Research Reports - Treatments for traumatic brain injury with emphasis on transcranial near-infrared laser phototherapy

Neuropsychiatr Dis Treat. 2015 Aug 20;11:2159-75. doi: 10.2147/NDT.S65809.
eCollection 2015.

Morries LD(1), Cassano P(2), Henderson TA(3).

Traumatic brain injury (TBI) is a growing health concern affecting civilians and
military personnel. In this review, treatments for the chronic TBI patient are
discussed, including pharmaceuticals, nutraceuticals, cognitive therapy, and
hyperbaric oxygen therapy. All available literature suggests a marginal benefit
with prolonged treatment courses. An emerging modality of treatment is
near-infrared (NIR) light, which has benefit in animal models of stroke, spinal
cord injury, optic nerve injury, and TBI, and in human trials for stroke and TBI.
The extant literature is confounded by variable degrees of efficacy and a
bewildering array of treatment parameters. Some data indicate that diodes
emitting low-level NIR energy often have failed to demonstrate therapeutic
efficacy, perhaps due to failing to deliver sufficient radiant energy to the
necessary depth. As part of this review, we present a retrospective case series
using high-power NIR laser phototherapy with a Class IV laser to treat TBI. We
demonstrate greater clinical efficacy with higher fluence, in contrast to the
bimodal model of efficacy previously proposed. In ten patients with chronic TBI
(average time since injury 9.3 years) given ten treatments over the course of 2
months using a high-power NIR laser (13.2 W/0.89 cm(2) at 810 nm or 9 W/0.89
cm(2) at 810 nm and 980 nm), symptoms of headache, sleep disturbance, cognition,
mood dysregulation, anxiety, and irritability improved. Symptoms were monitored
by depression scales and a novel patient diary system specifically designed for
this study. NIR light in the power range of 10-15 W at 810 nm and 980 nm can
safely and effectively treat chronic symptoms of TBI. The clinical benefit and
effects of infrared phototherapy on mitochondrial function and secondary
molecular events are discussed in the context of adequate radiant energy
penetration.

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