Therapeutic potential of intranasal photobiomodulation therapy for neurological and neuropsychiatric disorders: a narrative review

Abstract

The application of photobiomodulation therapy (PBMT) for neuronal stimulation is studied in different animal models and in humans, and has shown to improve cerebral metabolic activity and blood flow, and provide neuroprotection via anti-inflammatory and antioxidant pathways. Recently, intranasal PBMT (i-PBMT) has become an attractive and potential method for the treatment of brain conditions. Herein, we provide a summary of different intranasal light delivery approaches including a nostril-based portable method and implanted deep-nasal methods for the effective systemic or direct irradiation of the brain. Nostril-based i-PBMT devices are available, using either lasers or light emitting diodes (LEDs), and can be applied either alone or in combination to transcranial devices (the latter applied directly to the scalp) to treat a wide range of brain conditions such as mild cognitive impairment, Alzheimer’s disease, Parkinson’s disease, cerebrovascular diseases, depression and anxiety as well as insomnia. Evidence shows that nostril-based i-PBMT improves blood rheology and cerebral blood flow, so that, without needing to puncture blood vessels, i-PBMT may have equivalent results to a peripheral intravenous laser irradiation procedure. Up to now, no studies were conducted to implant PBMT light sources deep within the nose in a clinical setting, but simulation studies suggest that deep-nasal PBMT via cribriform plate and sphenoid sinus might be an effective method to deliver light to the ventromedial part of the prefrontal and orbitofrontal cortex. Home-based i-PBMT, using inexpensive LED applicators, has potential as a novel approach for neurorehabilitation; comparative studies also testing sham, and transcranial PBMT are warranted.

Transcranial Photobiomodulation to Improve Cognition in Gulf War Illness

“…Since all subjects in each group wore the goggles, it is possible that the green color perceived through the goggles had a modulating effect on the cortical activation associated with pain in migraine, in accordance with the literature ( 101 – 103 ). In addition, the red photons from the red intranasal may have improved blood circulation, improving their migraines ( 63 , 64 ).…”

“…Four dementia patients using NIR intranasal plus tLED at home, three times per week for 12 weeks, also observed cognitive improvement ( 57 ). Application of red intranasal PBM has been observed to improve blood rheology (blood viscosity, plasma viscosity, redox viscosity and red blood cell aggregation), and improve cholesterol levels (blood lipid total cholesterol and low/high-density lipoprotein cholesterol) in patients with coronary heart disease and cerebral infarction ( 63 , 64 ).…”

Impacto terapêutico da fotobiomodulação no tratamento da doença de Alzheimer: Uma revisão integrativa

“…A i-PBM é ministrada pelas narinas ou via cavidades nasais, através de uma ou duas sondas pequenas composta por laser/LED, cujos efeitos estão relacionados a melhora das disfunções neuronais, como por exemplo, a DA (Saltmarche, et al, 2017;Chao, 2019 (Hamblin, 2016b, Hennessy, Hamblin, 2016. Além desses efeitos, a i-PBM pode ainda liberar óxido nítrico (NO) e modular a formação de espécie reativas de oxigênio (ERO), o que explica sua ação neuro protetora (Salehpour et al, 2020) e resultados positivos das funções executivas e atividades da vida diária. Todos os métodos de PBM aplicados nos estudos apresentam resultados importantes no controle das perdas das funções cognitivas, porém não se pode afirmar qual a melhor dosagem quanto ao comprimento de onda, densidade de potência e duração da exposição, embora os estudos aqui apresentados usarem especificações bastante próximas.…”

Biophotonic Strategies of Measurement and Stimulation of the Cranial and the Extracranial Lymphatic Drainage Function

“…The successful clinically application of ILILT for therapy of the brain diseases shown in several studies. ILILT is used for treatment of patients with Alzheimer' disease [129] and improves insomnia problems [130]- [132]. The mechanisms of therapeutic effects of ILILT are not clear, but there is evidence that ILILT modulates blood circulation and drainage function of the lymphatic system [133].…”