Effects of intravascular photobiomodulation on cognitive impairment and crossed cerebellar diaschisis in patients with traumatic brain injury: a longitudinal study

Abstract

The association between intravascular photobiomodulation (iPBM) and crossed cerebellar diaschisis (CCD) and cognitive dysfunction in patients with traumatic brain injury (TBI) remains unknown. We postulate that iPBM might enable greater neurologic improvements. The objective of this study was to evaluate the clinical impact of iPBM on the prognosis of patients with TBI. In this longitudinal study, patients who were diagnosed with TBI were recruited. CCD was identified from brain perfusion images when the uptake difference of both cerebella was > 20%. Thus, two groups were identified: CCD( +) and CCD( −). All patients received general traditional physical therapy and three courses of iPBM (helium–neon laser illuminator, 632.8 nm). Treatment assemblies were conducted on weekdays for 2 consecutive weeks as a solitary treatment course. Three courses of iPBM were performed over 2–3 months, with 1–3 weeks of rest between each course. The outcomes were measured using the Rancho Los Amigos Levels of Cognitive Functioning (LCF) tool. The chi-square test was used to compare categorical variables. Generalized estimating equations were used to verify the associations of various effects between the two groups. p < 0.05 indicated a statistically significant difference. Thirty patients were included and classified into the CCD( +) and CCD( −) groups (n = 15, each group). Statistics showed that before iPBM, CCD in the CCD( +) group was 2.74 (exp 1.0081) times higher than that of CCD( −) group (p = 0.1632). After iPBM, the CCD was 0.64 (exp-0.4436) times lower in the CCD( +) group than in the CCD( −) group (p < 0.0001). Cognitive assessment revealed that, before iPBM, the CCD( +) group had a non-significantly 0.1030 lower LCF score than that of CCD( −) group (p = 0.1632). Similarly, the CCD( +) group had a non-significantly 0.0013 higher score than that of CCD( −) after iPBM treatment (p = 0.7041), indicating no significant differences between the CCD( +) or CCD( −) following iPBM and general physical therapy. CCD was less likely to appear in iPBM-treated patients. Additionally, iPBM was not associated with LCF score. Administration of iPBM could be applied in TBI patients to reduce the occurrence of CCD. The study failed to show differences in cognitive function after iPBM, which still serves as an alternative non-pharmacological intervention.

Intravascular laser irradiation of blood as novel migraine treatment: an observational study

“…Despite these benefits, ILIB has not been used to treat migraine. Our previous case report showed that ILIB could improve perfusion of the contralateral cerebellum during diaschisis after an ischemic stroke event [ 17 ], or traumatic brain injury [ 14 ], and improve sleep quality in patients with musculoskeletal pain [ 18 , 19 ]. In the current study, we demonstrated ILIB-associated improvements in pain, cognition, disability, insomnia, and rCBF in patients with migraine.…”

“…Laser power intensity was 0.51–2.55 W/cm 2 , energy was 3.6–18 J, and energy density was 1836.73–9183.67 J/cm 2 . Power intensity was adjusted based on the patient’s clinical responses [ 14 ]. Specifically: (1) Initial Dosage Setting Based on BMI: The starting output dosage for the laser was determined by the patient's body mass index (BMI).…”

Effects of Intravascular Photobiomodulation on Insomnia, Muscle Soreness, and Biochemistry Profiles: An Eight-Year Retrospective Cohort

“…This approach ensured that almost 100% of the total blood volume was irradiated during each 60 min session. The mean transit time from the regional arm to the brain was less than 30 s, indicating that all the blood was likely irradiated during each session [ 35 ]. Although the iPBM treatment required the insertion of a catheter into a vein, it was generally considered a minimally invasive procedure because it did not require any incisions or major surgical interventions.…”

Transcranial Photobiomodulation in Neurological and Psychiatric Practice: Fundamental and Clinical Aspects

“…1 | is extremely wide and includes neurological [1-3, 8, 17, 31, 39], traumatological and orthopedic [5,48], ophthalmological pathology [20], a number of psychiatric diseases [6,9,11,21,29,33] and others. In addition, there is information in the literature about the positive experience of using PBM technology in dentistry [37], regenerative medicine (in particular, for the treatment of wounds of various origins [7], the treatment of alopecia [24] and stimulation of osteogenesis [18]) and post-traumatic conditions [10,23,30,[34][35][36], sports medicine [4,19,28] and even the treatment of some forms of cancer [25]. Such an extensive range of clinical applications of the technology is due to the diverse effects of photobiomodulation, however, for a full understanding of the pathogenetic mechanisms of its action and targeted inclusion of the method in clinical recommendations, further disclosure of both fundamental aspects of the problem and large-scale clinical testing of the technology in various categories of patients is necessary.…”

“…A separate area of application of the technology is post-stroke rehabilitation, which promotes accelerated recovery of speech functions and verbal skills [2]. A number of publications are devoted to the effectiveness of using the method in the treatment of patients with traumatic brain injury [10,23,30,[34][35][36]38]. The authors note a decrease in the severity of headache, sleep disorders, accelerated normalization of cognitive functions, elimination of symptoms of depression, anxiety and irritability.…”