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单次额部近红外光治疗后 2 周和 4 周的心理获益:10 例抑郁症和焦虑症患者的初步研究。

Psychological benefits 2 and 4 weeks after a single treatment with near infrared light to the forehead: a pilot study of 10 patients with major depression and anxiety.

机构信息

The Department of Psychiatry, Harvard Medical School and the Developmental Biopsychiatry Research Program, McLean Hospital, 115 Mill Street Belmont, MA 02478 USA.

出版信息

Behav Brain Funct. 2009 Dec 8;5:46. doi: 10.1186/1744-9081-5-46.


DOI:10.1186/1744-9081-5-46
PMID:19995444
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2796659/
Abstract

BACKGROUND: Many studies have reported beneficial effects from the application of near-infrared (NIR) light photobiomodulation (PBM) to the body, and one group has reported beneficial effects applying it to the brain in stroke patients. We have reported that the measurement of a patient's left and right hemispheric emotional valence (HEV) may clarify data and guide lateralized treatments. We sought to test whether a NIR treatment could 1. improve the psychological status of patients, 2. show a relationship between immediate psychological improvements when HEV was taken into account, and 3. show an increase in frontal pole regional cerebral blood flow (rCBF), and 4. be applied without side effects. METHODS: We gave 10 patients, (5 M/5 F) with major depression, including 9 with anxiety, 7 with a past history of substance abuse (6 with an opiate abuse and 1 with an alcohol abuse history), and 3 with post traumatic stress disorder, a baseline standard diagnostic interview, a Hamilton Depression Rating Scale (HAM-D), a Hamilton Anxiety Rating Scale (HAM-A), and a Positive and Negative Affect Scale (PANAS). We then gave four 4-minute treatments in a random order: NIR to left forehead at F3, to right forehead at F4, and placebo treatments (light off) at the same sites. Immediately following each treatment we repeated the PANAS, and at 2-weeks and at 4-weeks post treatment we repeated all 3 rating scales. During all treatments we recorded total hemoglobin (cHb), as a measure of rCBF with a commercial NIR spectroscopy device over the left and the right frontal poles of the brain. RESULTS: At 2-weeks post treatment 6 of 10 patients had a remission (a score </= 10) on the HAM-D and 7 of 10 achieved this on the HAM-A. Patients experienced highly significant reductions in both HAM-D and HAM-A scores following treatment, with the greatest reductions occurring at 2 weeks. Mean rCBF across hemispheres increased from 0.011 units in the off condition to 0.043 units in the on condition, for a difference of 0.032 (95% CI: -0.016, 0.080) units, though this result did not reach statistical significance. Immediately after treatment the PANAS improved to a significantly greater extent with NIR "on" relative to NIR "off" when a hemisphere with more positive HEV was treated than when one with more negative HEV was treated. We observed no side effects. CONCLUSION: This small feasibility study suggests that NIR-PBM may have utility for the treatment of depression and other psychiatric disorders and that double blind randomized placebo-controlled trials are indicated. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00961454.

摘要

背景:许多研究报告了近红外(NIR)光光生物调节(PBM)对身体的有益影响,有一组研究报告了将其应用于中风患者大脑的有益效果。我们已经报告说,测量患者的左右半球情绪效价(HEV)可以澄清数据并指导偏侧化治疗。我们试图测试 NIR 治疗是否可以:1. 改善患者的心理状态;2. 显示出在考虑到 HEV 时立即改善心理状态的关系;3. 显示额叶区域脑血流(rCBF)增加;4. 没有副作用。

方法:我们对 10 名患有重度抑郁症的患者(5 名男性/5 名女性)进行了治疗,其中包括 9 名焦虑症患者,7 名有药物滥用史(6 名阿片类药物滥用和 1 名酒精滥用史),3 名创伤后应激障碍患者,进行了基线标准诊断访谈、汉密尔顿抑郁量表(HAM-D)、汉密尔顿焦虑量表(HAM-A)和正负情感量表(PANAS)。然后,我们以随机顺序进行了 4 次 4 分钟的治疗:NIR 左额 F3,NIR 右额 F4,安慰剂治疗(关闭光)在相同部位。每次治疗后立即重复 PANAS,在治疗后 2 周和 4 周时重复所有 3 个评分量表。在所有治疗过程中,我们使用商业 NIR 光谱设备记录了大脑左、右额叶的总血红蛋白(cHb),作为 rCBF 的测量值。

结果:治疗后 2 周,10 名患者中有 6 名 HAM-D 评分<=10 分,10 名患者中有 7 名 HAM-A 评分<=10 分。治疗后患者的 HAM-D 和 HAM-A 评分均显著降低,其中最大的降低发生在 2 周时。左右半球的平均 rCBF 从关闭状态的 0.011 单位增加到打开状态的 0.043 单位,差异为 0.032(95%CI:-0.016,0.080)单位,尽管这一结果未达到统计学意义。治疗后立即,当用 NIR 治疗 HEV 更积极的半球时,与用 NIR 治疗 HEV 更消极的半球时相比,PANAS 改善程度明显更大。我们没有观察到副作用。

结论:这项小型可行性研究表明,NIR-PBM 可能对治疗抑郁症和其他精神疾病有用,需要进行双盲随机安慰剂对照试验。

试验注册:ClinicalTrials.gov 标识符:NCT00961454。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1f7/2796659/af03ade2f6aa/1744-9081-5-46-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1f7/2796659/5bfb83860ab7/1744-9081-5-46-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1f7/2796659/8f9cb436dce3/1744-9081-5-46-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1f7/2796659/bade358f95e7/1744-9081-5-46-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1f7/2796659/af03ade2f6aa/1744-9081-5-46-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1f7/2796659/5bfb83860ab7/1744-9081-5-46-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1f7/2796659/8f9cb436dce3/1744-9081-5-46-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1f7/2796659/bade358f95e7/1744-9081-5-46-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1f7/2796659/af03ade2f6aa/1744-9081-5-46-4.jpg

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