Transcranial low-level laser therapy may improve alertness and awareness in traumatic brain injured subjects with severe disorders of consciousness: a case series

Abstract

Background:Transcranial low-level laser therapy (T-LLT) proved promising in acute stroke studies and in single traumatic brain injured subjects (TBI). It was assumed to increase cortical mitochondrial energy production and/or vasodilatation.Objective: Within this case series the potential of transcranial lowlevel laser therapy in improving the alertness and awareness in TBI subjects with severe disorders of consciousness will be investigated. Methods:Following a 21-day baseline, the forehead of five patients, four chronic in a state of unresponsive wakefulness or minimal consciousness, one subacute in the state of akinetic mutism, was stimulated with the T-LLT (785 nm, 10 mW/cm 2 , CW mode, 21 emitting diodes) for 10 min every workday for six weeks. Follow-up was four weeks after end of intervention. Primary variable was the revised version of the Coma Recovery Scale (r-CRS, 0-23), blindly assessed by an external reviewer with the help of videos. Results:The r-CRS, almost stable during baseline, improved in all patients during the intervention, from 3 to 12, 9 to 12, 8 to 12 and 5-12 in the chronic, and from 6 to 21 in the subacute patient. Follow-up revealed a sustained effect. The patient in the state of akinetic mutism improved her competence in the activities of daily living and mobility status. Single epileptic fits occurred in two patients during the intervention. Conclusion: T-LLT

Photoneuromodulation makes a difficult cognitive task less arduous

“…When PBM is applied to the head, it is called photoneuromodulation (PNM) and can be used to improve brain function 1 . Studies on PNM have shown positive effects on patients with dementia 2 – 4 , traumatic brain injury 5 – 8 , stroke 9 – 12 , and depression 13 – 15 . Specifically, PNM in patients with traumatic brain injury 5 , 6 showed improvement in executive functioning, verbal learning, and memory after several sessions of treatment provided over several weeks to years.…”

Effect of Transcranial Laser on Somatosensory Integration in Patients with Nonspecific Neck Pain: Randomized Controlled Trial

“…they stimulated the cortex of five subjects, four of them are chronic with unresponsive attentiveness or minimal awareness, and one patient subacute with a kinetic mutism, with the transcranial laser (785 nm, 10 mW/cm2, continuous wave mode, 21 emitting diodes) for ten minutes every workday for 6 weeks. Their results supported that TLT had been found to improve the patients' alertness and awareness [38]. The second explanation for the nonsignificant difference between groups regarding P22-N30 may be attributed to that application of laser did not exert an analgesic effect as patients with neck pain had a significantly higher joint position sense error than healthy controls (De Vries and others in 2015) which in turn affects somatosensory integration [39].…”

Traumatic Brain Injury Recovery with Photobiomodulation: Cellular Mechanisms, Clinical Evidence, and Future Potential

“…In 2015, Hesse et al reported the use of low-level lasers with a wavelength of 785 nm, continuous wave, and 10 mW/cm 2 power density over 10 weeks on four chronic patients in a state of unresponsive wakefulness or minimal consciousness and one subacute patient in the state of akinetic mutism (total of five patients). In summary, the treatment protocol improved the patients’ alertness and awareness, but epileptic fits were potential side effects [ 77 ].…”