Tedford Clark E, DeLapp Scott, Jacques Steven, Anders Juanita
LumiThera, Inc., Poulsbo, Washington, 98370.
Lasers Surg Med. 2015 Apr;47(4):312-22. doi: 10.1002/lsm.22343. Epub 2015 Mar 13.
BACKGROUND AND OBJECTIVE: Photobiomodulation (PBM) also known as low-level light therapy has been used successfully for the treatment of injury and disease of the nervous system. The use of PBM to treat injury and diseases of the brain requires an in-depth understanding of light propagation through tissues including scalp, skull, meninges, and brain. This study investigated the light penetration gradients in the human cadaver brain using a Transcranial Laser System with a 30 mm diameter beam of 808 nm wavelength light. In addition, the wavelength-dependence of light scatter and absorbance in intraparenchymal brain tissue using 660, 808, and 940 nm wavelengths was investigated. STUDY DESIGN/MATERIAL AND METHODS: Intact human cadaver heads (n = 8) were obtained for measurement of light propagation through the scalp/skull/meninges and into brain tissue. The cadaver heads were sectioned in either the transverse or mid-sagittal. The sectioned head was mounted into a cranial fixture with an 808 nm wavelength laser system illuminating the head from beneath with either pulsed-wave (PW) or continuous-wave (CW) laser light. A linear array of nine isotropic optical fibers on a 5 mm pitch was inserted into the brain tissue along the optical axis of the beam. Light collected from each fiber was delivered to a multichannel power meter. As the array was lowered into the tissue, the power from each probe was recorded at 5 mm increments until the inner aspect of the dura mater was reached. Intraparenchymal light penetration measurements were made by delivering a series of wavelengths (660, 808, and 940 nm) through a separate optical fiber within the array, which was offset from the array line by 5 mm. Local light penetration was determined and compared across the selected wavelengths. RESULTS: Unfixed cadaver brains provide good anatomical localization and reliable measurements of light scatter and penetration in the CNS tissues. Transcranial application of 808 nm wavelength light penetrated the scalp, skull, meninges, and brain to a depth of approximately 40 mm with an effective attenuation coefficient for the system of 2.22 cm(-1) . No differences were observed in the results between the PW and CW laser light. The intraparenchymal studies demonstrated less absorption and scattering for the 808 nm wavelength light compared to the 660 or 940 nm wavelengths. CONCLUSIONS: Transcranial light measurements of unfixed human cadaver brains allowed for determinations of light penetration variables. While unfixed human cadaver studies do not reflect all the conditions seen in the living condition, comparisons of light scatter and penetration and estimates of fluence levels can be used to establish further clinical dosing. The 808 nm wavelength light demonstrated superior CNS tissue penetration.
背景与目的:光生物调节作用(PBM)也被称为低强度光疗法,已成功用于治疗神经系统损伤和疾病。使用PBM治疗脑部损伤和疾病需要深入了解光在包括头皮、颅骨、脑膜和脑在内的组织中的传播情况。本研究使用波长为808nm、光束直径为30mm的经颅激光系统,对人类尸体大脑中的光穿透梯度进行了研究。此外,还研究了使用660、808和940nm波长时脑实质内脑组织的光散射和吸光度与波长的依赖性。 研究设计/材料与方法:获取完整的人类尸体头部(n = 8),用于测量光通过头皮/颅骨/脑膜并进入脑组织的传播情况。将尸体头部切成横断面或正中矢状面。将切开的头部安装在颅骨固定装置中,用波长为808nm的激光系统从下方用脉冲波(PW)或连续波(CW)激光照射头部。沿光束光轴将一个间距为5mm的由9根各向同性光纤组成的线性阵列插入脑组织中。从每根光纤收集的光被传输到多通道功率计。当阵列下降到组织中时,以5mm的增量记录每个探头的功率,直到到达硬脑膜的内侧。通过阵列中一根与阵列线偏移5mm的单独光纤传输一系列波长(660、808和940nm)的光,进行脑实质内光穿透测量。确定局部光穿透情况并在选定波长之间进行比较。 结果:未固定的尸体大脑为中枢神经系统组织中的光散射和穿透提供了良好的解剖定位和可靠的测量。经颅应用808nm波长的光穿透头皮、颅骨、脑膜和脑的深度约为40mm,该系统的有效衰减系数为2.22cm⁻¹。PW激光和CW激光的结果未观察到差异。脑实质内研究表明,与660或940nm波长相比,808nm波长的光吸收和散射较少。 结论:对未固定的人类尸体大脑进行经颅光测量可确定光穿透变量。虽然未固定的人类尸体研究不能反映活体中出现的所有情况,但光散射和穿透的比较以及能量水平的估计可用于确定进一步的临床剂量。808nm波长的光在中枢神经系统组织穿透方面表现出优势。
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