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Henderson TA. Can infrared light really be doing what we claim it is doing? Infrared light penetration principles, practices, and limitations. Front Neurol 2024; 15:1398894. [PMID: 39263274 PMCID: PMC11388112 DOI: 10.3389/fneur.2024.1398894] [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: 03/11/2024] [Accepted: 06/10/2024] [Indexed: 09/13/2024] Open
Abstract
Near infrared (NIR) light has been shown to provide beneficial treatment of traumatic brain injury (TBI) and other neurological problems. This concept has spawned a plethora of commercial entities and practitioners utilizing panels of light emitting diodes (LEDs) and promising to treat patients with TBI and other disorders, who are desperate for some treatment for their untreatable conditions. Unfortunately, an LED intended to deliver photonic energy to the human brain does not necessarily do what an LED pointed at a mouse brain does. There is a problem of scale. Extensive prior research has shown that infrared light from a 0.5-watt LED will not penetrate the scalp and skull of a human. Both the properties of NIR light and the manner in which it interacts with tissue are examined. Based on these principles, the shortcomings of current approaches to treating neurological disorders with NIR light are explored. Claims of clinical benefit from low-level LED-based devices are explored and the proof of concept challenged. To date, that proof is thin with marginal benefits which are largely transient. Extensive research has shown fluence at the level of the target tissue which falls within the range of 0.9 J/cm2 to 15 J/cm2 is most effective in activating the biological processes at the cellular level which underlie direct photobiomodulation. If low-level infrared light from LED devices is not penetrating the scalp and skull, then these devices certainly are not delivering that level of fluence to the neurons of the subjacent brain. Alternative mechanisms, such as remote photobiomodulation, which may underlie the small and transient benefits for TBI symptoms reported for low-power LED-based NIR studies are presented. Actionable recommendations for the field are offered.
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Affiliation(s)
- Theodore A Henderson
- Neuro-Luminance, Inc., Denver, CO, United States
- Neuro-Laser Foundation, Denver, CO, United States
- Dr. Theodore Henderson, Inc., Denver, CO, United States
- The Synaptic Space, Inc., Denver, CO, United States
- The International Society of Applied Neuroimaging (ISAN), Toronto, ON, Canada
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Coelho DRA, Renet C, López-Rodríguez S, Cassano P, Vieira WF. Transcranial photobiomodulation for neurodevelopmental disorders: a narrative review. Photochem Photobiol Sci 2024; 23:1609-1623. [PMID: 39009808 DOI: 10.1007/s43630-024-00613-7] [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: 02/08/2024] [Accepted: 07/07/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and Down syndrome (DS) significantly impact social, communicative, and behavioral functioning. Transcranial photobiomodulation (t-PBM) with near-infrared light is a promising non-invasive neurostimulation technique for neuropsychiatric disorders, including NDDs. This narrative review aimed to examine the preclinical and clinical evidence of photobiomodulation (PBM) in treating NDDs. METHODS A comprehensive search across six databases was conducted, using a combination of MeSH terms and title/abstract keywords: "photobiomodulation", "PBM", "neurodevelopmental disorders", "NDD", and others. Studies applying PBM to diagnosed NDD cases or animal models replicating NDDs were included. Protocols, reviews, studies published in languages other than English, and studies not evaluating clinical or cognitive outcomes were excluded. RESULTS Nine studies were identified, including one preclinical and eight clinical studies (five on ASD, two on ADHD, and one on DS). The reviewed studies encompassed various t-PBM parameters (wavelengths: 635-905 nm) and targeted primarily frontal cortex areas. t-PBM showed efficacy in improving disruptive behavior, social communication, cognitive rigidity, sleep quality, and attention in ASD; in enhancing attention in ADHD; and in improving motor skills and verbal fluency in DS. Minimal adverse effects were reported. Proposed mechanisms involve enhanced mitochondrial function, modulated oxidative stress, and reduced neuroinflammation. CONCLUSIONS t-PBM emerges as a promising intervention for NDDs, with potential therapeutic effects across ASD, ADHD, and DS. These findings underscore the need for further research, including larger-scale, randomized sham-controlled clinical trials with comprehensive biomarker analyses, to optimize treatment parameters and understand the underlying mechanisms associated with the effects of t-PBM.
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Affiliation(s)
- David Richer Araujo Coelho
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
- Harvard T. H. Chan School of Public Health, Boston, USA
| | - Christian Renet
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, USA
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sergi López-Rodríguez
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, USA
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute, Carlos III Health Institute, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Paolo Cassano
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Willians Fernando Vieira
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, USA.
- Department of Psychiatry, Harvard Medical School, Boston, USA.
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
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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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Fernandes F, Oliveira S, Monteiro F, Gasik M, Silva FS, Sousa N, Carvalho Ó, Catarino SO. Devices used for photobiomodulation of the brain-a comprehensive and systematic review. J Neuroeng Rehabil 2024; 21:53. [PMID: 38600582 PMCID: PMC11007916 DOI: 10.1186/s12984-024-01351-8] [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: 10/18/2023] [Accepted: 04/02/2024] [Indexed: 04/12/2024] Open
Abstract
A systematic review was conducted to determine the trends in devices and parameters used for brain photobiomodulation (PBM). The revised studies included clinical and cadaveric approaches, in which light stimuli were applied to the head and/or neck. PubMed, Scopus, Web of Science and Google Scholar databases were used for the systematic search. A total of 2133 records were screened, from which 97 were included in this review. The parameters that were extracted and analysed in each article were the device design, actuation area, actuation site, wavelength, mode of operation, power density, energy density, power output, energy per session and treatment time. To organize device information, 11 categories of devices were defined, according to their characteristics. The most used category of devices was laser handpieces, which relate to 21% of all devices, while 28% of the devices were not described. Studies for cognitive function and physiological characterisation are the most well defined ones and with more tangible results. There is a lack of consistency when reporting PBM studies, with several articles under defining the stimulation protocol, and a wide variety of parameters used for the same health conditions (e.g., Alzheimer's or Parkinson's disease) resulting in positive outcomes. Standardization for the report of these studies is warranted, as well as sham-controlled comparative studies to determine which parameters have the greatest effect on PBM treatments for different neurological conditions.
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Affiliation(s)
- Filipa Fernandes
- Center for Micro-ElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Portugal.
| | - Sofia Oliveira
- Center for Micro-ElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Portugal
| | - Francisca Monteiro
- Center for Micro-ElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Portugal
| | - Michael Gasik
- Department of Chemical and Metallurgical Engineering, School of Chemical Engineering, Aalto University Foundation, Espoo, Finland
| | - Filipe S Silva
- Center for Micro-ElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Portugal
- LABBELS-Associate Laboratory, Braga, Guimarães, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), University of Minho, 4710-057, Braga, Portugal
- ICVS/3BS, PT Government Associate Laboratory, 4710-057, Braga, Portugal
- 2CA-Braga, CVS/3BS, PT Government Associate Laboratory, 4710-057, Braga, Portugal
| | - Óscar Carvalho
- Center for Micro-ElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Portugal
- LABBELS-Associate Laboratory, Braga, Guimarães, Portugal
| | - Susana O Catarino
- Center for Micro-ElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Portugal.
- LABBELS-Associate Laboratory, Braga, Guimarães, Portugal.
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Prasad BV, Patil V, Sony KK. Neurodevelopmental Disorders: Role of Non-invasive Neuromodulation Therapies. Ann Neurosci 2024; 31:77-79. [PMID: 38694712 PMCID: PMC11060127 DOI: 10.1177/09727531241245664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024] Open
Affiliation(s)
| | | | - Krishan K. Sony
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Coelho DRA, Salvi JD, Vieira WF, Cassano P. Inflammation in obsessive-compulsive disorder: A literature review and hypothesis-based potential of transcranial photobiomodulation. J Neurosci Res 2024; 102:e25317. [PMID: 38459770 DOI: 10.1002/jnr.25317] [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: 08/01/2023] [Revised: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 03/10/2024]
Abstract
Obsessive-compulsive disorder (OCD) is a disabling neuropsychiatric disorder that affects about 2%-3% of the global population. Despite the availability of several treatments, many patients with OCD do not respond adequately, highlighting the need for new therapeutic approaches. Recent studies have associated various inflammatory processes with the pathogenesis of OCD, including alterations in peripheral immune cells, alterations in cytokine levels, and neuroinflammation. These findings suggest that inflammation could be a promising target for intervention. Transcranial photobiomodulation (t-PBM) with near-infrared light is a noninvasive neuromodulation technique that has shown potential for several neuropsychiatric disorders. However, its efficacy in OCD remains to be fully explored. This study aimed to review the literature on inflammation in OCD, detailing associations with T-cell populations, monocytes, NLRP3 inflammasome components, microglial activation, and elevated proinflammatory cytokines such as TNF-α, CRP, IL-1β, and IL-6. We also examined the hypothesis-based potential of t-PBM in targeting these inflammatory pathways of OCD, focusing on mechanisms such as modulation of oxidative stress, regulation of immune cell function, reduction of proinflammatory cytokine levels, deactivation of neurotoxic microglia, and upregulation of BDNF gene expression. Our review suggests that t-PBM could be a promising, noninvasive intervention for OCD, with the potential to modulate underlying inflammatory processes. Future research should focus on randomized clinical trials to assess t-PBM's efficacy and optimal treatment parameters in OCD. Biomarker analyses and neuroimaging studies will be important in understanding the relationship between inflammatory modulation and OCD symptom improvement following t-PBM sessions.
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Affiliation(s)
- David Richer Araujo Coelho
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Joshua D Salvi
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Center for OCD and Related Disorders, Massachusetts General Hospital, Boston, Massachusetts, USA
- McLean Hospital, Belmont, Massachusetts, USA
| | - Willians Fernando Vieira
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Paolo Cassano
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Ceranoglu TA, Hutt Vater C. Dr. Joseph Biederman's Enduring Legacy: Illuminating the Path to Addressing Autistic Traits in Attention Deficit Hyperactivity Disorder With Transcranial Photobiomodulation. J Atten Disord 2024; 28:664-668. [PMID: 38327034 DOI: 10.1177/10870547231222599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To review the existing literature on transcranial photobiomodulation (tPBM) treatment effects on Autism Spectrum Disorder (ASD), in search for an effective treatment of a symptom cluster identified largely by contributions from late Dr. Biederman who asserted that they frequently present with Attention Deficit Hyperactivity Disorder (ADHD). METHOD A survey of two databases, PubMed and PsycINFO, for clinical trials reporting on tPBM treatment in ASD was performed. Identified manuscripts that met eligibility criteria were then reviewed. RESULTS Three original manuscripts reporting findings on a heterogenous group of study methods met the eligibility criteria. Despite the heterogenous nature of study designs, findings from all three studies reported tPBM treatment to be associated with improvements in ASD symptoms. No serious or treatment limiting adverse events were reported. CONCLUSIONS A nascent body of research suggests further clinical studies investigating efficacy of tPBM in treatment of ASD symptoms should be supported.
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Neurodevelopmental Disorders (NDDs): Beyond the Clinical Definition and Translational Approach. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010099. [PMID: 36670649 PMCID: PMC9856257 DOI: 10.3390/children10010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023]
Abstract
Neurodevelopmental disorders (NDDs) are complex and heterogeneous disorders that affect the growth and development of the brain and are often associated with impairments in cognitive and motor functions, communication, and adaptive behavior [...].
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Lee TL, Ding Z, Chan AS. Can transcranial photobiomodulation improve cognitive function? A systematic review of human studies. Ageing Res Rev 2023; 83:101786. [PMID: 36371017 DOI: 10.1016/j.arr.2022.101786] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/12/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Transcranial photobiomodulation (tPBM) has been studied for over a decade as a possible cognitive intervention. OBJECTIVE To evaluate the effect of tPBM for enhancing human cognitive function in healthy adults and remediating impaired cognitive function in adults with cognitive disorders. METHODS A systematic literature search from three electronic databases (PubMed, Scopus, Web of Science) was conducted from 1987 to May 2022. The cognitive function being evaluated included learning and memory, attention, executive function, language, and global cognitive function. RESULTS Of the 35 studies identified, 29 (82.9 %) studies reported positive improvement in cognitive functions after tPBM. All nine studies on participants with subjective memory complaints, mild cognitive impairment, and dementia, showed positive outcomes. Seven (87.5 %) studies on traumatic brain injury (TBI) patients also showed positive results. A series of clinical trials on stroke patients showed positive trends on improved neurological deficit at first, but was prematurely terminated later at phase III due to the lack of statistical significance. One of the most common protocols for clinical populations employed devices delivering near-infrared light (810 nm), the irradiance of 20-25 mW/cm2, and fluence of 1-10 J/cm2. While this was common, the reviewed protocols also included other wavelengths of light ranging from visible, red (630-635 nm) to invisible near-infrared maximum wavelengths of 1060-1068 nm. CONCLUSIONS tPBM seems to improve cognitive function. However, only half of the reviewed clinical trials were randomized control trials, further investigation is warranted.
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Affiliation(s)
- Tsz-Lok Lee
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Zihan Ding
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Agnes S Chan
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China; Research Centre for Neuropsychological Well-Being, The Chinese University of Hong Kong, Hong Kong, China.
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Kim UJ, Hong N, Ahn JC. Photobiomodulation Attenuated Cognitive Dysfunction and Neuroinflammation in a Prenatal Valproic Acid-Induced Autism Spectrum Disorder Mouse Model. Int J Mol Sci 2022; 23:ijms232416099. [PMID: 36555737 PMCID: PMC9785820 DOI: 10.3390/ijms232416099] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/05/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social communication and interaction disorders, as well as repetitive and restrictive behaviors. To date, no effective treatment strategies have been identified. However, photobiomodulation (PBM) is emerging as a promising treatment for neurological and neuropsychiatric disorders. We used mice exposed to valproic acid (VPA) as a model of ASD and found that pathological behavioral and histological changes that may have been induced by VPA were attenuated by PBM treatment. Pregnant mice that had been exposed to VPA were treated with PBM three times. Thereafter, we evaluated the offspring for developmental disorders, motor function, hyperactivity, repetitive behaviors, and cognitive impairment. PBM attenuated many of the pathological behaviors observed in the VPA-induced ASD mouse model. In addition, pathophysiological analyses confirmed that the increase in activated microglia and astrocytes observed in the VPA-induced ASD mouse model was attenuated by PBM treatment. This suggests that PBM can counteract the behavioral changes caused by neuroinflammation in ASD. Therefore, our data show that PBM has therapeutic potential and may reduce the prevalence of neurodevelopmental disorders such as ASD.
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Affiliation(s)
- Ui-Jin Kim
- Department of Medical Laser, Graduate School, College of Medicine, Dankook University, Cheonan 31116, Republic of Korea
| | - Namgue Hong
- Medical Laser Research Center, College of Medicine, Dankook University, Cheonan 31116, Republic of Korea
- Correspondence: (N.H.); (J.-C.A.)
| | - Jin-Chul Ahn
- Department of Biomedical Science, College of Medicine, Dankook University, Cheonan 31116, Republic of Korea
- Correspondence: (N.H.); (J.-C.A.)
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