Barrett Douglas W, Davis Roger E, Siegel-Ramsay Jennifer E, Bichlmeier Amy, Almeida Jorge R C, Gonzalez-Lima F
Departments of Psychology, Psychiatry and Behavioral Sciences, and Institute for Neuroscience, The University of Texas at Austin, Austin, TX, United States.
Bipolar Disorder Center, Department of Psychiatry and Behavioral Sciences, Dell Medical School, Austin, TX, United States.
Front Psychiatry. 2025 Jan 30;16:1547230. doi: 10.3389/fpsyt.2025.1547230. eCollection 2025.
Converging evidence suggests that bipolar disorder (BD) involves mitochondrial dysfunction and prefrontal cortex (PFC) hypometabolism associated with cognitive impairment, which persists in remitted BD individuals. Transcranial infrared laser stimulation (TILS) provides safe, non-invasive brain stimulation that enhances PFC metabolism via photobiomodulation of mitochondrial respiration and tissue oxygenation. We tested the hypothesis that the neurocognitive deficits found in BD may be ameliorated by TILS treatments.
This is the first study to explore neurocognitive effects of repeated TILS administration in BD. Using an open-label design, 29 individuals with remitted BD received six weekly TILS treatments. Working memory and attention were assessed with trail-making and 2-back tasks sensitive to TILS cognitive effects in individuals with BD. Changes in PFC network interactions were measured with functional near-infrared spectroscopy (fNIRS) because this method can measure TILS effects on oxygen metabolism in the PFC of individuals with BD.
Participants reported no adverse effects from treatment, confirming the safety of this intervention in individuals with BD. Cognitive test results showed that in people with remitted BD, TILS was effective at improving cognition, i.e., enhanced speed and accuracy in tasks reflecting cognitive flexibility, working memory, and attentional control. Antipsychotic medication improved TILS cognitive effects. The fNIRS results showed a significant reduction in PFC network correlations of oxygenated hemoglobin changes driven by cognitive task performance. The right-hemisphere frontopolar cortex showed greater TILS effects than its left-hemisphere counterpart.
Repeated TILS is a safe intervention to improve cognition in people with remitted BD. Continued antipsychotic medication may have contributed to the cognitive improvement. To confirm TILS efficacy, a sham-controlled, double-blinded randomized trial is needed.
https://clinicaltrials.gov/, identifier NCT05354895.
越来越多的证据表明，双相情感障碍（BD）涉及线粒体功能障碍和前额叶皮质（PFC）代谢减退，这与认知障碍相关，且在BD缓解期个体中持续存在。经颅红外激光刺激（TILS）提供了一种安全、非侵入性的脑刺激，可通过对线粒体呼吸和组织氧合的光生物调节来增强PFC代谢。我们检验了这样一个假设，即BD中发现的神经认知缺陷可能通过TILS治疗得到改善。
这是第一项探索重复给予TILS对BD神经认知影响的研究。采用开放标签设计，29名BD缓解期个体接受了为期六周的每周一次TILS治疗。使用对BD个体的TILS认知效应敏感的连线测验和2-back任务评估工作记忆和注意力。用功能近红外光谱（fNIRS）测量PFC网络相互作用的变化，因为该方法可以测量TILS对BD个体PFC氧代谢的影响。
参与者报告治疗无不良反应，证实了该干预措施对BD个体的安全性。认知测试结果表明，在BD缓解期个体中，TILS能有效改善认知，即在反映认知灵活性、工作记忆和注意力控制的任务中提高速度和准确性。抗精神病药物可增强TILS改善认知的效果。fNIRS结果显示，由认知任务表现驱动的氧合血红蛋白变化的PFC网络相关性显著降低。右侧额极皮质的TILS效应大于左侧。
重复TILS是改善BD缓解期个体认知的一种安全干预措施。持续使用抗精神病药物可能有助于认知改善。为证实TILS的疗效，需要进行一项假对照、双盲随机试验。
