School of Nursing, Peking University, Beijing, China.
Bryn Mawr College, Bryn Mawr, PA, USA.
Lasers Med Sci. 2023 Oct 16;38(1):237. doi: 10.1007/s10103-023-03899-8.
The increasing incident of age-related cognitive impairment worldwide and the lack of pharmaceutical treatments emphasizes the value of non-pharmaceutical therapy. Emerging evidence suggested photobiomodulation (PBM) is a popular intervention to brain disorder; however, it remains unclear the efficacy of PBM for patients with age-related cognitive impairment. The purpose of this systematic review is to compare the different parameters used in PBM, analyze the beneficial effects of PBM as a potential therapy for age-related cognitive impairment. Five electronic database, PubMed, Web of Science, Cochrane Library, CINAHL, and PsycINFO, were systematically searched from inception to November 2021. Relevant randomized controlled trials (RCTs) were screened and assessed for risk of bias. Eleven RCTs evaluating PBM interventions were included. The systematic review and meta-analysis has been registered in PROSPERO(CRD42022374562). Results showed that PBM had a significant moderated effect on global cognition function (SMD=0.51, 95% CI [0.162, 0.864], p=0.004). We found that multiple wavelength PBM (SMD=0.648, 95% CI [0.220, 1.075], p=0.003) had significant effects while single wavelength PBM was non-significant (SMD=0.385, 95% CI [-0.168, 0.987], p=0.172). Laser effect (SMD=0.682, 95% CI [0.37, 0,994], p<0.001) was larger than LED effect (SMD=0.582, 95% CI [0.269, 0.895], p<0.001). PBM in clinical setting (SMD=0.468, 95% CI [0.050, 0.887], p=0.028) had significant effect, but there was no significant effect of home-used PBM (SMD=0.616, 95% CI [-0.121, 1.354], p=0.101). The pool effect of multi-modality PBM (SMD=0.720, 95% CI [0.027, 1.414], p=0.040) was significantly higher in the studies of transcranial irradiation (SMD=0.616, 95% CI [-0.121, 1.354], p=0.010). Cumulative irradiation time was a moderator between the PBM and cognitive function improvement. Photobiomodulation have the potential to improve cognitive function in aging adults. Cumulative irradiation duration, light source, device type, penetration modality, and intervention site can affect the effectiveness of PBM intervention.
全球与年龄相关的认知障碍发生率不断上升,而药物治疗的缺乏强调了非药物治疗的价值。新出现的证据表明,光生物调节(PBM)是一种治疗脑部疾病的流行干预措施;然而,PBM 对与年龄相关的认知障碍患者的疗效仍不清楚。本系统评价的目的是比较 PBM 中使用的不同参数,分析 PBM 作为治疗与年龄相关的认知障碍的潜在疗法的有益效果。从开始到 2021 年 11 月,系统地检索了五个电子数据库,包括 PubMed、Web of Science、Cochrane Library、CINAHL 和 PsycINFO。筛选并评估了相关的随机对照试验(RCT)的偏倚风险。纳入了 11 项评估 PBM 干预措施的 RCT。该系统评价和荟萃分析已在 PROSPERO(CRD42022374562)中注册。结果表明,PBM 对整体认知功能有显著的调节作用(SMD=0.51,95%CI [0.162, 0.864],p=0.004)。我们发现多波长 PBM(SMD=0.648,95%CI [0.220, 1.075],p=0.003)有显著效果,而单波长 PBM 则不显著(SMD=0.385,95%CI [-0.168, 0.987],p=0.172)。激光效应(SMD=0.682,95%CI [0.37, 0.994],p<0.001)大于 LED 效应(SMD=0.582,95%CI [0.269, 0.895],p<0.001)。临床设置中的 PBM(SMD=0.468,95%CI [0.050, 0.887],p=0.028)有显著效果,但家庭使用的 PBM 则没有显著效果(SMD=0.616,95%CI [-0.121, 1.354],p=0.101)。多模态 PBM 的荟萃效应(SMD=0.720,95%CI [0.027, 1.414],p=0.040)在经颅照射的研究中显著更高(SMD=0.616,95%CI [-0.121, 1.354],p=0.010)。累积辐照时间是 PBM 与认知功能改善之间的调节因素。光生物调节有可能改善老年人大脑的认知功能。累积辐照时间、光源、设备类型、穿透方式和干预部位会影响 PBM 干预的效果。