Chao Linda L, Barlow Cody, Karimpoor Mahta, Lim Lew
Departments of Radiology & Biomedical Imaging and Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.
VA Advanced Imaging Research Center, San Francisco VA Health Care System, San Francisco, CA, United States.
Front Neurol. 2020 Sep 8;11:952. doi: 10.3389/fneur.2020.00952. eCollection 2020.
Traumatic brain injury (TBI) is a common neurological disorder among athletes. Although there are no widely accepted treatments for TBI, new investigational approaches, such as photobiomodulation (PBM), are being tested. PBM is a light therapy that uses red to near-infrared (NIR) light to stimulate, heal, and protect tissue that has been injured or is at risk of dying. Benefits following transcranial PBM treatments in animal models of acute TBI and a small number of chronic TBI patients have been reported. However, the human PBM TBI studies published to date have been based on behavioral assessments. This report describes changes in behavioral and neuroimaging measures after 8 weeks of PBM treatments. The subject was a 23-year professional hockey player with a history of concussions, presumed to have caused his symptoms of headaches, mild anxiety, and difficulty concentrating. He treated himself at home with commercially available, low-risk PBM devices that used light-emitting diodes (LEDs) to emit 810-nm light pulsing at 10 or 40 Hz delivered by an intranasal and four transcranial modules that targeted nodes of the default mode network (DMN) with a maximum power density of 100 mW/cm. After 8 weeks of PBM treatments, increased brain volumes, improved functional connectivity, and increased cerebral perfusion and improvements on neuropsychological test scores were observed. Although this is a single, sport-related case with a history of concussions, these positive findings encourage replication studies that could provide further validation for this non-invasive, non-pharmacological modality as a viable treatment option for TBI.
创伤性脑损伤（TBI）是运动员中常见的神经疾病。尽管目前尚无被广泛接受的TBI治疗方法，但诸如光生物调节（PBM）等新的研究方法正在进行测试。PBM是一种光疗法，使用红色至近红外（NIR）光来刺激、治愈和保护已受伤或有死亡风险的组织。在急性TBI动物模型和少数慢性TBI患者中进行经颅PBM治疗后的益处已有报道。然而，迄今为止发表的关于人类PBM治疗TBI的研究均基于行为评估。本报告描述了PBM治疗8周后行为和神经影像学测量的变化。受试者是一名23岁的职业曲棍球运动员，有脑震荡病史，推测其头痛、轻度焦虑和注意力不集中的症状由此引起。他在家中使用市售的低风险PBM设备进行自我治疗，该设备使用发光二极管（LED）发射810纳米的光脉冲，频率为10或40赫兹，通过鼻内和四个经颅模块传递，靶向默认模式网络（DMN）的节点，最大功率密度为100毫瓦/平方厘米。经过8周的PBM治疗后，观察到脑容量增加、功能连接改善、脑灌注增加以及神经心理学测试分数提高。尽管这是一个与运动相关的单一病例，且有脑震荡病史，但这些积极发现鼓励进行重复性研究，可为这种非侵入性、非药物治疗方式作为TBI的可行治疗选择提供进一步验证。
