Hipskind S Gregory, Grover Fred L, Fort T Richard, Helffenstein Dennis, Burke Thomas J, Quint Shane A, Bussiere Garrett, Stone Michael, Hurtado Timothy
1 Brain Injury Consulting, LLC , Department of Brain Research, Addison, Texas.
2 InLight Medical , Medical Advisory Department, Addison, Texas.
Photomed Laser Surg. 2018 Nov 28. doi: 10.1089/pho.2018.4489.
This study explored the outcome of applying red/near-infrared light therapy using light-emitting diodes (LEDs) pulsed with three different frequencies transcranially to treat traumatic brain injury (TBI) in Veterans.
Photobiomodulation therapy (PBMT) using LEDs has been shown to have positive effects on TBI in humans and animal models.
Twelve symptomatic military Veterans diagnosed with chronic TBI >18 months post-trauma received pulsed transcranial PBMT (tPBMT) using two neoprene therapy pads containing 220 infrared and 180 red LEDs, generating a power output of 3.3 W and an average power density of 6.4 mW/cm for 20 min, thrice per week over 6 weeks. Outcome measures included standardized neuropsychological test scores and qualitative and quantitative single photon emission computed tomography (SPECT) measures of regional cerebral blood flow (rCBF).
Pulsed tPBMT significantly improved neuropsychological scores in 6 of 15 subscales (40.0%; p < 0.05; two tailed). SPECT analysis showed increase in rCBF in 8 of 12 (66.7%) study participants. Quantitative SPECT analysis revealed a significant increase in rCBF in this subgroup of study participants and a significant difference between pre-treatment and post-treatment gamma ray counts per cubic centimeter [t = 3.77, df = 7, p = 0.007, 95% confidence interval (95,543.21-21,931.82)]. This is the first study to report quantitative SPECT analysis of rCBF in regions of interest following pulsed tPBMT with LEDs in TBI.
Pulsed tPBMT using LEDs shows promise in improving cognitive function and rCBF several years after TBI. Larger, controlled studies are indicated.
本研究探讨了使用三种不同频率脉冲的发光二极管（LED）经颅应用红/近红外光疗法治疗退伍军人创伤性脑损伤（TBI）的效果。
使用LED的光生物调节疗法（PBMT）已被证明对人类和动物模型中的TBI有积极影响。
12名在创伤后超过18个月被诊断为慢性TBI的有症状退伍军人接受了脉冲经颅PBMT（tPBMT），使用两个含有220个红外LED和180个红色LED的氯丁橡胶治疗垫，产生3.3瓦的功率输出和6.4毫瓦/平方厘米的平均功率密度，持续20分钟，每周三次，共6周。结果测量包括标准化神经心理测试分数以及区域脑血流（rCBF）的定性和定量单光子发射计算机断层扫描（SPECT）测量。
脉冲tPBMT在15个分量表中的6个中显著改善了神经心理分数（40.0%；p < 0.05；双尾）。SPECT分析显示12名研究参与者中有8名（66.7%）的rCBF增加。定量SPECT分析显示该研究参与者亚组的rCBF显著增加，且每立方厘米治疗前和治疗后的伽马射线计数之间存在显著差异[t = 3.77，自由度 = 7，p = 0.007，95%置信区间（95,543.21 - 21,931.82）]。这是第一项报告在TBI患者中使用LED进行脉冲tPBMT后感兴趣区域rCBF的定量SPECT分析的研究。
使用LED的脉冲tPBMT在TBI数年后改善认知功能和rCBF方面显示出前景。需要进行更大规模的对照研究。
