Henderson Theodore A, Morries Larry D
Neuro-Laser Foundation, Centennial, CO, United States.
The Synaptic Space Inc., Centennial, CO, United States.
Front Psychiatry. 2017 Sep 29;8:187. doi: 10.3389/fpsyt.2017.00187. eCollection 2017.
The treatment of depression has been hampered by low efficacy of antidepressant medications and safety concerns with alternative modalities. Recent work demonstrated that multi-Watt transcranial near-infrared light therapy (NILT) can effectively treat traumatic brain injury (TBI). The current objective is to explore multi-Watt NILT efficacy in a proof-of-concept study as a treatment for depression.
Thirty-nine sequential patients treated for TBI between March 2013 and May 2017 provided depression self-assessment data and/or were administered the Hamilton depression rating scale. Each completed the Quick Inventory of Depression Symptomatology-Self Report (QIDS) before and after treatment. Patients received multi-Watt NILT using near-infrared lasers (810/980 nm at 8-15 W) applied to forehead and temporal regions bilaterally for 9-12 min to each area. Pre- and posttreatment scores were analyzed by paired -tests.
All met QIDS criteria for mild to severe depression and 69% had prior antidepressant trials. For 36 of the 39 patients, after 16.82 ± 6.26 treatments, QIDS scores indicated a robust response (decrease of QIDS total score by ≥50%). For 32 of 39 patients, posttreatment QIDS scores indicated a remission from depression (decrease of QIDS total score ≤5). Overall, the QIDS score fell from 14.10 ± 3.39 to 3.41 ± 3.30 SD ( = 6.29 × 10). With 12 or fewer treatments, QIDS score dropped from 14.83 ± 2.55 to 4.17 ± 3.93. Patients receiving ≥13 treatments showed a change in QIDS score from 13.67 ± 3.64 to 3.11 ± 3.14. Those ( = 15) who received the entire treatment course within ≤8 weeks (5.33 ± 1.72 weeks) showed a change in QIDS score from 13.86 ± 3.14 to 4.5 ± 3.94. Suicidal ideation resolved in all, but two patients. Patients remained in remission for up to 55 months after a single course of treatment.
This is the first report of high-powered NILT showing efficacy for depression. Multi-Watt NILT showed far greater efficacy and persistent benefit compared to low-power (<1 Watt) infrared light treatments. Patients saw benefit often within four treatments and resolution of depressive symptoms occurred within 4 weeks for some. These data raise an intriguing possibility-that multi-Watt NILT may be a safe, effective, and rapid treatment for depression comorbid with TBI and possibly primary major depression disorder. A double-blind, placebo controlled trial is warranted to verify these proof-of-concept data.
抗抑郁药物疗效欠佳以及替代疗法的安全性问题一直阻碍着抑郁症的治疗。近期研究表明，多瓦级经颅近红外光疗法（NILT）可有效治疗创伤性脑损伤（TBI）。当前目标是在一项概念验证研究中探索多瓦级NILT作为抑郁症治疗方法的疗效。
2013年3月至2017年5月期间连续接受TBI治疗的39例患者提供了抑郁自评数据和/或接受了汉密尔顿抑郁评定量表评估。每位患者在治疗前后均完成了抑郁症状快速自评量表（QIDS）。患者接受多瓦级NILT治疗，使用近红外激光（810/980nm，8 - 15瓦）双侧照射前额和颞部区域，每个区域照射9 - 12分钟。治疗前后的评分通过配对检验进行分析。
所有患者均符合QIDS轻度至重度抑郁标准，69%的患者曾接受过抗抑郁药物试验。39例患者中的36例，在接受16.82±6.26次治疗后，QIDS评分显示出显著改善（QIDS总分降低≥50%）。39例患者中的32例，治疗后的QIDS评分显示抑郁症状缓解（QIDS总分降低≤5分）。总体而言，QIDS评分从14.10±3.39降至3.41±3.30标准差（t = 6.29×10）。接受12次或更少治疗时，QIDS评分从14.83±2.55降至4.17±3.93。接受≥13次治疗的患者QIDS评分从13.67±3.64变为3.11±3.14。其中15例在≤8周（5.33±1.72周）内完成整个治疗疗程的患者，QIDS评分从13.86±3.14变为4.5±3.94。除两名患者外，所有患者的自杀观念均消失。单次治疗疗程后，患者缓解状态持续长达55个月。
这是首篇关于高功率NILT治疗抑郁症有效的报告。与低功率（<1瓦）红外光治疗相比，多瓦级NILT显示出更高的疗效和持续的益处。患者通常在四次治疗内即可获益，部分患者在4周内抑郁症状得到缓解。这些数据提出了一个有趣的可能性——多瓦级NILT可能是一种安全、有效且快速的治疗方法，可用于治疗与TBI共病的抑郁症以及可能的原发性重度抑郁症。有必要进行一项双盲、安慰剂对照试验来验证这些概念验证数据。
