brain In Vivo. Lasers Surg Med 2020; 52:807-813. [PMID: 32173886 PMCID: PMC7492377 DOI: 10.1002/lsm.23232] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES In our previous proof-of-principle study, transcranial photobiomodulation (tPBM) with 1,064-nm laser was reported to significantly increase concentration changes of oxygenated hemoglobin (∆[HbO]) and oxidized-state cytochrome c oxidase (∆[oxi-CCO]) in the human brain. This paper further investigated (i) its validity in two different subsets of young human subjects at two study sites over a period of 3 years and (ii) age-related effects of tPBM by comparing sham-controlled increases of ∆[HbO] and ∆[oxi-CCO] between young and older adults. STUDY DESIGN/MATERIALS AND METHODS We measured sham-controlled ∆[HbO] and ∆[oxi-CCO] using broadband near-infrared spectroscopy (bb-NIRS) in 15 young (26.7 ± 2.7 years of age) and 5 older (68.2 ± 4.8 years of age) healthy normal subjects before, during, and after right-forehead tPBM/sham stimulation with 1,064-nm laser. Student t tests were used to test statistical differences in tPBM-induced ∆[HbO] and ∆[oxi-CCO] (i) between the 15 young subjects and those of 11 reported previously and (ii) between the two age groups measured in this study. RESULTS Statistical analysis showed that no significant difference existed in ∆[HbO] and ∆[oxi-CCO] during and post tPBM between the two subsets of young subjects at two study sites over a period of 3 years. Furthermore, the two age groups showed statistically identical net increases in sham-controlled ∆[HbO] and ∆[oxi-CCO]. CONCLUSIONS This study provided strong evidence to validate/confirm our previous findings that tPBM with 1,064-nm laser enables to increase cerebral ∆[HbO] and ∆[oxi-CCO] in the human brain, as measured by bb-NIRS. Overall, it demonstrated the robust reproducibility of tPBM being able to improve cerebral hemodynamics and metabolism of the human brain in vivo in both young and older adults. Lasers Surg. Med. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.
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Affiliation(s)
- Tyrell Pruitt
- Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd, Arlington, Texas, 76019.,Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas, 75390
| | - Xinlong Wang
- Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd, Arlington, Texas, 76019
| | - Anqi Wu
- Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd, Arlington, Texas, 76019
| | - Elisa Kallioniemi
- Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas, 75390
| | - Mustafa M Husain
- Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas, 75390
| | - Hanli Liu
- Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd, Arlington, Texas, 76019
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Gendron DJ, Hamblin MR. Applications of Photobiomodulation Therapy to Musculoskeletal Disorders and Osteoarthritis with Particular Relevance to Canada. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 37:408-420. [PMID: 31265376 DOI: 10.1089/photob.2018.4597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background: Musculoskeletal disorders caused by osteoarthritis (MSDs/OA) are a growing problem in the modern industrialized society in Canada. Overall aging of the general population and a progressive lack of exercise contribute to this alarming increase. Moreover, a range of chronic conditions including cardiovascular and mental diseases show significantly higher comorbidity with MSDs/OA. Conventional medical treatment for MSDs/OA includes nonsteroidal anti-inflammatory drugs and opiate pain killers. These drugs have major drawbacks such as a relative lack of efficacy, potential for addiction, and even death (Vioxx scandal). Photobiomodulation (PBM) was discovered over 50 years ago but has still not attained widespread acceptance by the medical community. This is partly due to uncertainty about the precise molecular mechanisms of action and a bewildering array of different wavelengths and dosimetric parameters employed in reported studies. Objective: The goal of this review was to survey literature reports of PBM, also known as low-level laser therapy used for treatment of MSDs/OA, concentrating on the growth over time, different wavelengths employed, and application to different joints. Methods: We searched the PubMed database for publication of study on PBM to treat the most common joints. Results: We show that the field of PBM to treat MSDs/OA is expanding exponentially over the past 20 years. A trend has emerged over time for more power to achieve better effective treatments, and the understanding of the physiological effect of safe parameters has improved. There is, however, no consensus on the best set of parameters to treat a specific patient indication. Conclusions: Finally, we highlight gaps in our knowledge and the barriers to further clinical trials. We suggest that the growing body of evidence indicating efficacy, and the almost total lack of side effects, should encourage continued clinical research to support clinical applications where better rehabilitation treatments are much needed.
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Affiliation(s)
| | - Michael R Hamblin
- 2 Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,3 Department of Dermatology, Harvard Medical School, Boston, Massachusetts.,4 Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts
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Naeser MA, Ho MD, Martin PI, Hamblin MR, Koo BB. Increased Functional Connectivity Within Intrinsic Neural Networks in Chronic Stroke Following Treatment with Red/Near-Infrared Transcranial Photobiomodulation: Case Series with Improved Naming in Aphasia. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 38:115-131. [PMID: 31621498 DOI: 10.1089/photob.2019.4630] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: To examine effects of four different transcranial, red/near-infrared (NIR), light-emitting diode (tLED) protocols on naming ability in persons with aphasia (PWA) due to left hemisphere (LH) stroke. This is the first study to report beneficial effects from tLED therapy in chronic stroke, and parallel changes on functional magnetic resonance imaging (fMRI). Materials and methods: Six PWA, 2-18 years poststroke, in whom 18 tLED treatments were applied (3 × /week, 6 weeks) using LED cluster heads: 500 mW, red (633 nm) and NIR (870 nm), 22.48 cm2, 22.2 mW/cm2. Results: After Protocol A with bilateral LED placements, including midline, at scalp vertex over left and right supplementary motor areas (L and R SMAs), picture naming was not improved. P1 underwent pre-/postovert, picture-naming task-fMRI scans; P2 could not. After Protocol A, P1 showed increased activation in LH and right hemisphere, including L and R SMAs. After Protocol B with LEDs only on ipsilesional, LH side, naming ability significantly improved for P1 and P2; the fMRI scans for P1 then showed activation only on the ipsilesional LH side. After Protocol C with LED placements on ipsilesional LH side, plus one midline placement over mesial prefrontal cortex (mPFC) at front hairline, a cortical node of the default mode network (DMN), P3 and P4 had only moderate/poor response, and no increase in functional connectivity on resting-state functional-connectivity MRI. After Protocol D, however, with LED placements on ipsilesional LH side, plus over two midline nodes of DMN, mPFC, and precuneus (high parietal) simultaneously, P5 and P6 each had good response with significant increase in functional connectivity within DMN, p < 0.0005; salience network, p < 0.0005; and central executive network, p < 0.05. Conclusions: NIR photons can affect surface brain cortex areas subjacent to where LEDs are applied on the scalp. Improved naming ability was present with optimal Protocol D. Transcranial photobiomodulation may be an additional noninvasive therapy for stroke.
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Affiliation(s)
- Margaret A Naeser
- VA Boston Healthcare System (12-A), Boston, Massachusetts.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Michael D Ho
- VA Boston Healthcare System (12-A), Boston, Massachusetts
| | - Paula I Martin
- VA Boston Healthcare System (12-A), Boston, Massachusetts.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Dermatology, Harvard Medical School, Boston, Massachusetts.,Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts
| | - Bang-Bon Koo
- Brain-Imaging and Informatics Lab (BIL), Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
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Jahan A, Nazari MA, Mahmoudi J, Salehpour F, Salimi MM. Transcranial near-infrared photobiomodulation could modulate brain electrophysiological features and attentional performance in healthy young adults. Lasers Med Sci 2019; 34:1193-1200. [DOI: 10.1007/s10103-018-02710-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/19/2018] [Indexed: 12/19/2022]
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Stone J, Mitrofanis J, Johnstone DM, Falsini B, Bisti S, Adam P, Nuevo AB, George-Weinstein M, Mason R, Eells J. Acquired Resilience: An Evolved System of Tissue Protection in Mammals. Dose Response 2018; 16:1559325818803428. [PMID: 30627064 PMCID: PMC6311597 DOI: 10.1177/1559325818803428] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/22/2018] [Accepted: 08/29/2018] [Indexed: 12/11/2022] Open
Abstract
This review brings together observations on the stress-induced regulation of resilience mechanisms in body tissues. It is argued that the stresses that induce tissue resilience in mammals arise from everyday sources: sunlight, food, lack of food, hypoxia and physical stresses. At low levels, these stresses induce an organised protective response in probably all tissues; and, at some higher level, cause tissue destruction. This pattern of response to stress is well known to toxicologists, who have termed it hormesis. The phenotypes of resilience are diverse and reports of stress-induced resilience are to be found in journals of neuroscience, sports medicine, cancer, healthy ageing, dementia, parkinsonism, ophthalmology and more. This diversity makes the proposing of a general concept of induced resilience a significant task, which this review attempts. We suggest that a system of stress-induced tissue resilience has evolved to enhance the survival of animals. By analogy with acquired immunity, we term this system 'acquired resilience'. Evidence is reviewed that acquired resilience, like acquired immunity, fades with age. This fading is, we suggest, a major component of ageing. Understanding of acquired resilience may, we argue, open pathways for the maintenance of good health in the later decades of human life.
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Affiliation(s)
- Jonathan Stone
- Discipline of Physiology, Bosch Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - John Mitrofanis
- Discipline of Anatomy and Histology, Bosch Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Daniel M. Johnstone
- Discipline of Physiology, Bosch Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Benedetto Falsini
- Facolta’ di Medicina e Chirurgia, Fondazione Policlinico A. Gemelli, Universita’ Cattolica del S. Cuore, Rome, Italy
| | - Silvia Bisti
- Department of Biotechnical and Applied Clinical Sciences, Università degli Studi dell’Aquila, IIT Istituto Italiano di Tecnologia Genova and INBB Istituto Nazionale Biosistemi e Biostrutture, Rome, Italy
| | - Paul Adam
- School of Biological, Earth and Environmental Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Arturo Bravo Nuevo
- Department of Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Mindy George-Weinstein
- Department of Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Rebecca Mason
- Discipline of Physiology, Bosch Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Janis Eells
- College of Health Sciences, University of Wisconsin, Milwaukee, WI, USA
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Dos Santos JGRP, Paiva WS, Teixeira MJ. Transcranial light-emitting diode therapy for neuropsychological improvement after traumatic brain injury: a new perspective for diffuse axonal lesion management. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2018; 11:139-146. [PMID: 29731669 PMCID: PMC5927185 DOI: 10.2147/mder.s155356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The cost of traumatic brain injury (TBI) for public health policies is undeniable today. Even patients who suffer from mild TBI may persist with cognitive symptoms weeks after the accident. Most of them show no lesion in computed tomography or conventional magnetic resonance imaging, but microstructural white matter abnormalities (diffuse axonal lesion) can be found in diffusion tensor imaging. Different brain networks work together to form an important part of the cognition process, and they can be affected by TBI. The default mode network (DMN) plays an important central role in normal brain activities, presenting greater relative deactivation during more cognitively demanding tasks. After deactivation, it allows a distinct network to activate. This network (the central executive network) acts mainly during tasks involving executive functions. The salience network is another network necessary for normal executive function, and its activation leads to deactivation of the DMN. The use of red or near-infrared (NIR) light to stimulate or regenerate tissue is known as photobiomodulation. It was discovered that NIR (wavelength 800-900 nm) and red (wavelength 600 nm) light-emitting diodes (LEDs) are able to penetrate through scalp and skull and have the potential to improve the subnormal, cellular activity of compromised brain tissue. Based on this, different experimental and clinical studies were done to test LED therapy for TBI, and promising results were found. It leads us to consider developing different approaches to maximize the positive effects of this therapy and improve the quality of life of TBI patients.
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Affiliation(s)
| | - Wellingson Silva Paiva
- Department of Neurological Surgery, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Manoel Jacobsen Teixeira
- Department of Neurological Surgery, University of São Paulo School of Medicine, São Paulo, Brazil
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Santos JGRPD, Zaninotto ALC, Zângaro RA, Carneiro AMC, Neville IS, de Andrade AF, Teixeira MJ, Paiva WS. Effects of transcranial LED therapy on the cognitive rehabilitation for diffuse axonal injury due to severe acute traumatic brain injury: study protocol for a randomized controlled trial. Trials 2018; 19:249. [PMID: 29690927 PMCID: PMC5916588 DOI: 10.1186/s13063-018-2632-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 04/09/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Photobiomodulation describes the use of red or near-infrared light to stimulate or regenerate tissue. It was discovered that near-infrared wavelengths (800-900 nm) and red (600 nm) light-emitting diodes (LED) are able to penetrate through the scalp and skull and have the potential to improve the subnormal cellular activity of compromised brain tissue. Different experimental and clinical studies were performed to test LED therapy for traumatic brain injury (TBI) with promising results. One of the proposals of this present study is to develop different approaches to maximize the positive effects of this therapy and improve the quality of life of TBI patients. METHODS/DESIGN This is a double-blinded, randomized, controlled trial of patients with diffuse axonal injury (DAI) due to a severe TBI in an acute stage (less than 8 h). Thirty two patients will be randomized to active coil helmet and inactive coil (sham) groups in a 1:1 ratio. The protocol includes 18 sessions of transcranial LED stimulation (627 nm, 70 mW/cm2, 10 J/cm2) at four points of the frontal and parietal regions for 30 s each, totaling 120 s, three times per week for 6 weeks, lasting 30 min. Patients will be evaluated with the Glasgow Outcome Scale Extended (GOSE) before stimulation and 1, 3, and 6 months after the first stimulation. The study hypotheses are as follows: (1) transcranial LED therapy (TCLT) will improve the cognitive function of DAI patients and (2) TCLT will promote beneficial hemodynamic changes in cerebral circulation. DISCUSSION This study evaluates early and delayed effects of TCLT on the cognitive rehabilitation for DAI following severe acute TBI. There is a paucity of studies regarding the use of this therapy for cognitive improvement in TBI. There are some experimental studies and case series presenting interesting results for TBI cognitive improvement but no clinical trials. TRIAL REGISTRATION ClinicalTrials.gov, NCT03281759 . Registered on 13 September 2017.
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Affiliation(s)
- João Gustavo Rocha Peixoto dos Santos
- Department of Neurological Surgery, University of São Paulo School of Medicine, 255 Dr. Enéas de Carvalho Aguiar Av., São Paulo, SP 05403-010 Brazil
| | | | - Renato Amaro Zângaro
- Center for Innovation, Technology and Education (CITÉ) SJ dos Campos, São Paulo, 12245-650 Brazil
| | | | - Iuri Santana Neville
- Department of Neurological Surgery, University of São Paulo School of Medicine, 255 Dr. Enéas de Carvalho Aguiar Av., São Paulo, SP 05403-010 Brazil
| | - Almir Ferreira de Andrade
- Department of Neurological Surgery, University of São Paulo School of Medicine, 255 Dr. Enéas de Carvalho Aguiar Av., São Paulo, SP 05403-010 Brazil
| | - Manoel Jacobsen Teixeira
- Department of Neurological Surgery, University of São Paulo School of Medicine, 255 Dr. Enéas de Carvalho Aguiar Av., São Paulo, SP 05403-010 Brazil
| | - Wellingson Silva Paiva
- Department of Neurological Surgery, University of São Paulo School of Medicine, 255 Dr. Enéas de Carvalho Aguiar Av., São Paulo, SP 05403-010 Brazil
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Brain Photobiomodulation Therapy: a Narrative Review. Mol Neurobiol 2018; 55:6601-6636. [PMID: 29327206 DOI: 10.1007/s12035-017-0852-4] [Citation(s) in RCA: 232] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 12/19/2017] [Indexed: 12/20/2022]
Abstract
Brain photobiomodulation (PBM) therapy using red to near-infrared (NIR) light is an innovative treatment for a wide range of neurological and psychological conditions. Red/NIR light is able to stimulate complex IV of the mitochondrial respiratory chain (cytochrome c oxidase) and increase ATP synthesis. Moreover, light absorption by ion channels results in release of Ca2+ and leads to activation of transcription factors and gene expression. Brain PBM therapy enhances the metabolic capacity of neurons and stimulates anti-inflammatory, anti-apoptotic, and antioxidant responses, as well as neurogenesis and synaptogenesis. Its therapeutic role in disorders such as dementia and Parkinson's disease, as well as to treat stroke, brain trauma, and depression has gained increasing interest. In the transcranial PBM approach, delivering a sufficient dose to achieve optimal stimulation is challenging due to exponential attenuation of light penetration in tissue. Alternative approaches such as intracranial and intranasal light delivery methods have been suggested to overcome this limitation. This article reviews the state-of-the-art preclinical and clinical evidence regarding the efficacy of brain PBM therapy.
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Poiani GDCR, Zaninotto AL, Carneiro AMC, Zangaro RA, Salgado ASI, Parreira RB, de Andrade AF, Teixeira MJ, Paiva WS. Photobiomodulation using low-level laser therapy (LLLT) for patients with chronic traumatic brain injury: a randomized controlled trial study protocol. Trials 2018; 19:17. [PMID: 29310710 PMCID: PMC5759360 DOI: 10.1186/s13063-017-2414-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Photobiomodulation using low-level laser therapy (LLLT) has been tested as a new technique to optimize recovery of patients with traumatic brain injury (TBI). The aim of this study is to evaluate inhibitory attentional control after 18 sessions of active LLLT and compare with the placebo group (sham LLLT). Our exploratory analysis will evaluate the efficacy of the active LLLT on verbal and visuospatial episodic memory, executive functions (working memory, verbal and visuospatial fluency, attentional processes), and anxiety and depressive symptoms compared to the sham group. METHODS/DESIGN A randomized double-blinded trial will be made in 36 patients with moderate and severe TBI. The active LLLT will use an optical device composed of LEDs emitting 632 nm of radiation at the site with full potency of 830 mW. The cranial region with an area of 400 cm2 will be irradiated for 30 min, giving a total dose per session of 3.74 J/cm2. The sham LLLT group contains only an LED device with power < 1 mW, only serving to simulate the irradiation. Each patient will be irradiated three times per week for six weeks, totaling 18 sessions. Neuropsychological assessments will be held one week before the beginning of the sessions, after one week, and three months after the end of LLLT sessions. Memory domain, attention, executive functioning, and visual construction will be evaluated, in addition to symptoms of depression, anxiety, and social demographics. DISCUSSION LLLT has been demonstrated as a safe and effective technique in significantly improving the memory, attention, and mood performance in healthy and neurologic patients. We expect that our trial can complement previous finds, as an effective low-cost therapy to improve cognitive sequel after TBI. TRIAL REGISTRATION ClinicalTrials.gov, NCT02393079 . Registered on 20 February 2015.
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Affiliation(s)
- Guilherme da Cruz Ribeiro Poiani
- Division of Neurosurgery, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, 01246-903, Sao Paulo, SP, Brazil.
| | - Ana Luiza Zaninotto
- Division of Psychology at Hospital of Clinics, University of Sao Paulo Medical School, Sao Paulo, Brazil.,Division of Neurosurgery, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, 01246-903, Sao Paulo, SP, Brazil
| | - Ana Maria Costa Carneiro
- Institute of Biomedical Engineering, Anhembi Morumbi University, Sao Jose dos Campos, Sao Paulo, Brazil
| | - Renato Amaro Zangaro
- Institute of Biomedical Engineering, Anhembi Morumbi University, Sao Jose dos Campos, Sao Paulo, Brazil.,Center for Innovation, Technology and Education - CTE, Sao Jose dos Campos, Sao Paulo, Brazil
| | | | - Rodolfo Borges Parreira
- Salgado Institute of Integral Health; School of Postural and Manual Therapy, Londrina, Parana, Brazil
| | - Almir Ferreira de Andrade
- Division of Neurosurgery, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, 01246-903, Sao Paulo, SP, Brazil
| | - Manoel Jacobsen Teixeira
- Division of Neurosurgery, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, 01246-903, Sao Paulo, SP, Brazil
| | - Wellingson Silva Paiva
- Division of Neurosurgery, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, 01246-903, Sao Paulo, SP, Brazil
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Hamblin MR. Photobiomodulation for traumatic brain injury and stroke. J Neurosci Res 2017; 96:731-743. [PMID: 29131369 DOI: 10.1002/jnr.24190] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 10/04/2017] [Accepted: 10/04/2017] [Indexed: 12/12/2022]
Abstract
There is a notable lack of therapeutic alternatives for what is fast becoming a global epidemic of traumatic brain injury (TBI). Photobiomodulation (PBM) employs red or near-infrared (NIR) light (600-1100nm) to stimulate healing, protect tissue from dying, increase mitochondrial function, improve blood flow, and tissue oxygenation. PBM can also act to reduce swelling, increase antioxidants, decrease inflammation, protect against apoptosis, and modulate microglial activation state. All these mechanisms of action strongly suggest that PBM delivered to the head should be beneficial in cases of both acute and chronic TBI. Most reports have used NIR light either from lasers or from light-emitting diodes (LEDs). Many studies in small animal models of acute TBI have found positive effects on neurological function, learning and memory, and reduced inflammation and cell death in the brain. There is evidence that PBM can help the brain repair itself by stimulating neurogenesis, upregulating BDNF synthesis, and encouraging synaptogenesis. In healthy human volunteers (including students and healthy elderly women), PBM has been shown to increase regional cerebral blood flow, tissue oxygenation, and improve memory, mood, and cognitive function. Clinical studies have been conducted in patients suffering from the chronic effects of TBI. There have been reports showing improvement in executive function, working memory, and sleep. Functional magnetic resonance imaging has shown modulation of activation in intrinsic brain networks likely to be damaged in TBI (default mode network and salience network).
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Affiliation(s)
- Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA.,Department of Dermatology, Harvard Medical School, Boston, MA.,Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA
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Nawashiro H, Sato S, Kawauchi S, Takeuchi S, Nagatani K, Yoshihara N, Shinmoto H. Blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) during transcranial near-infrared laser irradiation. Brain Stimul 2017; 10:1136-1138. [PMID: 28870511 DOI: 10.1016/j.brs.2017.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 11/19/2022] Open
Affiliation(s)
- Hiroshi Nawashiro
- Division of Neurosurgery, Tokorozawa Central Hospital, 3-18-1 Kusunokidai, Tokorozawa, Saitama 359-0037, Japan.
| | - Shunichi Sato
- Division of Bioinformation and Therapeutic Systems, National Defense Medical College Research Institute, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
| | - Satoko Kawauchi
- Division of Bioinformation and Therapeutic Systems, National Defense Medical College Research Institute, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
| | - Satoru Takeuchi
- Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
| | - Kimihiro Nagatani
- Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
| | - Nobuyuki Yoshihara
- Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
| | - Hiroshi Shinmoto
- Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
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Beirne K, Rozanowska M, Votruba M. Photostimulation of mitochondria as a treatment for retinal neurodegeneration. Mitochondrion 2017; 36:85-95. [PMID: 28499983 DOI: 10.1016/j.mito.2017.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 02/15/2017] [Accepted: 05/08/2017] [Indexed: 01/01/2023]
Abstract
Absorption of photon energy by neuronal mitochondria leads to numerous downstream neuroprotective effects. Red and near infrared (NIR) light are associated with significantly less safety concerns than light of shorter wavelengths and they are therefore, the optimal choice for irradiating the retina. Potent neuroprotective effects have been demonstrated in various models of retinal damage, by red/NIR light, with limited data from human studies showing its ability to improve visual function. Improved neuronal mitochondrial function, increased blood flow to neural tissue, upregulation of cell survival mediators and restoration of normal microglial function have all been proposed as potential underlying mechanisms of red/NIR light.
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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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Beneficial neurocognitive effects of transcranial laser in older adults. Lasers Med Sci 2017; 32:1153-1162. [PMID: 28466195 DOI: 10.1007/s10103-017-2221-y] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Abstract
Transcranial infrared laser stimulation (TILS) at 1064 nm, 250 mW/cm2 has been proven safe and effective for increasing neurocognitive functions in young adults in controlled studies using photobiomodulation of the right prefrontal cortex. The objective of this pilot study was to determine whether there is any effect from TILS on neurocognitive function in older adults with subjective memory complaint at risk for cognitive decline (e.g., increased carotid artery intima-media thickness or mild traumatic brain injury). We investigated the cognitive effects of TILS in older adults (ages 49-90, n = 12) using prefrontal cortex measures of attention (psychomotor vigilance task (PVT)) and memory (delayed match to sample (DMS)), carotid artery intima-media thickness (measured by ultrasound), and evaluated the potential neural mechanisms mediating the cognitive effects of TILS using exploratory brain studies of electroencephalography (EEG, n = 6) and functional magnetic resonance imaging (fMRI, n = 6). Cognitive performance, age, and carotid artery intima-media thickness were highly correlated, but all participants improved in all cognitive measures after TILS treatments. Baseline vs. chronic (five weekly sessions, 8 min each) comparisons of mean cognitive scores all showed improvements, significant for PVT reaction time (p < 0.001), PVT lapses (p < 0.001), and DMS correct responses (p < 0.05). The neural studies also showed for the first time that TILS increases resting-state EEG alpha, beta, and gamma power and promotes more efficient prefrontal blood-oxygen-level-dependent (BOLD)-fMRI response. Importantly, no adverse effects were found. These preliminary findings support the use of TILS for larger randomized clinical trials with this non-invasive approach to augment neurocognitive function in older people to combat aging-related and vascular disease-related cognitive decline.
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