Transcranial Photobiomodulation Treatment: Significant Improvements in Four Ex-Football Players with Possible Chronic Traumatic Encephalopathy

Margaret A Naeser; Paula I Martin; Michael D Ho; Maxine H Krengel; Yelena Bogdanova; Jeffrey A Knight; Michael R Hamblin; Andrea E Fedoruk; Luke G Poole; ChiaHsin Cheng; BangBon Koo

doi:10.3233/ADR-220022

Transcranial Photobiomodulation Treatment: Significant Improvements in Four Ex-Football Players with Possible Chronic Traumatic Encephalopathy

J Alzheimers Dis Rep. 2023 Jan 31;7(1):77-105. doi: 10.3233/ADR-220022. eCollection 2023.

Authors

Margaret A Naeser^{1

2}, Paula I Martin^{1

2}, Michael D Ho¹, Maxine H Krengel^{1

2}, Yelena Bogdanova^{1

3}, Jeffrey A Knight^{1

3

4}, Michael R Hamblin^{5

6}, Andrea E Fedoruk¹, Luke G Poole¹, ChiaHsin Cheng⁷, BangBon Koo⁷

Affiliations

¹ VA Boston Healthcare System, Jamaica Plain Campus, Boston, MA, USA.
² Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
³ Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
⁴ National Center for PTSD - Behavioral Sciences Division, VA Boston Healthcare System, Boston, MA, USA.
⁵ Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa.
⁶ Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran.
⁷ Department of Anatomy & Neurobiology, Bio-imaging Informatics Lab, Boston University School of Medicine, Boston, MA, USA.

Abstract

Background: Chronic traumatic encephalopathy, diagnosed postmortem (hyperphosphorylated tau), is preceded by traumatic encephalopathy syndrome with worsening cognition and behavior/mood disturbances, over years. Transcranial photobiomodulation (tPBM) may promote improvements by increasing ATP in compromised/stressed cells and increasing local blood, lymphatic vessel vasodilation.

Objective: Aim 1: Examine cognition, behavior/mood changes Post-tPBM. Aim 2: MRI changes - resting-state functional-connectivity MRI: salience, central executive, default mode networks (SN, CEN, DMN); magnetic resonance spectroscopy, cingulate cortex.

Methods: Four ex-players with traumatic encephalopathy syndrome/possible chronic traumatic encephalopathy, playing 11- 16 years, received In-office, red/near-infrared tPBM to scalp, 3x/week for 6 weeks. Two had cavum septum pellucidum.

Results: The three younger cases (ages 55, 57, 65) improved 2 SD (p < 0.05) on three to six neuropsychological tests/subtests at 1 week or 1 month Post-tPBM, compared to Pre-Treatment, while the older case (age 74) improved by 1.5 SD on three tests. There was significant improvement at 1 month on post-traumatic stress disorder (PTSD), depression, pain, and sleep. One case discontinued narcotic pain medications and had reduced tinnitus. The possible placebo effect is unknown. At 2 months Post-tPBM, two cases regressed. Then, home tPBM was applied to only cortical nodes, DMN (12 weeks); again, significant improvements were seen. Significant correlations for increased SN functional connectivity (FC) over time, with executive function, attention, PTSD, pain, and sleep; and CEN FC, with verbal learning/memory, depression. Increased n-acetyl-aspartate (NAA) (oxygen consumption, mitochondria) was present in anterior cingulate cortex (ACC), parallel to less pain and PTSD.

Conclusion: After tPBM, these ex-football players improved. Significant correlations of increased SN FC and CEN FC with specific cognitive tests and behavior/mood ratings, plus increased NAA in ACC support beneficial effects from tPBM.

Keywords: Chronic traumatic encephalopathy; dementia; depression; neurodegenerative; pain; photobiomodulation; post-traumatic stress disorder; sleep; traumatic brain injury; traumatic encephalopathy syndrome.