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经颅光生物调节治疗神经发育障碍:叙述性综述。

Transcranial photobiomodulation for neurodevelopmental disorders: a narrative review.

机构信息

Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, USA.

Department of Psychiatry, Harvard Medical School, Boston, USA.

出版信息

Photochem Photobiol Sci. 2024 Aug;23(8):1609-1623. doi: 10.1007/s43630-024-00613-7. Epub 2024 Jul 15.

Abstract

BACKGROUND

Neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and Down syndrome (DS) significantly impact social, communicative, and behavioral functioning. Transcranial photobiomodulation (t-PBM) with near-infrared light is a promising non-invasive neurostimulation technique for neuropsychiatric disorders, including NDDs. This narrative review aimed to examine the preclinical and clinical evidence of photobiomodulation (PBM) in treating NDDs.

METHODS

A comprehensive search across six databases was conducted, using a combination of MeSH terms and title/abstract keywords: "photobiomodulation", "PBM", "neurodevelopmental disorders", "NDD", and others. Studies applying PBM to diagnosed NDD cases or animal models replicating NDDs were included. Protocols, reviews, studies published in languages other than English, and studies not evaluating clinical or cognitive outcomes were excluded.

RESULTS

Nine studies were identified, including one preclinical and eight clinical studies (five on ASD, two on ADHD, and one on DS). The reviewed studies encompassed various t-PBM parameters (wavelengths: 635-905 nm) and targeted primarily frontal cortex areas. t-PBM showed efficacy in improving disruptive behavior, social communication, cognitive rigidity, sleep quality, and attention in ASD; in enhancing attention in ADHD; and in improving motor skills and verbal fluency in DS. Minimal adverse effects were reported. Proposed mechanisms involve enhanced mitochondrial function, modulated oxidative stress, and reduced neuroinflammation.

CONCLUSIONS

t-PBM emerges as a promising intervention for NDDs, with potential therapeutic effects across ASD, ADHD, and DS. These findings underscore the need for further research, including larger-scale, randomized sham-controlled clinical trials with comprehensive biomarker analyses, to optimize treatment parameters and understand the underlying mechanisms associated with the effects of t-PBM.

摘要

背景

神经发育障碍(NDD),如自闭症谱系障碍(ASD)、注意缺陷/多动障碍(ADHD)和唐氏综合征(DS),严重影响社交、沟通和行为功能。经颅近红外光光生物调节(t-PBM)是一种有前途的神经精神疾病非侵入性神经刺激技术,包括 NDD。本叙述性综述旨在检查光生物调节(PBM)治疗 NDD 的临床前和临床证据。

方法

我们对六个数据库进行了全面搜索,使用了 MeSH 术语和标题/摘要关键词的组合:“光生物调节”、“PBM”、“神经发育障碍”、“NDD”等。纳入了应用 PBM 治疗诊断为 NDD 的病例或复制 NDD 的动物模型的研究。排除了方案、综述、发表在英语以外语言的研究以及未评估临床或认知结果的研究。

结果

共确定了 9 项研究,包括 1 项临床前研究和 8 项临床研究(5 项关于 ASD,2 项关于 ADHD,1 项关于 DS)。综述的研究涵盖了各种 t-PBM 参数(波长:635-905nm),主要针对额叶皮层区域。t-PBM 在改善 ASD 中的破坏性行为、社交沟通、认知僵化、睡眠质量和注意力方面、在 ADHD 中提高注意力方面以及在 DS 中改善运动技能和语言流畅性方面均显示出疗效。报告的不良反应很少。提出的机制包括增强线粒体功能、调节氧化应激和减少神经炎症。

结论

t-PBM 作为 NDD 的一种有前途的干预手段,在 ASD、ADHD 和 DS 中具有潜在的治疗效果。这些发现强调了需要进一步研究,包括更大规模、随机假对照临床试验和全面的生物标志物分析,以优化治疗参数并了解与 t-PBM 相关的潜在机制。

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