title: Significant improvements in cognitive performance post-transcranial, red/near-infrared light-emitting diode treatments in chronic, mild traumatic brain injury: open-protocol study.
abstract: This pilot, open-protocol study examined whether scalp application of red and near-infrared (NIR) light-emitting diodes (LED) could improve cognition in patients with chronic, mild traumatic brain injury (mTBI). Application of red/NIR light improves mitochondrial function (especially in hypoxic/compromised cells) promoting increased adenosine triphosphate (ATP) important for cellular metabolism. Nitric oxide is released locally, increasing regional cerebral blood flow. LED therapy is noninvasive, painless, and non-thermal (cleared by the United States Food and Drug Administration [FDA], an insignificant risk device). Eleven chronic, mTBI participants (26-62 years of age, 6 males) with nonpenetrating brain injury and persistent cognitive dysfunction were treated for 18 outpatient sessions (Monday, Wednesday, Friday, for 6 weeks), starting at 10 months to 8 years post- mTBI (motor vehicle accident [MVA] or sports-related; and one participant, improvised explosive device [IED] blast injury). Four had a history of multiple concussions. Each LED cluster head (5.35 cm diameter, 500 mW, 22.2 mW/cm(2)) was applied for 10 min to each of 11 scalp placements (13 J/cm(2)). LEDs were placed on the midline from front-to-back hairline; and bilaterally on frontal, parietal, and temporal areas. Neuropsychological testing was performed pre-LED, and at 1 week, and 1 and 2 months after the 18th treatment. A significant linear trend was observed for the effect of LED treatment over time for the Stroop test for Executive Function, Trial 3 inhibition (p=0.004); Stroop, Trial 4 inhibition switching (p=0.003); California Verbal Learning Test (CVLT)-II, Total Trials 1-5 (p=0.003); and CVLT-II, Long Delay Free Recall (p=0.006). Participants reported improved sleep, and fewer post-traumatic stress disorder (PTSD) symptoms, if present. Participants and family reported better ability to perform social, interpersonal, and occupational functions. These open-protocol data suggest that placebo-controlled studies are warranted.
authors.affiliation: 1 VA Boston Healthcare System , Boston, Massachusetts.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Naeser
authors.forename: Ross
authors.initials: R
authors.lastname: Zafonte
authors.forename: Maxine H
authors.initials: MH
authors.lastname: Krengel
authors.forename: Paula I
authors.initials: PI
authors.lastname: Martin
authors.forename: Judith
authors.initials: J
authors.lastname: Frazier
authors.forename: Michael R
authors.initials: MR
authors.lastname: Hamblin
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Knight
authors.forename: William P
authors.initials: WP
authors.lastname: Meehan
authors.forename: Errol H
authors.initials: EH
authors.lastname: Baker
mesh_terms: D000328:Adult; D001924:Brain Concussion / Q000532:radiotherapy / Q000628:therapy; D020208:Brain Injury, Chronic / Q000523:psychology* / Q000532:radiotherapy*; D002908:Chronic Disease; D003071:Cognition; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007259:Infrared Rays; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010789:Phototherapy / Q000379:methods*; D010865:Pilot Projects; D011597:Psychomotor Performance; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome; D014474:Unconsciousness / Q000150:complications
keywords: executive function; mTBI; photobiomodulation; treatment for mTBI