Read the Research for Specific Conditions:

Shining Light On the Head: Photobiomodulation for Brain Disorders

AUTHORS: Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA.
Department of Dermatology, Harvard Medical School, Boston, MA.
Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA 02139, USA

Read and download the entire article here.

CONCLUSIONS AND IMPLICATIONS OF FUTURE THERAPY
The brain suffers from many different disorders that can be classified into three broad groupings: traumatic events (stroke, traumatic brain injury, and global ischemia), degenerative diseases (dementia, Alzheimer’s, and Parkinson’s), and psychiatric disorders (depression, anxiety, post-traumatic stress disorder). There is some evidence that all these seemingly diverse conditions can be beneficially affected by applying light to the head. There is even the possibility that PBM could be used for cognitive enhancement in normal healthy people. 

Many investigators believe that PBM for brain disorders will become one of the most important medical applications of light therapy in the coming years and decades. Despite the efforts of “Big Pharma”, prescription drugs for psychiatric disorders are not generally regarded very highly (either by the medical profession or by the public), and many of these drugs perform little better than placebos in different trials, and moreover can also have major side-effects. Even after many years of research, no drug has yet been developed to benefit these neurodegenerative disorders. A similar state of play exists with drugs for stroke (with the exception of clot-busting enzymes) and TBI. New indications for tPBM such as global ischemia (brain damage after a heart attack), post-operative cognitive dysfunction, and neurodevelopmental disorders such as autism spectrum disorder may well emerge. Table 2 shows the wide range of brain disorders and diseases that may eventually be treated by some kind of tPBM, whether that be an office/clinic-based procedure or a home-use based device. 

The Potential of Near-Infrared Light Therapy in Alzheimer’s and Parkinson’s Disease.

AUTHORS: Daniel M. Johnstone 1, Cécile Moro 2, Jonathan Stone 1, Alim-Louis Benabid 2 and John Mitrofanis 2* 1 Department of Physiology, University of Sydney, Sydney, NSW, Australia, 2 University Grenoble Alpes, CEA, LETI, CLINATEC, MINATEC Campus, Grenoble, France, 3 Department of Anatomy, University of Sydney, Sydney, NSW, Australia

This article is a review of many research studies. Read and download the entire article here.

CONCLUSIONS AND IMPLICATIONS OF FUTURE THERAPY
Although in its infancy, with the bulk of results still at the pre-clinical “proof of concept” stage, NIr (Near-infrared) therapy has the potential to develop into a safe and effective neuroprotective treatment for patients with Alzheimer’s and Parkinson’s disease (and presumably other neurodegenerative diseases such multiple sclerosis and amyotrophic lateral sclerosis). If NIr was applied at early stages of the disease process, for example at first diagnosis, it could potentially slow further progression by protecting neurons from death. Consequently, over time, the greater neuronal survival would lessen the clinical signs and symptoms. Further, NIr therapy—because of its lack of side-effects and neuroprotective potential—is amenable to use in conjunction with other treatments. For example, patients may have NIr therapy with a reduced dosage of drugs as a first line treatment; the potential neuroprotective effect oF NIr could prolong the efficacy of the drug therapy. Further, in Parkinson’s patients selected for deep brain stimulation, they may also have an NIr optical fiber implanted surgically at the same time, thereby potentially offering neuroprotection of the remaining dopaminergic cells. There is much to do in further developing this treatment, but the therapeutic possibilities are many and the potential outcomes very exciting. We await the outcomes of major clinical trials using NIr therapy on these patients with much anticipation.

AUTHORS: Raj Gupta, MD, PhD–Director, Ultra-high Resolution Volume CT Lab, Director, Advanced X-ray Imaging Sciences (AXIS) Center, Associate Professor of Radiology, Harvard Medical School. Benjamin Vakoc, PhD, Wellman Center for Photomedicine at Massachusetts General Hospital

CONCLUSIONS AND IMPLICATIONS OF FUTURE THERAPY
Researchers found that they could measure the effects of transcranial LLLT on the brain. The MRI studies showed statistically significant differences in the integrity of myelin surrounding the neurons of treated patients versus the control group. The study also showed the light does impact the cells. In conclusion, the findings indicate that light therapy is safe and has measurable effects on the brain, and could become the first widely accepted treatment for moderate traumatic brain injury.

AUTHORS: John Mitrofanis, Luke A. Henderson Department of Anatomy, School of Medical Sciences, University of Sydney, Sydney, Australia

CONCLUSIONS AND IMPLICATIONS OF FUTURE THERAPY: In conclusion, light has a considerable influence on brain activity. It does so by stimulating mitochondrial function within individual neurons either by an activation of cytochrome c oxidase, a change in the composition of interfacial water, and/or a stimulation of any accumulated chlorophyll metabolites. When light hits the neurons “flush”, it activates various intrinsic cellular mechanisms. Light is absorbed by a chromophore (accumulated chlorophyll metabolites, interfacial nanowater and/or cytochrome c oxidase) that then prompts mitochondrial activity and hence ATP levels. Such an interaction, between light and mitochondria, helps to preserve the homeostasis of neurons, maintaining their proper function when in a healthy state or aiding their survival when in distress or after damage (Hamblin, 2016; Mitrofanis, 2019). As to why light, from a transcranial approach, influences the neurons of the default mode network, we suggest that there are evolutionary links, relating to a survival strategy for the organism against any potentially threatening or dangerous situation.

Read and download the entire article here.

AUTHOR: Ali Le Vere

This article references over 29 different studies.

CONCLUSION: Contrary to conventional wisdom, brain regeneration is possible. One promising therapy that promotes neurogenesis and is effective in pre-clinical studies of Alzheimer’s and Parkinson’s is near-infrared light therapy, and it may improve other mental illnesses and neurodegenerative disorders including dementia, stroke, ALS, and traumatic brain injury as well.

Given its large margin of safety and lack of adverse effects, near-infrared light therapy should be offered as an option for patients suffering from a myriad of chronic conditions, but is especially promising for neurodegenerative diseases including Alzheimer’s and Parkinson’s and may even have future use in multiple sclerosis. Near-infrared therapy is superior to the mainstay drug treatments for these diseases since pre-clinical studies have demonstrated proof-of-concept that near-infrared either arrests or slows the underlying pathology of these disease processes and leads to the birth of new neurons, rather than merely mitigating symptoms (10).

Read and download the entire article here.

Photobiomodulation for Alzheimer’s Disease: Has the Light Dawned?

AUTHORS: Michael R. Hamblin (with 158 documented references)

Read and download the entire article here.

CONCLUSIONS AND IMPLICATIONS OF FUTURE THERAPY

The fact that PBMT may produce a large range of beneficial changes in the brain, and is without any major side effects, suggests it should be more widely tested for AD and dementia in large controlled trials. Exposing the head to light at power levels less than that received in direct sunlight (but without harmful ultraviolet wavelengths) is intrinsically safe. Any side-effects reported have been rare, mild, and transient, consisting of a slight headache, difficulty sleeping, and mild itching on the scalp. It is likely that PBM for AD will need to be continued indefinitely, as regressions have been observed when PBM treatments have ceased. Home use PBM devices can be applied by caregivers, who consistently report improvements in their own quality of life.

Why and how does light therapy offer neuroprotection in Parkinson’s disease?

Accepted 2017 Mar 27.
Copyright : © Neural Regeneration Research

Author: John Mitrofanis, Ph.D.^*
Department of Anatomy F13, University of Sydney, Sydney, Australia

Conclusions: Light therapy stimulates a bespoke intrinsic mechanism that gives the neuron the best chance of survival (Hamblin, 2016) – this is exemplified further by findings indicating that patterns of neuronal survival are similar whether the light is applied either at the same time or well after the injury (Johnstone et al., 2016). That light not only helps to defend and protect healthy neurons against degeneration but also to repair and rescue distressed neurons after injury. The repair and rescue of distressed neurons are particularly relevant to the clinical reality of Parkinson’s disease, where patients first suffer degeneration and then receive therapeutic intervention. As it stands, light therapy in the experimental setting has been shown to both protect and rescue neurons from degeneration after Parkinsonian injury, something that current therapies in patients do not do; that in itself, should be an incentive for trial in the clinical setting.

A Randomized Clinical Trial of the Effectiveness of Photon Stimulation on Pain, Sensation, and Quality of Life in Patients With Diabetic Peripheral Neuropathy

Arthur Swislocki, MD, Marla Orth, MS, MPH, Maurice Bales, AA,
Jennifer Weisshaupt, BA, Claudia West, RN, MS, Janet Edrington, RN, PhD,
Bruce Cooper, PhD, Len Saputo, MD, Melissa Islas, MD,
and Christine Miaskowski, RN, PhD, FAAN

Department of Medicine, Veterans Affairs Northern California Health Care System (A.S., M.O., M.B.,
J.W., M.I.), Martinez; Departments of Physiological Nursing (C.W., J.E., C.M.) and Community
Health Systems (B.C.) University of California, San Francisco; and Health Medicine Institute (L.S.), Lafayette, California, USA

ABSTRACT: Context. Peripheral neuropathy is one of the most common complications of diabetes.

Objectives. The purpose of this study was to evaluate the effects of photon stimulation on pain intensity, pain relief, pain qualities, and sensation and quality of life (QOL) in patients with painful diabetic peripheral neuropathy.

Methods. In this randomized, placebo-controlled trial, patients were assigned to receive either four photon stimulations (n . 63) or four placebo (n . 58) treatments. Pain intensity, pain relief, and pain qualities were assessed using self report questionnaires. Sensation was evaluated using monofilament testing. QOL was measured using the Medical Outcomes Study Short Form-36 (SF-36). Multilevel regression model analyses were used to evaluate between-group differences in study outcomes.

Results. No differences, over time, in any pain intensity scores (i.e., pain intensity immediately posttreatment, average pain, worst pain) or pain relief scores were found between the placebo and treatment groups. However, significant decreases, over time, were found in some pain quality scores, and significant improvements in sensation were found in patients who received the photon stimulation compared with placebo. In addition, patients in the treatment group reported significant improvements in SF-36 social functioning and mental health scores. Findings from a responder analysis demonstrated that no differences were found in the percentages of patients in the placebo and treatment groups who received 30% or more or 50% or more reduction in pain scores immediately posttreatment. However, significant differences were found in the distribution of the changes in pain relief scores, with most of the patients in the photon stimulation group reporting a slight (28.6%) to moderate (34.9%) improvement in pain relief from the beginning to the end of the study compared with no change in pain relief (43.1%) in the placebo group.

Conclusions.  Four treatments with photon stimulation resulted in significant improvements in some pain qualities, sensation, and QOL outcomes in a sample of patients with a significant amount of pain and disability from their diabetes. A longer duration study is needed to further refine the photon stimulation treatment protocol in these chronically ill patients and to evaluate the sustainability of its effects. J Pain Symptom Manage 2009;- :-e- . 2009 U.S.

Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Thermal Imaging Processor (TIP) & Photon Stimulation: A New Form of Therapy for Chronic Diabetic Medical Painful Neuropathy of the Feet

by Jacob Green, M.D., Ph.D., Earl Horowitz, D.P.M., Deborah Fralicker, R.N., D.C., William Clewell, Ph.D., George Ossi, B.S., Aerospace Minnie Briley, C.M.E.T. and Tim Luce

B.S. Pain Digest, September/October 1999, Volume 9, Number 5

ABSTRACT: Diabetic neuropathy is a common, significant, and painful condition that does not readily lend itself to simplified Photonic therapy. Patients with painful diabetic neuropathy were treated with a new entity, i.e., a photon stimulator, and this device is described. Patients and control subjects were all assessed by physiological means (high-resolution digital infrared imaging)before and after all therapy. Patients were all given the opportunity to express their own opinions as to the efficacy of treatment outcomes via use of the standard visual analogue scale (VAS). The results are noted.

Infrared Photon Stimulation: A New Form of Chronic Pain Therapy

by Jacob Green, M.D., Deborah Fralicker, R.N., D.C., William Clewell, Ph.D., Earl Horowitz, D.P.M., Tim Luce, B.S., Victor Yannacone, L.L.B., and Constance Haber, D.C.

ABSTRACT: Three diverse problems were studied, the first of which was “chronic painful diabetic neuropathy.” This was typified by cold, painful feet. Photon therapy over the acupuncture sites and over the afflicted area resulted in increased temperature and amelioration of pain in many patients. In addition, it was noted that those who became temperature coherent (we noted a wide dispersion of recorded temperatures in symptomatic patients) were associated with better assessment of the technique by the patient.The second group of “chronic myofascial pain” syndrome patients typically demonstrated an increased are of temperature in the skin, were also treated by utilization of typical acupuncture points. For the most part, clinical improvement in pain ratings were noted associated with decreased skin temperature in affected areas becoming side-to-side coherent over time. A third patient with complex regional pain syndrome type II was also treated with this technology with clinical improvement in his previously dramatically reduced skin temperature without admission of any basic symptom change. It is felt that the infrared energy creates a change in the potentiostatic electrochemical process which invokes a non-local coupling reaction in the body’s electrical system. This would also indicate a new anatomical designation of acupuncture treatment points in correspondence with the older nomenclature which was often misleading.This is the first overall reporting of a treatment utilizing the body’s own “electrical buttons” as opposed to invoking electrical change of an internal or external invasive or semi-invasive procedure.

Photon stimulation therapy for chronic regional pain syndrome: a new technique.

Green, J, Fralicker,D, Clewell, W, et al. (1999)

Complex regional pain syndrome type I, previously known as reflex asymmetry dystrophy is notoriously difficult to treat. We report on the significant temperature reduction and side-to-side symmetry noted in one patient treated with infrared photon therapy. We review recently published experience with the photon stimulator in chronic diabetic painful neuropathy and chronic pain syndrome. Significant temperature asymmetries which were the hallmark of these other disorders were likewise similarly affected. Considerations for acupuncture type of electrochemical process change in non-local coupling functions are thought to be responsible. Neuromodulation and neuroaugmentation by this technology seem to be helpful in the amelioration of this chronic painful condition.

Chronic Myofascial Pain Treated with a New Device: The Photon Stimulator – Physiological and Clinical Assessment

by Deborah Fralicker, D.C., Jacob Green, M.D., Ph.D., William Clewell, Ph.D., George Ossi, B.S., and Minnie Briley, C.M.E.T.

JMPT, Submitted April 1999

ABSTRACT: Classical spinal and peripheral acupuncture treatment points were stimulated by an FDA approved infrared photon device in the treatment of chronic myofascial pain. Favorable assessments by the patients of this new mode of photon therapy were reported for both groups. A significant reduction in the patient’s level of pain using the standard visual analog scale for pain measurement were found. A reduction of the classic hotter (spot) skin surface temperatures in the area of the myofascial complaints that the surrounding body in both groups of patients. This infrared photon therapy device appears quite acceptable for the outpatient treatments in chiropractic physicians offices, especially those with an interest in myofascial pain and knowledge of acupuncture technique.

Healing of Bone Affections and Gangrene with Low-Intensity Laser Irradiation in Diabetic Patients Suffering from Foot Infections.

Schindl, M, Schindl, A, Polzleitner, D and Schindl, L (1998)
OBJECTIVE: Evalution of low-intensity laser irradiation on the healing of bone affections and gangrene in patients suffering from diabetic microangiopathy.

DESIGN: Case-report study.

PATIENTS: Two consecutive diabetic male patients with gangrene, osteomyelitis, and bone fractures.

INTERVENTION: Helium-neon laser irradiation (36 J/cm2 ) 50 min/day.

MAIN OUTCOME PARAMETER: Healing of gangrene and corticalis lesion as well as remineralisation of bone affections.

RESULTS: Within a mean period of 14 weeks not only a complete healing of the diabetic gangrenes but also a radiographically determined reestablishment of corticalis and remineralisation of preexisting bone affections could be achieved.

CONCLUSION: We therefore conclude that low-intensity laser irradiation should be further tested as an additional beneficial therapeutic modality for the healing of gangrene and bone affections in diabetic patients.

Low-intensity laser irradiation improves skin circulation in patients with diabetic microangiopathy.

Schindl, A, Schindl, M, Schon, H, et al. (1998)

OBJECTIVE: Diabetic foot problems due to angiopathy and neuropathy account for 50% of all nontraumatic amputations and constitute a significant economic burden to society. Low-intensity laser irradiation has been shown to induce wound healing in conditions of reduced microcirculation. We investigated the influence of low-intensity laser irradiation by means of infrared thermography on skin blood circulation in diabetic patients with diabetic microangiopathy.

RESEARCH DESIGN AND METHODS: Thirty consecutive patients with diabetic ulcers or gangrenes and elevated levels of glycosylated hemoglobin were randomized by blocks of two to receive either a single low-intensity laser irradiation with an energy density of 30 J/cm2 or a sham irradiation over both forefoot regions in a double-blind placebo-controlled clinical study. Skin blood circulation as indicated by temperature recordings over the forefoot region was detected by infrared thermography.

RESULTS: After a single transcutaneous low-intensity laser irradiation, a statistically significant rise in skin temperature was noted (P < 0.001 by ANOVA for repeated measurements), whereas in the sham-irradiated control group, a slight but significant drop in temperature (P < 0.001) was found. Subsequently performed contrasts for comparison of measurements before and after irradiation revealed significant temperature increases at 20 min of irradiation time (P < 0.001), at the end of the irradiation (P < 0.001), and 15 min after stopping the irradiation (P < 0.001). In the sham-irradiated feet, the drop in local skin temperature was not significant at 20 min (P = 0.1), but reached significance at the end of the sham-irradiation procedure (P < 0.001) and 15 min after the end of sham irradiation (P < 0.001).

CONCLUSIONS: The data from this first randomized double-blind placebo-controlled clinical trial demonstrate an increase in skin microcirculation due to athermic laser irradiation in patients with diabetic microangiopathy.

Diabetic neuropathic foot ulcer: successful treatment by low-intensity laser therapy.

Schindl, A, Schindl, M, Pernerstorfer-Schon, H, et al. (1999)

OBJECTIVE: To evaluate the efficacy of low-intensity laser irradiation for the induction of wound healing of a diabetic neuropathic foot ulcer.

CASE: We report a case of a man with insulin-dependent diabetes mellitus, sensory neuropathy, macroangiopathy and microangiopathy who had been suffering from an ulcer of his first left toe accompanied by osteomyelitis for 6 weeks.

RESULTS: After a total of 16 sessions of low-intensity laser therapy using a 670-nm diode laser administered within a 4-week period the ulcer healed completely. During a follow-up period of 9 months, there was no recurrence of the ulcer even though the patient’s metabolic condition remained unstable.

CONCLUSIONS: Although laser therapy was not applied as a monotherapy, the present observation suggests that it might constitute a useful side-effect-free alternative treatment modality for the induction of wound healing of neuropathic ulcers in diabetic patients. Therefore large properly controlled randomized studies seem justified.

Induction of complete wound healing in recalcitrant ulcers by low-intensity laser irradiation depends on ulcer cause and size.

Schindl, M, Kerschan, K, Schindl, A, et al. (1999)

Chronic skin ulcers still represent a therapeutic challenge in dermatology. Among the various non-invasive treatment modalities used for the improvement of impaired wound healing, low-intensity laser irradiations are gaining an increasing body of interest. We used low-intensity laser irradiations delivered by a 30 mW helium-neon laser at an energy density of 30 J/cm2 three times weekly for the induction of wound healing in ulcers of diverse causes. Twenty patients with the same number of ulcers, which had previously been treated by conventional wound care for a median period of 34 weeks (range: 3-120 weeks) without any significant evidence of healing, were included in the study. Concerning the underlying disorders, patients were divided into four groups: diabetes, arterial insufficiency, radio damage and autoimmune vasculitis. In all ulcers, complete epithelization could be induced by laser therapy. No amputation or any other surgical intervention was necessary and no adverse effects of any kind were noted during low-intensity laser treatment. Regarding the different diagnoses, a statistically significant difference was noted (P = 0.008): ulcers due to radio damage healed significantly faster than those caused by diabetes (6 weeks [range: 3-10 weeks] vs. 16 weeks [range: 9-45 weeks], P = 0.005). Wound healing in autoimmune vasculitis (24 weeks [range: 20-35 weeks]) required longer than in radiodermitis, although the difference was not significant. In addition to the diagnosis, wound size was found to be an important factor influencing the duration of wound closure (P = 0.028), whereas duration of previous conventional treatment (P = 0.24) and depth (P = 0.14) showed no effect. Our results indicate that low-intensity laser irradiation could be a valuable non-invasive tool for the induction of wound healing in recalcitrant ulcers, and that healing time is correlated with the ulcer cause and size.

GaAs laser treatment of venous ulcers.

Soriano, F (1998)

In a study extended over 6 years Soriano treated 231 patients with venous leg ulcers. The exclusion criterias were diabetes, arterial disease, vasculitis, congestive heart failure and loss of follow up at 6 months. 122 of 154 patients in the laser group fulfilled the study. In the control group (traditional treatment only) 46 of 77 patients fulfilled. Wounds were all of Size Rate 4 or larger (diameter major + diameter minor). A 40 mW GaAs laser at 10.000 Hz was used, The laser was applied in the point technique with a dose of 3 J/cm2 per point around the border and onto the bed of the ulcer in non contact. Three sessions a week were performed for 4 months, or until the ulcer was completely healed. The results were evaluated as complete healing, partial healing (more than 50%) or non healing (less than 50%). In the laser group there was a 70% healing rate and a 14% rate of partial healing. In the control group 26% of the patients had a complete healing and 22% a partial healing. In the laser group, only 19% of the ulcers of great size (>16) healed completely and if the wound was more than one year old, the percentage of complete healing was 40%. Wounds with an oedema failed to heal with the parameters used.

Low intensity laser irradiation in the treatment of recalcitrant radiation ulcers in patients with breast cancer–long-term results of 3 cases.

Schindl, A, Schindl, M, Pernerstorfer-Schon, H, Mossbacher, U and Schindl, L (2000)

Radiotherapy can be followed by recalcitrant skin ulcers. As low intensity laser irradiation has been demonstrated to have a beneficial effect on impaired wound healing, we investigated its efficacy and safety in three patients with chronic radiation ulcers. The three patients, previously mastectomized due to breast cancer, with recalcitrant radiation ulcers of the skin were treated with a 30 mW helium-neon laser (wavelength: 632.8 nm, intensity: 3 mW/cm2, dose: 30 J/ cm2) three times weekly. In all patients, complete wound closure was achieved within a period of 7, 5, and 8 weeks. One patient died 6 weeks after laser treatment due to tumor cachexia. Neither of the other patients showed recurrence of radiation ulcers or neoplasm during a follow-up of 36 months. Low intensity helium-neon laser irradiation has been shown to be effective in the induction of wound healing in radiotherapy-induced ulcers in three patients with breast cancer.

Thermography in the Diagnosis of CRPS: A Physician’s Opinion 

by Dr P Getson DO Pain Practitioner 2006 Vol. 16 No. 1 REVIEW ARTICLE FROM PARC PEARL DEC. 2006

Diagnosing CRPS is difficult at best and doctors have yet to come up with a definitive test. One helpful diagnostic tool which helps assemble the pieces of the puzzle is thermography. It has been around since the 1950’s and still is used at NASA.

Neuromuscular disorders can be diagnosed with thermography. With regard to CRPS, the infrared cameras are hi-tech computer images which measure changes in skin temperature.

“The sympathetic nervous system (SNS) controls these changes and changes in the sympathetics cause changes in the thermal imaging which do not conform to dermatomal patterns”. Thermography is exacting in measuring temperature and temperature differences.

“Thermography shows changes in skin temperature to one tenth of one degree centigrade. Lack of symmetry is out of conformation to dermatomal distributions.”

Measurements on a CRPS patient within the first six months shows the affected side to be warmer than the contralateral side by 0.9 Degrees C which is considered as standard for sympathetically maintained thermal asymmetry. Sometimes this uneven temperature is 1.5-2 degrees C. difference. After six months, the pattern changes and the affected side is the “cold side”. The temperature difference is often seen in very striking, vivid images.

While feeling the affected side with the hand measures temperature, the thermogram is much more sensitive and the temperature scale is very sensitive also. It is specifically calibrated to measure very small differences. It can be adjusted to allow for room or body temperature.

Another interesting thing to observe in “CRPS is the spreading patterns which can be seen 6-9 months prior to the occurrence of symptoms in a limb that has been affected with dysfunction but has not yet become symptomatic“. Patients mention symptoms in one limb which are seen as thermal abnormalities in other limb.

Thermography means that patients can be diagnosed and treated earlier.

USES: New cameras have real-time imaging properties that could help monitor a limb while a spinal cord stimulator is being installed. Thermography could help the surgeon place the leads accurately so that the patient gets maximum benefit from the stimulator.

DIAGNOSING CRPS: Thermography is the best tool we have to date to help us with diagnosis of CRPS. It also completely validates the symptoms described by the patient. he/she is not making it up, exaggerating or hallucinating. Earlier diagnosis means earlier treatment and a better prognosis. Thermography continues to surprise us with its uses and is a valuable help in making a diagnosis of CRPS.

Source: Pain Practitioner Vol 16 No. 1 Spring 2006 and ©PARC PEARL December 2006 p. 7.

Cellular Effects of Light Therapy

Photobiomodulation Directly Benefits Primary Neurons
Functionally Inactivated by Toxins

THE ROLE OF CYTOCHROME c OXIDASE*

Received for publication, August 23, 2004, and in revised form, November 10, 2004
Published, JBC Papers in Press, November 22, 2004, DOI 10.1074/jbc.M409650200

Margaret T. T. Wong-Riley, Huan Ling Liang, Janis T. Eells, Britton Chance,
Michele M. Henry, Ellen Buchmann, Mary Kane, and Harry T. Whelan

From the Departments of Cell Biology, Neurobiology, and Anatomy, Neurology, and Ophthalmology, Medical College
of Wisconsin, Milwaukee, Wisconsin 53226, Department of Health Sciences, University of Wisconsin, Milwaukee,
Wisconsin 53201, and Department of Biochemistry and Biophysics, University of Pennsylvania,
Philadelphia, Pennsylvania 19104-6059

ABSTRACT: Far-red and near infrared (NIR) light promotes wound healing, but the mechanism is poorly understood. Our previous studies using 670 nm light-emitting diode (LED) arrays suggest that cytochrome c oxidase, a photo acceptor in the NIR range, plays an important role in therapeutic photobiomodulation. If this is true, then an irreversible inhibitor of cytochrome c oxidase, potassium cyanide (KCN), should compete with LED and reduce its beneficial effects.

Results: This hypothesis was tested on primary cultured neurons. LED treatment partially restored enzyme activity blocked by 10–100 M KCN. It significantly reduced neuronal cell death induced by 300 M KCN from 83.6 to 43.5%. However, at 1–100 mM KCN, the protective effects of LED decreased, and neuronal deaths increased. LED significantly restored neuronal ATP content only at 10 M KCN but not at higher concentrations of KCN tested. Pretreatment with LED-enhanced efficacy of LED during exposure to 10 or 100 M KCN but did not restore enzyme activity to control levels. In contrast, LED was able to completely reverse the detrimental effect of tetrodotoxin, which only indirectly down-regulated enzyme levels. Among the wavelengths tested (670, 728, 770, 830, and 880 nm), the most effective ones (830 nm, 670 nm) paralleled the NIR absorption spectrum of oxidized cytochrome c oxidase, whereas the least effective wavelength, 728 nm, did not.

Conclusions: The results are consistent with our hypothesis that the mechanism of photobiomodulation involves the up-regulation of cytochrome c oxidase, leading to increased energy metabolism in neurons functionally inactivated by toxins.

Improvement of Pain and Disability in Elderly Patients with Degenerative Osteoarthritis of the Knee Treated with Narrow-Band Light Therapy

by Jean Stelian, M.D., Israel Gil, M.D., Beni Habot, M.D., Michael Rosenthal, M.D., Julian Abramovici, M.D., Nathalia Kutok, M.D., and Auni Khahil, M.D.

Journal of the American Geriatric Society, January 1992, Volume 40, Number 1

ABSTRACT: Objective: To evaluate the effects of low-power light therapy on pain and disability in elderly patients with degenerative osteoarthritis of the knee. Design: Partially double-blinded, full randomized trial comparing red, infrared, and placebo light emitters. Patients: 50 patients with degenerative osteoarthritis of both knees were randomly assigned to three treatment groups: red (15 patients), infrared (18 patients), and placebo (17 patients). Infrared and placebo emitters were double-blinded. Interventions: Self-applied treatment to both sides of the knee for 15 minutes twice a day for 10 days. Main Outcomes: Short-form McGill Pain Questionnaire, Present Pain Intensity, and Visual Analog Scale for pain and Disability Index Questionnaire for disability were used. We evaluated pain and disability before and on the tenth day of therapy. The period from the end of the treatment until the patient’s request to be retreated was summed up 1 year after the trial.

Results: Pain and disability before treatment did not show statistically significant differences between the three groups.Pain reduction in the red and infrared groups after the treatment was more than 50% in all scoring methods (P less than 0.05). There was no significant pain improvement in the placebo group. We observed significant functional improvement in red- and infrared-treated groups (p less than 0.05), but not in the placebo group. The period from the end of treatment until the patients required treatment was longer for red and infrared groups than for the placebo group (4.2 +/- 3.0, 6.1 +/- 3.2, and 0.53 +/- 0.62 months, for red, infrared, and placebo, respectively).

Conclusions: Low-power light therapy is effective in relieving pain and disability in degenerative osteoarthritis of the knee.