Naeser Margaret A, Saltmarche Anita, Krengel Maxine H, Hamblin Michael R, Knight Jeffrey A
VA Boston Healthcare System , Boston, Massachusetts.
Photomed Laser Surg. 2011 May;29(5):351-8. doi: 10.1089/pho.2010.2814. Epub 2010 Dec 23.
Two chronic, traumatic brain injury (TBI) cases, where cognition improved following treatment with red and near-infrared light-emitting diodes (LEDs), applied transcranially to forehead and scalp areas, are presented.
Significant benefits have been reported following application of transcranial, low-level laser therapy (LLLT) to humans with acute stroke and mice with acute TBI. These are the first case reports documenting improved cognitive function in chronic, TBI patients treated with transcranial LED.
Treatments were applied bilaterally and to midline sagittal areas using LED cluster heads [2.1″ diameter, 61 diodes (9 × 633 nm, 52 × 870 nm); 12-15 mW per diode; total power: 500 mW; 22.2 mW/cm(2); 13.3 J/cm(2) at scalp (estimated 0.4 J/cm(2) to cortex)].
Seven years after closed-head TBI from a motor vehicle accident, Patient 1 began transcranial LED treatments. Pre-LED, her ability for sustained attention (computer work) lasted 20 min. After eight weekly LED treatments, her sustained attention time increased to 3 h. The patient performs nightly home treatments (5 years); if she stops treating for more than 2 weeks, she regresses. Patient 2 had a history of closed-head trauma (sports/military, and recent fall), and magnetic resonance imaging showed frontoparietal atrophy. Pre-LED, she was on medical disability for 5 months. After 4 months of nightly LED treatments at home, medical disability discontinued; she returned to working full-time as an executive consultant with an international technology consulting firm. Neuropsychological testing after 9 months of transcranial LED indicated significant improvement (+1, +2SD) in executive function (inhibition, inhibition accuracy) and memory, as well as reduction in post-traumatic stress disorder. If she stops treating for more than 1 week, she regresses. At the time of this report, both patients are continuing treatment.
Transcranial LED may improve cognition, reduce costs in TBI treatment, and be applied at home. Controlled studies are warranted.
介绍两例慢性创伤性脑损伤（TBI）病例，这两名患者在经颅应用红色和近红外发光二极管（LED）治疗后认知功能得到改善，治疗部位为前额和头皮区域。
据报道，经颅低强度激光疗法（LLLT）应用于急性中风患者和急性TBI小鼠后有显著益处。这是首批记录经颅LED治疗慢性TBI患者后认知功能改善的病例报告。
使用LED簇状头（直径2.1英寸，61个二极管（9个×633纳米，52个×870纳米）；每个二极管12 - 15毫瓦；总功率：500毫瓦；22.2毫瓦/平方厘米；头皮处13.3焦/平方厘米（估计皮质处为0.4焦/平方厘米））双侧及中线矢状区域进行治疗。
患者1在因机动车事故导致闭合性颅脑损伤7年后开始经颅LED治疗。在进行LED治疗前，她持续注意力（电脑工作）的时间为20分钟。经过8周的每周一次LED治疗后，她的持续注意力时间增加到了3小时。该患者进行了5年的夜间家庭治疗；如果她停止治疗超过2周，病情就会恶化。患者2有闭合性头部创伤史（运动/军事及近期摔倒），磁共振成像显示额顶叶萎缩。在进行LED治疗前，她因伤病休5个月。经过4个月的夜间家庭LED治疗后，伤病休停止；她回到一家国际技术咨询公司担任全职执行顾问。经颅LED治疗9个月后的神经心理学测试表明，执行功能（抑制、抑制准确性）和记忆力有显著改善（+1，+2标准差），创伤后应激障碍也有所减轻。如果她停止治疗超过1周，病情就会恶化。在撰写本报告时，两名患者都在继续接受治疗。
经颅LED可能改善认知功能，降低TBI治疗成本，且可在家中应用。有必要进行对照研究。
