Salehpour Farzad, Majdi Alireza, Pazhuhi Mahdiyeh, Ghasemi Faranak, Khademi Mahsa, Pashazadeh Fariba, Hamblin Michael R, Cassano Paolo
Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran.
Niraxx Light Therapeutics, Inc., Irvine, California.
Photobiomodul Photomed Laser Surg. 2019 Oct;37(10):635-643. doi: 10.1089/photob.2019.4673. Epub 2019 Sep 24.
Transcranial photobiomodulation (t-PBM) is a noninvasive modality that may improve cognitive function in both healthy and diseased subjects. This systematic review and meta-analysis addresses the question of whether t-PBM improves cognitive function in healthy adults. We searched MEDLINE using PubMed, EMBASE, SCOPUS, Web of Science, and Cochrane Library up to March 2019. We also searched ProQuest and Google Scholar databases for unpublished material. The search was limited to articles on the procognitive effects of t-PBM in healthy adults. The initial search resulted in 871 studies, of which nine publications met our criteria for inclusion and exclusion. Seven studies were performed on young, healthy subjects (17-35 years), and two studies were conducted on older (≥49 years), normal subjects. A meta-analysis was performed on six full-text publications whose subjects were young adults. t-PBM administration improved cognition-related outcomes by an 0.833 standardized mean difference (SMD; 95% confidence interval (CI): 0.458-1.209, 14 comparisons) in young, healthy participants. Funnel plotting revealed asymmetry, which was validated using Egger's ( = 0.030) and Begg's regression ( = 0.006) tests. However after reanalysis, this asymmetry disappeared in the attention subgroup, but not in the memory subgroup. The trim-and-fill analysis indicated two studies were lacking required data. Thus, the effect size was adjusted from an SMD of 0.761 (95% CI: 0.573-0.949) to 0.949 (0.779-1.120). The overall quality score of the studies was modest. We demonstrated a significant, beneficial effect of t-PBM on cognitive performance of young, healthy individuals; however, the heterogeneity of the data was high. This could be due to the modest quality or to the low number of included studies, or to the differences between the various subdomains assessed. These shortcomings should be meticulously addressed before concluding that t-PBM is a cognitive-enhancing intervention in healthy individuals.
经颅光生物调节疗法（t-PBM）是一种非侵入性治疗方法，可能改善健康人群和患病个体的认知功能。本系统评价和荟萃分析探讨了t-PBM是否能改善健康成年人认知功能这一问题。我们检索了截至2019年3月的MEDLINE数据库，使用了PubMed、EMBASE、SCOPUS、Web of Science和Cochrane图书馆。我们还在ProQuest和谷歌学术数据库中搜索未发表的资料。检索仅限于关于t-PBM对健康成年人认知促进作用的文章。初步检索得到871项研究，其中9篇出版物符合我们的纳入和排除标准。7项研究针对年轻健康受试者（17 - 35岁），2项研究针对年龄较大（≥49岁）的正常受试者。对6篇以年轻成年人为受试者的全文出版物进行了荟萃分析。在年轻健康参与者中，t-PBM治疗使认知相关结局的标准化平均差（SMD）提高了0.833（95%置信区间（CI）：0.458 - 1.209，14项比较）。漏斗图显示存在不对称性，使用Egger检验（P = 0.030）和Begg回归检验（P = 0.006）进行了验证。然而，重新分析后，这种不对称性在注意力亚组中消失，但在记忆亚组中未消失。修剪填充分析表明有两项研究缺乏所需数据。因此，效应量从SMD为0.761（95%CI：0.573 - 0.949）调整为0.949（0.779 - 1.120）。这些研究的总体质量评分中等。我们证明了t-PBM对年轻健康个体的认知表现有显著的有益影响；然而，数据的异质性较高。这可能是由于质量中等、纳入研究数量较少，或者是由于所评估的各个子领域之间存在差异。在得出t-PBM是健康个体认知增强干预措施的结论之前，应仔细解决这些缺点。
