Journal
JOURNAL OF NEUROTRAUMA
Volume 31, Issue 11, Pages 1008-1017Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/neu.2013.3244
Keywords
executive function; mTBI; photobiomodulation; treatment for mTBI
Funding
- Clinical Sciences Research and Development, Department of Veterans Affairs
- United States National Institutes of Health (NIH) [R01AI050875]
- American Medical Society for Sports Medicine (AMSSM) Young Investigator Award
- American College of Sports Medicine-American Medical Society for Sports Medicine Foundation Award
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This pilot, open-protocol study examined whether scalp application of red and near-infrared (NIR) light-emitting diodes (LED) could improve cognition in patients with chronic, mild traumatic brain injury (mTBI). Application of red/NIR light improves mitochondrial function (especially in hypoxic/compromised cells) promoting increased adenosine triphosphate (ATP) important for cellular metabolism. Nitric oxide is released locally, increasing regional cerebral blood flow. LED therapy is noninvasive, painless, and non-thermal (cleared by the United States Food and Drug Administration [FDA], an insignificant risk device). Eleven chronic, mTBI participants (26-62 years of age, 6 males) with nonpenetrating brain injury and persistent cognitive dysfunction were treated for 18 outpatient sessions (Monday, Wednesday, Friday, for 6 weeks), starting at 10 months to 8 years post-mTBI (motor vehicle accident [MVA] or sports-related; and one participant, improvised explosive device [IED] blast injury). Four had a history of multiple concussions. Each LED cluster head (5.35 cm diameter, 500mW, 22.2 mW/cm(2)) was applied for 10 min to each of 11 scalp placements (13 J/cm(2)). LEDs were placed on the midline from front-to-back hairline; and bilaterally on frontal, parietal, and temporal areas. Neuropsychological testing was performed pre-LED, and at 1 week, and 1 and 2 months after the 18th treatment. A significant linear trend was observed for the effect of LED treatment over time for the Stroop test for Executive Function, Trial 3 inhibition (p = 0.004); Stroop, Trial 4 inhibition switching (p = 0.003); California Verbal Learning Test (CVLT)-II, Total Trials 1-5 (p = 0.003); and CVLT-II, Long Delay Free Recall (p = 0.006). Participants reported improved sleep, and fewer post-traumatic stress disorder (PTSD) symptoms, if present. Participants and family reported better ability to perform social, interpersonal, and occupational functions. These open-protocol data suggest that placebo-controlled studies are warranted.
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