We have reported previously on the efficacy of LLLT for the reduction of tonic muscle spasms in cerebral palsy patients and for the prevention of femoral head necrosis in pediatric patients. (1,2) One of the mechanisms of the efficacy of LLLT is thought to be through improvement of tissue blood perfusion, and we have reported thermographic changes showing an increase in skin temperature following LLLT in cerebral palsy cases. (3,4) Currently there are many reported methods in the LLLT field concerning parameters, such as the point of laser irradiation, output power, or power desnity, and irradiation time or energy density/dose. In order to objectively assess the difference in response of in vivo blood flow changes according to different laser parameters, we used non-invasive Doppler ultrasound color flow imaging and observed changes in the blood flow of the common carotid arteries following irradiation with different LLLT parameters, at the same time using the same diagnostic ultrasound system to measure diameter and cross-sectional area of the vessels.
Subjects and MethodsTwelve spastic cerebral palsy patients, 7 males and 5 females, were enrolled in this study. The ages of the patients ranged from 15 to 18 years old with an average age of 16. The diagnostic ultrasound device used was the Prosound SSD-3500, (Aloka Co., Ltd., Tokyo, Japan) with a 29 mm wide superficial electronic linear probe attached (Fig. 1). Patients were placed in the supine position and long axis images of the bilateral common carotid arteries were obtained where the image of the vessel walls became parallel. Images of the systolic period were recorded and used for measurements. (Fig. 2) The laser used was a gallium aluminum arsenide (GaAlAs) diode laser, JQ305, (Minato Medical Science, Co., Ltd., Japan) giving output powers in continuous 127 There are several reports on improvement of blood flow following LLLT, and reports on actual vessel dilatation and blood flow enhancement has been observed in animal models. However there are no reports on changes in blood flow observed in human subjects using a non-invasive method for any duration of time. In this study, we used non-invasive Doppler color flow imaging to observe changes in the blood flow of the common carotid artery following laser irradiation to the lateral neck region. Laser output-and dose-dependent differences in the blood flow were observed, but there was also an increase in the diameter and cross-sectional area of vessels. Increased blood flow was noted in the common carotid artery of both the irradiated and unirradiated side, which lasted for over 1 hour after laser irradiation. The maximum increase in the crosssectional area, vessel diameter and the blood flow on the irradiated side were 69%, 31% and 63% respectively. On the unirradiated side the maximum increase of the cross-sectional area, vessel diameter and blood flow were 52%, 21% and 71% respectively. There were no changes observed in the maximum, minimum or average blood flow velocity of either the irradiated or unir...