Naeser Margaret A, Martin Paula I, Ho Michael D, Krengel Maxine H, Bogdanova Yelena, Knight Jeffrey A, Hamblin Michael R, Fedoruk Andrea E, Poole Luke G, Cheng ChiaHsin, Koo BangBon
VA Boston Healthcare System, Jamaica Plain Campus, Boston, MA, USA.
Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
J Alzheimers Dis Rep. 2023 Jan 31;7(1):77-105. doi: 10.3233/ADR-220022. eCollection 2023.
Chronic traumatic encephalopathy, diagnosed postmortem (hyperphosphorylated tau), is preceded by traumatic encephalopathy syndrome with worsening cognition and behavior/mood disturbances, over years. Transcranial photobiomodulation (tPBM) may promote improvements by increasing ATP in compromised/stressed cells and increasing local blood, lymphatic vessel vasodilation.
Aim 1: Examine cognition, behavior/mood changes Post-tPBM. Aim 2: MRI changes - resting-state functional-connectivity MRI: salience, central executive, default mode networks (SN, CEN, DMN); magnetic resonance spectroscopy, cingulate cortex.
Four ex-players with traumatic encephalopathy syndrome/possible chronic traumatic encephalopathy, playing 11- 16 years, received In-office, red/near-infrared tPBM to scalp, 3x/week for 6 weeks. Two had cavum septum pellucidum.
The three younger cases (ages 55, 57, 65) improved 2 SD ( < 0.05) on three to six neuropsychological tests/subtests at 1 week or 1 month Post-tPBM, compared to Pre-Treatment, while the older case (age 74) improved by 1.5 SD on three tests. There was significant improvement at 1 month on post-traumatic stress disorder (PTSD), depression, pain, and sleep. One case discontinued narcotic pain medications and had reduced tinnitus. The possible placebo effect is unknown. At 2 months Post-tPBM, two cases regressed. Then, home tPBM was applied to only cortical nodes, DMN (12 weeks); again, significant improvements were seen. Significant correlations for increased SN functional connectivity (FC) over time, with executive function, attention, PTSD, pain, and sleep; and CEN FC, with verbal learning/memory, depression. Increased n-acetyl-aspartate (NAA) (oxygen consumption, mitochondria) was present in anterior cingulate cortex (ACC), parallel to less pain and PTSD.
After tPBM, these ex-football players improved. Significant correlations of increased SN FC and CEN FC with specific cognitive tests and behavior/mood ratings, plus increased NAA in ACC support beneficial effects from tPBM.
慢性创伤性脑病在尸检时被诊断（tau蛋白过度磷酸化），在此之前数年存在创伤性脑病综合征，伴有认知功能恶化以及行为/情绪障碍。经颅光生物调节（tPBM）可通过增加受损/应激细胞中的三磷酸腺苷（ATP）以及促进局部血管和淋巴管扩张来促进病情改善。
目标1：检查经tPBM治疗后的认知、行为/情绪变化。目标2：磁共振成像（MRI）变化——静息态功能连接MRI：突显网络、中央执行网络、默认模式网络（SN、CEN、DMN）；磁共振波谱分析，扣带回皮质。
四名患有创伤性脑病综合征/可能的慢性创伤性脑病的前运动员，运动年限为11至16年，在门诊接受头皮的红色/近红外tPBM治疗，每周3次，共6周。其中两人有透明隔腔。
与治疗前相比，三名较年轻的病例（年龄分别为55岁、57岁、65岁）在经tPBM治疗后1周或1个月时，在三至六项神经心理学测试/子测试中改善了2个标准差（<0.05），而年龄较大的病例（74岁）在三项测试中改善了1.5个标准差。创伤后应激障碍（PTSD）、抑郁、疼痛和睡眠在1个月时均有显著改善。一名患者停用了麻醉性止痛药，耳鸣减轻。可能的安慰剂效应尚不清楚。经tPBM治疗2个月后，两名患者病情出现反复。随后，仅对皮质节点、默认模式网络进行家庭tPBM治疗（12周）；再次观察到显著改善。随着时间推移，SN功能连接（FC）增加与执行功能、注意力、PTSD、疼痛和睡眠显著相关；CEN FC增加与言语学习/记忆、抑郁显著相关。前扣带回皮质（ACC）中n-乙酰天门冬氨酸（NAA）增加（氧消耗、线粒体），同时疼痛和PTSD减轻。
经tPBM治疗后，这些前足球运动员病情有所改善。SN FC和CEN FC增加与特定认知测试及行为/情绪评分显著相关，加上ACC中NAA增加，支持tPBM具有有益效果。
