Transcranial near-infrared light therapy improves motor function following embolic strokes in rabbits: An extended therapeutic window study using continuous and pulse frequency delivery modes

Lapchak, Paul A.; Salgado, Karmen F.; Chao, Cehng; Zivin, Justin A.

doi:10.1016/j.neuroscience.2007.07.002

Cited by 122 publications

(105 citation statements)

References 25 publications

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“…839 The postulated mechanism of action is photobiostimulation, with near-infrared radiation absorbed by mitochondrial chromophores, which accelerates enzymatic activity, increases adenosine triphosphate production, and promotes tissue preservation in the ischemic penumbra and enhanced neurorecovery. [840][841][842] Evidence of benefit in animal models [843][844][845][846] led to a safety and preliminary efficacy trial in 120 patients with acute ischemic stroke, which demonstrated statistically better outcomes in the treated patients as measured by the NIHSS, mRS, Barthel index, and Glasgow Outcome Scale. 847 A confirmatory trial enrolling 660 patients reported a positive trend but not a definitive benefit, and an additional pivotal trial using refined selection criteria is planned.…”

Section: Near-infrared Laser Therapymentioning

confidence: 99%

Guidelines for the Early Management of Patients With Acute Ischemic Stroke

Jauch¹,

Saver²,

Adams³

et al. 2013

Stroke

5,336

1,801

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Background and Purpose-The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators responsible for the care of acute ischemic stroke patients within the first 48 hours from stroke onset. These guidelines supersede the prior 2007 guidelines and 2009 updates. Methods-Members of the writing committee were appointed by the American Stroke Association Stroke Council's Scientific Statement Oversight Committee, representing various areas of medical expertise. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Panel members were assigned topics relevant to their areas of expertise, reviewed the stroke literature with emphasis on publications since the prior guidelines, and drafted recommendations in accordance with the American Heart Association Stroke Council's Level of Evidence grading algorithm. Results-The goal of these guidelines is to limit the morbidity and mortality associated with stroke. The guidelines support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit. The guideline discusses early stroke evaluation and general medical care, as well as ischemic stroke, specific interventions such as reperfusion strategies, and general physiological optimization for cerebral resuscitation. The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest. Guidelines for the Early Management of PatientsThis statement was approved by the American Heart Association Science Advisory and Coordinating Committee on December 12, 2012. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.The Executive Summary is available as an online-only Data Supplement with this article at http://stroke.ahajournals.org/lookup/suppl/ doi:10.1161/STR.0b013e318284056a/-/DC1.The American Heart Association requests that this document be cited as follows: Jauch EC, Saver JL, Adams HP Jr, Bruno A, Connors JJ, Demaerschalk BM, Khatri P, McMullan PW Jr, Qureshi AI, Rosenfield K, Scott PA, Summers DR, Wang DZ, Wintermark M, Yonas H; on behalf of the American Heart Association Stroke Council, Council on Cardio...

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Section: Near-infrared Laser Therapymentioning

confidence: 99%

Guidelines for the Early Management of Patients With Acute Ischemic Stroke

Jauch¹,

Saver²,

Adams³

et al. 2013

Stroke

5,336

1,801

View full text Add to dashboard Cite

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“…All surgical, embolization, and histological procedures were done as described previously. [7][8][9]17,22,26 The Department of Veterans Affairs and Institutional Animal Care and Use Committee approved the surgical and treatment procedures used in this study. Extreme care was used throughout the study to minimize pain and discomfort.…”

Section: Animals and Animal Welfarementioning

confidence: 99%

“…The animals were allowed to recover from anesthesia for at least 2 hours before embolization. [7][8][9]17,22,26 Emboli were prepared by withdrawing 2 to 4 mL of arterial blood from a single donor rabbit. Because the studies had a 24-hour end point, there was no concern for immunogenicity of blood clots prepared from a single donor rabbit that were subsequently used in the experiment for a group of rabbits on a particular experiment day.…”

Section: Surgery and Embolizationmentioning

confidence: 99%

“…[7][8][9] The rodent studies using a rat middle cerebral artery occlusion model showed that laser therapy administered 24 hours after the start of occlusion resulted in significant behavioral improvement measured 28 days after the stroke, 10 an effect of TLT that may be independent of neuronal restoration or survival. In addition, rabbit studies showed that TLT could improve behavioral performance for up to 21 days after embolization if treatment was initiated up to 6 hours after a stroke.…”

mentioning

confidence: 99%

“…In addition, rabbit studies showed that TLT could improve behavioral performance for up to 21 days after embolization if treatment was initiated up to 6 hours after a stroke. 8,9 Thus, preclinical studies in 2 species using 2 methods of ischemia induction established that TLT could significantly improve behavioral outcome.…”

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confidence: 99%

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Safety Profile of Transcranial Near-Infrared Laser Therapy Administered in Combination With Thrombolytic Therapy to Embolized Rabbits

Lapchak

Han

Salgado

et al. 2008

Stroke

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Background and Purpose-Transcranial near-infrared laser therapy (TLT) is currently under investigation in a pivotal clinical trial that excludes thrombolytic therapy. To determine if combining tissue plasminogen activator (tPA; Alteplase) and TLT is safe, this study assessed the safety profile of TLT administered alone and in combination with Alteplase. The purpose for this study is to determine if the combination of TLT and thrombolysis should be investigated further in a human clinical trial. Methods-We determined whether postembolization treatment with TLT in the absence or presence of tPA would affect measures of hemorrhage or survival after large clot embolism-induced strokes in New Zealand white rabbits. Results-TLT did not significantly alter hemorrhage incidence after embolization, but there was a trend for a modest reduction of hemorrhage volume (by 65%) in the TLT-treated group compared with controls. Intravenous administration of tPA, using an optimized dosing regimen, significantly increased hemorrhage incidence by 160%. The tPA-induced increase in hemorrhage incidence was not significantly affected by TLT, although there was a 30% decrease in hemorrhage incidence in combination-treated rabbits. There was no effect of TLT on hemorrhage volume measured in tPA-treated rabbits and no effect of any treatment on 24-hour survival rate. Conclusion-In the embolism model, TLT administration did not affect the tPA-induced increase in hemorrhage incidence.TLT may be administered safely either alone or in combination with tPA because neither treatment affected hemorrhage incidence or volume. Our results support the study of TLT in combination with Alteplase in patients with stroke.

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Laser Treatment of Cerebral Ischemia

Huang

Arce

Taboada

et al. 2012

Handbook of Biophotonics

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The continued absence of any new pharmaceutical therapies for stroke has led researchers to test innovative approaches such as transcranial laser therapy. This approach is based upon a large body of knowledge gained from low‐level laser (light) therapy (LLLT) used for wound healing, pain relief and reduction of inflammation. Near‐infrared light (particularly 810 nm) shone on the head can penetrate into the brain where it can prevent neurons from dying, reduce inflammation, increase angiogenesis and stimulate neural progenitor cells to repair the lesion. This hypothesis has been tested in animal models of ischemic stroke created in rats and rabbits, with impressive results. Two clinical trials of stroke treated with a single transcranial exposure to 810 nm laser have been carried out with encouraging results. Laser therapy for stroke has the potential to become the treatment of choice for this dread disease.

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Transcranial near-infrared light therapy improves motor function following embolic strokes in rabbits: An extended therapeutic window study using continuous and pulse frequency delivery modes

Cited by 122 publications

References 25 publications

Guidelines for the Early Management of Patients With Acute Ischemic Stroke

Guidelines for the Early Management of Patients With Acute Ischemic Stroke

Safety Profile of Transcranial Near-Infrared Laser Therapy Administered in Combination With Thrombolytic Therapy to Embolized Rabbits

Laser Treatment of Cerebral Ischemia

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