Division of Neuropsychiatry and Neuromodulation, Department of Psychiatry, Massachusetts General Hospital, Charlestown, Massachusetts, USA.
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
Photobiomodul Photomed Laser Surg. 2023 Sep;41(9):460-466. doi: 10.1089/photob.2023.0041. Epub 2023 Aug 31.
Transcranial photobiomodulation (tPBM) is a novel, noninvasive, device-based intervention, which has been tested as a possible treatment for various neurological and psychiatric conditions. Recently, it has been investigated as an innovative treatment for major depressive disorder (MDD). There have been several animal and clinical studies that evaluated the underlying mechanism and the efficacy of its antidepressant effects, but results have been conflicting. Thus, we conducted the first meta-analysis on effects of tPBM on depressive symptoms. Thirty original articles on tPBM were retrieved, eight of them met criteria for inclusion to a random effects meta-analysis. tPBM appeared effective in decreasing depressive symptom severity regardless of diagnosis (Hedges' = 1.415, < 0.001, = 8), but a significant heterogeneity has been found. The meta-analysis of single-arm studies (baseline to endpoint changes) limited to participants with MDD has supported the significant effect of tPBM in reducing the depression severity, without a significant heterogeneity (Hedges' = 1.142, 95% confidence interval = 0.780-1.504, = 6.19, < 0.001, = 5). However, the meta-analysis of the few double-blind, sham-controlled studies in MDD has not supported the statistically significant superiority of tPBM over sham (Hedges' = 0.499, = 0.211, = 3), although a sample size bias is likely present. Overall, this meta-analysis provides weak support for the promising role of tPBM in the treatment of depressive symptoms. Dose finding studies to determine optimal tPBM parameters followed by larger, randomized, sham-controlled studies will be needed to fully demonstrate the antidepressant efficacy of tPBM.
经颅光生物调节（tPBM）是一种新颖的、非侵入性的基于设备的干预手段，已被测试用于治疗各种神经和精神疾病。最近，它被研究作为一种治疗重度抑郁症（MDD）的创新方法。已经有几项动物和临床研究评估了其抗抑郁作用的潜在机制和疗效，但结果存在矛盾。因此，我们首次对 tPBM 治疗抑郁症状的效果进行了荟萃分析。检索到 30 篇关于 tPBM 的原始文章，其中 8 篇符合纳入随机效应荟萃分析的标准。无论诊断如何，tPBM 似乎都能有效降低抑郁症状严重程度（Hedges' = 1.415， < 0.001， = 8），但存在显著的异质性。仅纳入 MDD 患者的单臂研究（从基线到终点的变化）荟萃分析支持 tPBM 显著降低抑郁严重程度的效果，且异质性不显著（Hedges' = 1.142，95%置信区间 = 0.780-1.504， = 6.19， < 0.001， = 5）。然而，在 MDD 中为数不多的双盲、假对照研究的荟萃分析中，并未支持 tPBM 在统计学上优于假对照（Hedges' = 0.499， = 0.211， = 3），尽管可能存在样本量偏倚。总的来说，本次荟萃分析为 tPBM 在治疗抑郁症状方面的应用提供了微弱的支持。需要进行剂量发现研究以确定最佳 tPBM 参数，然后进行更大规模的、随机的、假对照研究，以充分证明 tPBM 的抗抑郁疗效。
