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THOR on YouTube40 LLLT papers for you this month including an updated biphasic dose response paper from Mike Hamblin’s team at Harvard (including myself), plus clinical trials on lymphoedema (manual lymphatic drainage vs LLLT), oral mucositis literature review with meta-analysis, onychomycosis, improved treadmill training performance, improved orthodontic tooth movement (with less pain), TMJD, post extraction trismus, and a systematic review of treatments for frozen shoulder citing laser as effective for pain relief, improved range of motion, and overall outcome in adhesive capsulitis.
Biphasic dose response in low level light therapy – an update
Huang YY, Sharma SK, Carroll J, Hamblin MR.
Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School, Boston MA; and Aesthetic and Plastic Center of Guangxi Medical University, China.
Low-level laser (light) therapy (LLLT) has been known since 1967 but still remains controversial due to incomplete understanding of the basic mechanisms and the selection of inappropriate dosimetric parameters that led to negative studies. The biphasic dose-response or Arndt-Schulz curve in LLLT has been shown both in vitro studies and in animal experiments. This review will provide an update to our previous (Huang et al. 2009) coverage of this topic. In vitro mediators of LLLT such as adenosine triphosphate (ATP) and mitochondrial membrane potential show biphasic patterns, while others such as mitochondrial reactive oxygen species show a triphasic dose-response with two distinct peaks. The Janus nature of reactive oxygen species (ROS) that may act as a beneficial signaling molecule at low concentrations and a harmful cytotoxic agent at high concentrations, may partly explain the observed responses in vivo. Transcranial LLLT for traumatic brain injury (TBI) in mice shows a distinct biphasic pattern with peaks in beneficial neurological effects observed when the number of treatments is varied, and when the energy density of an individual treatment is varied. Further understanding of the extent to which biphasic dose responses apply in LLLT will be necessary to optimize clinical treatments.
Dose Response. 2011;9(4):602-18.
http://www.ncbi.nlm.nih.gov/pubmed/22461763
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Changes in tissue water and indentation resistance of lymphedematous limbs accompanying low level laser therapy (LLLT) of fibrotic skin.
Mayrovitz HN, Davey S
College of Medical Sciences, Nova Southeastern University, Ft. Lauderdale, Florida 33328, USA. mayrovit@nova.edu
Our goal was to determine effects of low-level-laser-therapy (LLLT) on skin water and tissue indentation resistance (TIR) in patients with arm (N = 38) or leg (N = 38) lymphedema. Skin water was determined from tissue dielectric constant (TDC) measurements and TIR determined from measurements of force resulting from tissue indentations of 3-4 mm. A limb-location with fibrosis was identified by palpation and treated with an LLLT device for one minute at each of five points within a 3 cm2 area. TDC and TIR at these sites and corresponding sites on the contralateral limb were measured prior to LLLT (pre-LLLT), immediately after LLLT (post-LLLT) and after a manual lymphatic drainage (MLD) session (post-MLD). Results, from arms and legs, showed that post-LLLT values of TIR and TDC were significantly less than pre-LLLT. TIR values remained significantly reduced at post-MLD whereas TDC values were not significantly different from pre-LLLT values. On follow-up visit, 17 previously LLLT treated legs were sham treated with an inactive LLLT unit and measurements replicated. A TIR and TDC change-pattern similar to that obtained with the active LLLT was obtained, but sham-related reductions in TIR and TDC immediately post sham-treatment were significantly less than achieved with the prior active LLLT treatment.
Lymphology 2011 Dec 44(4) 168-77
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Low-level laser therapy in the prevention and treatment of cancer therapy-induced mucositis: 2012 state of the art based on literature review and meta-analysis.
Bensadoun RJ, Nair RG
aRadiation Oncology Department, CHU de Poitiers, Poitiers, France bGriffith Health Institute, Griffith University and Department of Haematology/Oncology, Queensland Health, Gold Coast Hospital, Queensland, Australia.
PURPOSE OF REVIEW: To discuss the promising state of the art low-level laser therapy (LLLT) for preventive and therapeutic usage in oral mucositis due to cancer therapy. RECENT FINDINGS: Photomedicine using LLLT is very effective with intraoral and extraoral devices in the management of oral mucositis, based on several studies including randomized control studies. A systematic review identified 33 relevant articles that were subjected to meta-analysis based on which laser parameters in routine practice are being defined. Meta-analysis showed that LLLT reduced risk of oral mucositis with relative risk (RR) 2.45 [confidence interval (CI) 1.85-3.18], reduced duration, severity of oral mucositis and reduced number of days with oral mucositis (4.38 days, P = 0.0009). RR was similar between the red (630-670 nm) and infrared (780-830 nm) LLLT. Pain-relieving effect based on the Cohen scale was at 1.22 (CI 0.19-2.25). SUMMARY: No adverse side effects of LLLT were reported; hence, we recommend red or infrared LLLT with diode output between 10-100 mW, dose of 2-3 J/cm/cm for prophylaxis and 4 J/cm (maximum limit) for therapeutic effect, application on single spot rather than scanning motion. Lesions must be evaluated by a trained clinician and therapy should be repeated daily or every other day or a minimum of three times per week until resolution. There is moderate-to-strong evidence in favor of LLLT at optimal doses as a well tolerated, relatively inexpensive intervention for cancer therapy-induced oral mucositis. It is envisaged that LLLT will soon become part of routine oral supportive care in cancer.
Curr Opin Oncol 2012 Mar 23
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Treating Onychomycoses of the Toenail: Clinical Efficacy of the Sub-Millisecond 1,064 nm Nd: YAG Laser Using a 5 mm Spot Diameter.
Kimura U, Takeuchi K, Kinoshita A, Takamori K, Hiruma M, Suga Y
Background: Onychomycoses is a relatively common fungal infection. Current treatments have limited applicability and low cure rates. Recently introduced laser therapy has shown to be a safe and effective treatment for onychomycosis. In this study, we evaluate a submillisecond Nd:YAG 1,064 nm laser for treating onychomycoses of the tonail. Methods: Thirteen subjects (9 female, 4 male) with 37 affected toenails received 1 to 3 treatments 4 and/or 8 weeks apart with a sub-millisecond 1,064 nm Nd:YAG laser. Diagnosis of onychomycosis was confirmed with microscopy. Average follow-up time was 16 weeks post-final treatment. Photos were taken and degree of turbidity was determined using a turbidity scale (ranging from “0 = clear nail” to “10 = completely turbid nail”) at each visit. Improvement in turbidity was determined by comparison of turbidity scores at baseline and 16-week follow-up on average. Efficacy was assessed by an overall improvement scale (0 to 4), which combined improvement in turbidity scores and microscopic examination. Overall improvement was classified as “4 = complete clearance” if the turbidity score indicated “0 = clear nail” accompanied by a negative microscopic result. No microscopic examination was performed unless the turbidity score showed “0 = clear nail.” Results: Treatments were well tolerated by all subjects and there were no adverse events. Of the 37 toenails treated, 30 (81%) had “moderate” to “complete” clearance average of 16 weeks post-final treatment. Nineteen toenails (51%) were completely clear and all tested negative for fungal infection on direct microscopic analysis. Seven (19%) toenails had significant clearance and four (11%) had moderate clearance. Conclusions: The preliminary results of this study show this treatment modality is safe and effective for the treatment of onychomycosis in the short term. Additional studies are needed to more fully assess the clinical and mycological benefits as well as optimize the treatment protocol and parameters. J Drugs Dermatol. 2012;11(4):496-504.
J Drugs Dermatol 2012 Apr 1 11(4) 496-504
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Infrared LED irradiation applied during high-intensity treadmill training improves maximal exercise tolerance in postmenopausal women: a 6-month longitudinal study.
Paolillo FR, Corazza AV, Borghi-Silva A, Parizotto NA, Kurachi C, Bagnato VS
Optics Group, Instituto de Fisica de Sao Carlos (IFSC), University of Sao Paulo (USP), Sao Carlos, SP, Brazil, fer.nanda.rp@hotmail.com.
Reduced aerobic fitness is associated with an increased risk of cardiovascular diseases among the older population. The aim of this study was to investigate the effects of LED irradiation (850 nm) applied during treadmill training on the maximal exercise tolerance in postmenopausal women. At the beginning of the study, 45 postmenopausal women were assigned randomly to three groups, and 30 women completed the entire 6 months of the study. The groups were: (1) the LED group (treadmill training associated with phototherapy, n = 10), (2) the exercise group (treadmill training, n = 10), and (3) the sedentary group (neither physical training nor phototherapy, n = 10). The training was performed for 45 min twice a week for 6 months at intensities between 85% and 90% maximal heart rate (HR(max)). The irradiation parameters were 39 mW/cm(2), 45 min and 108 J/cm(2). The cardiovascular parameters were measured at baseline and after 6 months. As expected, no significant differences were found in the sedentary group (p >/= 0.05). The maximal time of tolerance (Tlim), metabolic equivalents (METs) and Bruce stage reached significantly higher values in the LED group and the exercise group (p < 0.01). Furthermore, the HR, double product and Borg score at isotime were significantly lower in the LED group and in the exercise group (p < 0.05). However, the time of recovery showed a significant decrease only in the LED group (p = 0.003). Moreover, the differences between before and after training (delta values) for the Tlim, METs and HR at isotime were greater in the LED group than in the exercise group with a significant intergroup difference (p < 0.05). Therefore, the infrared LED irradiation during treadmill training can improve maximal performance and post-exercise recovery in postmenopausal women.
Lasers Med Sci 2012 Mar 2
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Efficacy of low-intensity laser therapy in reducing treatment time and orthodontic pain: A clinical investigation.
Doshi-Mehta G, Bhad-Patil WA
Postgraduate student, Department of Orthodontics and Dentofacial Orthopedics, Government Dental College and Hospital, Nagpur, Maharashtra, India.
INTRODUCTION: The long duration of orthodontic treatment is a major concern for patients. A noninvasive method of accelerating tooth movement in a physiologic manner is needed. The aim of this study was to evaluate of the efficacy of low-intensity laser therapy in reducing orthodontic treatment duration and pain. METHODS: Twenty patients requiring extraction of first premolars were selected for this study. We used a randomly assigned incomplete block split-mouth design. Individual canine retraction by a nickel-titanium closed-coil spring was studied. The experimental side received infrared radiation from a semiconductor (aluminium gallium arsenide) diode laser with a wavelength of 810 nm. The laser regimen was applied on days 0, 3, 7, and 14 in the first month, and thereafter on every 15th day until complete canine retraction was achieved on the experimental side. Tooth movement was measured on progress models. Each patient’s pain response was ranked according to a visual analog scale. RESULTS: An average increase of 30% in the rate of tooth movement was observed with the low-intensity laser therapy. Pain scores on the experimental sides were significantly lower compared with the control sides. CONCLUSIONS: Low-intensity laser therapy is a good option to reduce treatment duration and pain.
Am J Orthod Dentofacial Orthop 2012 Mar 141(3) 289-97
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Evaluation of low-level laser therapy in patients with acute and chronic temporomandibular disorders.
Salmos-Brito JA, de Menezes RF, Teixeira CE, Gonzaga RK, Rodrigues BH, Braz R, Bessa-Nogueira RV, de Martinez Gerbi ME
Dental School, University of Pernambuco, Pernambuco, Brazil, janainasalmos@hotmail.com.
The purpose of this study was to address the following question: among patients with acute or chronic temporomandibular disorders (TMD), does low-level laser therapy (LLLT) reduce pain intensity and improve maximal mouth opening? The sample comprised myogenic TMD patients (according Research Diagnostic Criteria for TMD). Inclusion criteria were: male/female, no age limit, orofacial pain, tender points, limited jaw movements and chewing difficulties. Patients with other TMD subtypes or associated musculoskeletal/rheumatologic disease, missing incisors teeth, LLLT contra-indication, and previous TMD treatment were excluded. According to disease duration, patients were allocated into two groups, acute (/=6 months). For each patient, 12 LLLT sessions were performed (gallium-aluminum-arsenide; lambda = 830 nm, P = 40 mW, CW, ED = 8 J/cm(2)). Pain intensity was recorded using a 10-cm visual analog scale and maximal mouth opening using a digital ruler (both recorded before/after LLLT). The investigators were previously calibrated and blinded to the groups (double-blind study) and level of significance was 5% (p < 0.05). Fifty-eight patients met all criteria, 32 (acute TMD), and 26 (chronic TMD). Both groups had a significant pain intensity reduction and maximal mouth opening improvement after LLLT (Wilcoxon test, p < 0.001). Between the groups, acute TMD patient had a more significant pain intensity reduction (Mann-Whitney test, p = 0.002) and a more significant maximal mouth opening improvement (Mann-Whitney test, p = 0.011). Low-level laser therapy can be considered as an alternative physical modality or supplementary approach for management of acute and chronic myogenic temporomandibular disorder; however, patients with acute disease are likely to have a better outcome.
Lasers Med Sci 2012 Feb 25
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Is Adjuvant Laser Therapy Effective for Preventing Pain, Swelling, and Trismus After Surgical Removal of Impacted Mandibular Third Molars? A Systematic Review and Meta-Analysis.
Brignardello-Petersen R, Carrasco-Labra A, Araya I, Yanine N, Beyene J, Shah PS
Graduate student, Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada; and Lecturer, Evidence-Based Dentistry Unit and Pathology Department, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.
PURPOSE: To assess the efficacy and safety of low-level laser energy irradiation (LLEI) for decreasing pain, swelling, and trismus after surgical removal of impacted mandibular third molars (IMTMs). MATERIALS AND METHODS: MEDLINE, EMBASE, and the Central Register of Controlled Trials of the Cochrane Library were searched from their inception, and conference proceedings, cross-references, and gray literature were searched for the last 5 years for randomized and quasi-randomized controlled trials that evaluated the effects of any type of LLEI, compared with active or inactive treatments, in patients undergoing surgical removal of IMTMs. Risk of bias in included studies was assessed by 2 independent evaluators using the Cochrane Risk of Bias tool. A random-effects model meta-analysis was used to estimate the mean difference of trismus between the groups. Heterogeneity was assessed using Cochran chi(2) and I(2). RESULTS: Ten eligible trials were included in this systematic review. The included studies overall had a moderate risk of bias. Because of heterogeneity in the intervention and outcomes assessments, pain and swelling outcomes were only qualitatively summarized and indicated no beneficial effects of LLEI over placebo. Patients receiving LLEI had an average of 4.2 mm (95% confidence interval, 1.2 to 7.2) and 5.2 mm (95% confidence interval, 1.8 to 8.2) less trismus than patients receiving no active treatment on the second and seventh day after the surgery, respectively. CONCLUSIONS: There was no benefit of LLEI on pain or swelling and a moderate benefit on trismus after removal of IMTMs. It is necessary to standardize the intervention and outcomes assessment and to conduct adequately powered, well-designed trials to evaluate the efficacy of LLEI.
J Oral Maxillofac Surg 2012 Mar 5
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The effectiveness of nonoperative treatment for frozen shoulder: a systematic review.
Tashjian RZ
University of Utah School of Medicine, Salt Lake City, Utah.
OBJECTIVE: To systematically review the evidence for the effectiveness of nonoperative interventions in the management of frozen shoulder (adhesive capsulitis). DATA SOURCES: The Cochrane Library, PubMed, EMBASE, CINAHL, and Pedro were searched for randomized controlled trials (RCTs) and systematic reviews of interventions for primary adhesive capsulitis (search words included frozen shoulder, shoulder pain, and periarthritis) up to April 2008. STUDY SELECTION: Selection criteria required that studies included patients with frozen shoulder; the disorder was not caused by acute trauma or systemic disease; an intervention for treating adhesive capsulitis was evaluated; the outcome measures included pain, function, or recovery and were reported separately for patients in the study with adhesive capsulitis; and the article was written in English, French, German, or Dutch. Two reviewers independently selected relevant studies from the search results and resolved disagreements by consensus. The findings from 5 Cochrane reviews and 18 recent additional RCTs were included. DATA EXTRACTION: Information on the study population, interventions, outcome measures, and results was extracted by 1 reviewer and checked by a second. Methodologic quality was assessed independently by 2 reviewers. Heterogeneity of the studies was such that the data could not be quantitatively assessed. The level of evidence was ranked as strong, moderate, limited, or conflicting, depending on the consistency of positive findings and the quality of the RCTs; as no differences in effectiveness found; and as no evidence for the intervention from reviews or RCTs. MAIN RESULTS: There was strong evidence in the short term for the effectiveness of intra-articular steroid injections for pain but not range of motion and moderate evidence for steroid injections for pain in the medium term. No differences were found on range of motion between steroid injections and manipulation. There was moderate evidence in favor of arthrographic distension compared with steroid injections in the short term. Among physiotherapy interventions, there was strong evidence in favor of laser therapy compared with placebo in producing a good outcome and some evidence for reduced pain and disability. There was moderate evidence for several mobilization techniques in the short and long term and in combination with exercise. There was moderate evidence in the short term for the effectiveness of oral steroids compared with placebo or no treatment for pain relief and range of motion and for suprascapular nerve block compared with acupuncture, placebo, or steroid injections for pain relief. CONCLUSIONS: Pain, range of motion, and overall outcome in adhesive capsulitis were most effectively improved by steroid injections, laser therapy, some mobilization techniques, arthrographic distension, and suprascapular nerve block. Most effects were shown in the short term, although physiotherapy did show effects in the longer term.
Clin J Sport Med 2012 Mar 22(2) 168-9
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[The evaluation of exocrinous function of pancreas in patients with chronic pancreatitis].
The article deals with studying the impact of low-intensity laser therapy on the exocrinous function of pancreas in patients with chronic pancreatitis in exacerbation stage. The sample included 49 patients aged from 36 to 69 years. They were allocated on the main (39 patients) and control (10 patients) groups. The patients from the main group received pharmaceutical treatment along with low-intensity laser therapy. The patients from control group received only pharmaceutical treatment. The study demonstrated the positive impact of comprehensive therapy with low-intensity laser therapy added on the exocrinous function of pancreas in patients with chronic pancreatitis.
Klin Lab Diagn 2011 Dec (12) 44-5
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Short-Term Effects of 890-Nanometer Radiation on Pain, Physical Activity, and Postural Stability in Patients With Knee Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Study.
Hsieh RL, Lo MT, Liao WC, Lee WC
Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Taipei Medical University, Taipei, Taiwan.
Hsieh R-L, Lo M-T, Liao W-C, Lee W-C. Short-term effects of 890-nanometer radiation on pain, physical activity, and postural stability in patients with knee osteoarthritis: a double-blind, randomized, placebo-controlled study. OBJECTIVE: To investigate the effects of short-term light therapy with 890-nm radiation on pain, physical activity, and postural stability in patients with knee osteoarthritis (OA). DESIGN: A double-blind, randomized, placebo-controlled study. SETTING: Rehabilitation clinic. PARTICIPANTS: Women (n=62) and men (n=10) with a mean age of 61.2 years (range, 40-88y). All patients fulfilled the combined clinical and radiographic criteria for knee OA as established by the American College of Rheumatology, and all had obtained a Kellgren-Lawrence score of 2 or more. INTERVENTIONS: Participants received 6 sessions, lasting 40 minutes each, of active or placebo radiation treatment over the knee joints for 2 weeks (wavelength, 890nm; radiant power output, 6.24W; power density, 34.7mW/cm(2) for 40 minutes; total energy, 41.6J/cm(2) per knee per session). MAIN OUTCOME MEASURES: Participants were assessed weekly over 4 weeks using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain, stiffness, and physical function. Physical activity (timed stair climbing, 10-m fast-speed walking, and chair-rising time) and postural stability (using the postural stability evaluation system) were also assessed. The pain score on WOMAC was the primary outcome variable. Data were analyzed by repeated-measures analysis of covariance. RESULTS: Compared with baseline, no significant improvement was observed between groups for pain (P=.546), stiffness (P=.573), or physical function (P=.904). No significant improvement was noted for physical activity including the 10-m fast-speed walking time (P=.284), stair-climbing time (P=.202), stair-descending time (P=.468), chair-rising time (P=.499), or postural stability (P=.986) at the 4 follow-up assessments. Follow-up assessments were conducted after 1 week of treatment (thus, after 3 treatments); after 2 weeks of treatment (thus, after 6 treatments); and 1 and 2 weeks, respectively, after treatment was terminated. Although we found a significant time effect for the 10-m fast-speed walking time (P
Arch Phys Med Rehabil 2012 Mar 27
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The beneficial effects of adding low level laser to ultrasound and exercise in Iranian women with shoulder tendonitis: A randomized clinical trial.
Otadi K, Hadian MR, Olyaei G, Jalaie S
Faculty of Rehabilitation, Tehran University of Medical Sciences and Health Services, Tehran, Iran.
Objectives: A randomized, double-blind, clinical trial study was conducted with the aim of determining the efficacy of adding laser (830 nm) to ultrasound (US) and exercise for the management of shoulder tendonitis. Methods: 42 subjects (n=21, in adding laser group and n=21, in US and exercise group) received a course of 10 sessions treatment over one month in the shoulder region. Outcome measures such as Visual Analogue Scale (VAS), Tenderness Severity Scale (TSS), Constant Murley Score (CMS) and Manual Muscle Testing (MMT) were performed before treatment and at the end of 4 weeks treatment. In addition, follow up were performed 2 months after the end of treatment based on the degree of pain improvement. Results: VAS, TSS and CMS improved significantly (P=0.001) in both groups, however the muscle strengths only improved significantly in adding laser group (P< 0.01).Conclusion: It seems that both protocols of physical therapy interventions were effective in relieving the signs and symptoms of shoulder tendonitis. Furthermore, adding low level laser therapy (LLLT) to the US and exercise was more efficient in improving the muscle strength in patients with shoulder tendonitis over a period of three months. However, it should be emphasized that, the current results might be due to the effects of laser and exercise instead of laser, us and exercise (as we had no independent group for US).
J Back Musculoskelet Rehabil 2012 Jan 1 25(1) 13-9
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Alopecia: A review of laser and light therapies.
Rangwala S, Rashid RM
Department of Dermatology, MD Anderson Cancer Center, University of Texas, Houston, Houston, Texas.
Since the 1980s, laser technology has become increasingly popular to treat a variety of cutaneous conditions. Its successful use as an epilator comes with the rare but interesting side effect of paradoxical hypertrichosis. In this review, we summarize cases describing hair growth after photoepilation, as well as studies testing laser and light sources as treatment for alopecia, particularly androgenetic alopecia and alopecia areata. We also discuss the possible biologic mechanisms by which phototherapy induces hair regeneration.
Dermatol Online J 2012 18(2) 3
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[Comparison of therapeutic effects between plum-blossom needle tapping plus cupping and laser irradiation in the treatment of acute facial palsy patients with concomitant peri-auricular pain].
Zhang CY, Wang YX
People’s Hospital of Peking University, Beijing 100044, China. pumczhangcy@sina.com
OBJECTIVE: To compare the therapeutic effects of plum-blossom needle therapy with cupping and laser irradiation in the treatment of acute facial paralysis with ipsilateral peri-auricular pain. METHODS: Sixty outpatients with acute facial paralysis and ipsilateral peri-auricular pain were divided into plum-blossom needle (treatment) group (n = 28) and laser-irradiation (control) group (n = 32). In the acute stage, patients of the treatment group were treated with plum-blossom needle tapping in combination with cupping at Yifeng (TE 17) and Wangu (GB 12), while those of the control group treated with He-Ne laser irradiation over the same two acupoints until the peri-auricular pain disappeared. The treatment was given once daily. Following disappearance of the pain, routine acupuncture treatment of Yifeng (TE 17), Wangu (GB 12), Dicang (ST 4), etc. was given continuously to patients of the two groups, once daily for 20 times. The treatment times for healing ipsilateral peri-auricular pain, and the electromyogram (EMG, compound muscle action potential) of the ipsilateral musculus orbicularis oris were recorded. Scores of the facial nerve function were given to House-Brackmann Facial Nerve Grading System. RESULTS: The treatment times for healing peri-auricular pain in the treatment group and laser irradiation group were 2.9 +/- 1. 0 and 6.0 +/- 2.2 respectively (t = 6.816, P = 0.000). The scores of House-Brackmann scale of the paralyzed side in the treatment group and control group were (3.3 +/- 1.5) points and (3.3 +/- 1.4) points (P > 0.05) before the treatment; (1.8 +/- 1.1) points and (2.5 +/- 1.2) points (P < 0.05) one month after the treatment, and (1.5 +/- 0.9) points and (2.2 +/- 1.5) points (P < 0.05) three months after the treatment, respectively. The amplitude ratios of compound muscle action potential between the affected side and the healthy side in the treatment group and control group were (52.1 +/- 20.5)% and (51.2 +/- 22.6)% (P > 0.05) during the first two weeks after onset, and (79.2 +/- 11.3)% and (69.8 +/- 17.9)% (P < 0.05) three months after the treatment, respectively. CONCLUSION: Plum-blossom needle tapping plus cupping is significantly superior to that of He-Ne laser irradiation in reducing the treatment sessions for relieving peri-auricular pain during acute stage, and improving facial and muscular functions in the treatment of acute facial paralysis patients.
Zhen Ci Yan Jiu 2011 Dec 36(6) 433-6
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Application of low-level laser therapy for noninvasive body contouring.
Jackson RF, Stern FA, Neira R, Ortiz-Neira CL, Maloney J
Private Practice Physician, Marion, Indiana 46952.
BACKGROUND: Low-level laser therapy (LLLT) is a noninvasive treatment for a wide-assortment of medical ailments. A recent application is for noninvasive body slimming. A Level 1 clinical study was completed and recorded a significant reduction in circumferential measurements across waist, hips, and thighs compared to placebo subjects. Questions remain unanswered to whether the result observed was based upon simple fluid redistribution. The purpose of this retrospective study was to evaluate the efficacy of LLLT for noninvasive body slimming and determine if the loss was attributable to fluid or fat relocation. METHODS: Data from 689 participants were obtained to evaluate the circumferential reduction demonstrated across the treatment site of the waist, hips, and thighs as well as nontreated systemic regions. Patient data were not pre-selected; all reports provided by clinics using LLLT for body contouring were used to evaluate the efficacy of this treatment. Participants received a total of six LLLT treatments across 2-weeks having baseline and post-procedure circumferential measurements recorded. Measurement sites included waist, hips, thighs, arms, knees, neck, and chest. RESULTS: The mean circumferential reduction reported for the waist, hips, and thighs 1 week after the treatment regimen was 3.27 in. (P < 0.0001). Furthermore, participants demonstrated an overall mean reduction of 5.17 in. across all measurement points 5.17 in. (P < 0.0001). Each anatomical region measured exhibited a significant circumferential reduction. CONCLUSION: These data reveal that the circumferential reduction exhibited following LLLT is not attributable to fluid or fat relocation as all measurement points, including nontreated regions, reported an inch loss. Lasers Surg. Med. 44:211-217, 2012. (c) 2012 Wiley Periodicals, Inc.
Lasers Surg Med 2012 Mar 44(3) 211-7
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Nitric oxide produced by cytochrome c oxidase helps stabilize HIF-1alpha in hypoxic mammalian cells.
Ball KA, Nelson AW, Foster DG, Poyton RO
Department of Molecular, Cellular, and Developmental Biology, University of Colorado, Boulder, CO 80309-0347, USA.
The mitochondrial respiratory chain has been reported to play a role in the stabilization of HIF-1alpha when mammalian cells experience hypoxia, most likely through the generation of free radicals. Although previous studies have suggested the involvement of superoxide catalyzed by complex III more recent studies raise the possibility that nitric oxide (NO) catalyzed by cytochrome c oxidase (Cco/NO), which functions in hypoxic signaling in yeast, may also be involved. Herein, we have found that HEK293 cells, which do not express a NOS isoform, possess Cco/NO activity and that this activity is responsible for an increase in intracellular NO levels when these cells are exposed to hypoxia. By using PTIO, a NO scavenger, we have also found that the increased NO levels in hypoxic HEK293 cells help stabilize HIF-1alpha. These findings suggest a new mechanism for mitochondrial involvement in hypoxic signaling in mammalian cells.
Biochem Biophys Res Commun 2012 Mar 17
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TRPV4 channels mediate the infrared laser evoked response in sensory neurons.
Albert ES, Bec JM, Desmadryl G, Chekroud K, Travo C, Gaboyard S, Bardin F, Marc I, Dumas M, Lenaers G, Hamel C, Muller A, Chabbert C
1INSERM U1051.
Infrared (IR) laser irradiation has been established as an appropriate stimulus for primary sensory neurons under conditions where sensory receptor cells are impaired or lost. Yet, development of clinical applications has been impeded by lack of information about the molecular mechanisms underlying the laser induced neural response. Here, we directly address this question through pharmacological characterization of the biological response evoked by mid infrared irradiation of isolated retinal and vestibular ganglion cells from rodents. Whole-cell patch-clamp recordings reveal that both voltage-gated calcium and sodium channels contribute to the laser evoked neuronal voltage variations (LEVV). In addition, selective blockade of the LEVV by micromolar concentrations of ruthenium red and RN1734 identifies thermosensitive TRPV4 channels as the primary effectors of the chain reaction triggered by mid infrared laser irradiation. These results have the potential to greatly facilitate the design of future prosthetic devices aimed at restoring neurosensory capacities in disabled patients.
J Neurophysiol 2012 Mar 21
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Photobiomodulation of Aqueous Interfaces as Selective Rechargeable Bio-Batteries in Complex Diseases: Personal View.
Santana-Blank L, Rodriguez-Santana E, Santana-Rodriguez KE
Fundalas, Foundation for Interdisciplinary Research and Development . Caracas, Venezuela .
Abstract Objective: In this personal view, we propose that the modulation of the structure and function of water by light may come to embody a new mechanistic approach for the treatment of complex diseases. Background data: Long considered an innocuous medium, water has increasingly been found to be a key player in numerous mechanisms, including first-contact events in which cells decide between survival and apoptosis. Consequently, externally applied electromagnetic energy (light) may selectively target the organization of water to steer biological function. Methods: We survey light-water research with particular emphasis on the quasi-crystalline exclusion zone (EZ), part of the cell’s aqueous interface that is just now beginning to be decoded. The current state of research, the technical challenges involved in obtaining evidence in biological systems, and some potential uses and implications of EZ water in medicine are presented. Results: Though existing data have not yet proven the role of EZ water in photobiomodulation, research shows that EZ water can store charge and can later return it in the form of current flow, with as much as 70% of the input charge being readily obtainable. Macroscopic separation of charges can be stable for days to weeks and has unusual electric potential. Water is, thus, an unexpectedly effective charge separation and storage medium. Conclusions: We propose that the EZ may be selectively targeted in photobiomodulation as an efficient energy reservoir, which cells can use expeditiously to fuel cellular work, triggering signaling pathways and gene expression in the presence of injury-induced redox potentials.
Photomed Laser Surg 2012 Mar 19
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Minding the Mind in Photobiomodulation: It Matters!
Lanzafame RJ
Raymond J Lanzafame, M.D., PLLC , Rochester, New York.
Photomed Laser Surg 2012 Mar 8
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Light-induced vasodilation of coronary arteries and its possible clinical implication.
Plass CA, Loew HG, Podesser BK, Prusa AM
Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
BACKGROUND: Low-level laser therapy and light-emitting diodes (LED) are increasingly used in phototherapy. Their therapeutic effects are at least partly mediated by light-induced vasodilation. The aim of this study was to determine the effect of different light sources on coronary arteries. METHODS: Porcine left coronary arteries were cut into 4-mm rings that were irradiated either by a semiconductor nonthermal gallium-arsenide diode laser or a noncoherent athermic red light source both with the same energy density up to 16 J/cm(2). After precontraction with 9, 11-dideoxy-11alpha, 9alpha-epoxymethano-prostaglandin F(2)alpha, respective relaxation responses were evaluated. The role of endothelium as well as intracellular pathways was investigated. RESULTS: Maximum vasodilation after exposure to laser was observed at 10 J/cm(2) (56.8% +/- 1.2%) and decreased to 43.9% +/- 2.8% at 16 J/cm(2) (p < 0.003). After adjusting exposure time to achieve equivalent energy densities in the LED group, vessel segments revealed photorelaxation of 52.9% +/- 6.5% and 47.5% +/- 0.6%, respectively. Vasodilations achieved by either light source were comparable at 10 J/cm(2) (p < 0.574) and 16 J/cm(2) (p < 0.322). Furthermore, vasodilation could be inhibited by administration of 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (nitric oxide scavenger) and 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (guanocyclase inhibitor) but not with L-nitro-arginine methyl ester or deendothelialization. CONCLUSIONS: Vessels exposed to either light source showed a remarkable as well as comparable photorelaxation at definite energy densities. This effect is mediated by an intracellular nitric oxide-dependent mechanism. As LED sources are of small size, simple, and inexpensive build-up, they may be used during routine coronary artery bypass surgery to ease suturing of anastomosis by target vessel vasodilation.
Ann Thorac Surg 2012 Apr 93(4) 1181-6
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Low-level laser on femoral growth plate in rats.
Oliveira SP, Rahal SC, Pereira EJ, Bersano PR, Vieira Fde A, Padovani CR
Department of Veterinary Surgery and Anesthesiology, School of Veterinary Medicine and Animal Science, UNESP, Botucatu, SP, Brazil.
PURPOSE: To determine the influence of low-level laser therapy on femoral growth plate in rats. METHODS: Thirty male Wistar rats aged 40 days were divided into two groups, G1 and G2. In G1 the area of the distal growth plate of the right femur was irradiated at one point using GaAlAs laser 830 nm wavelength, output power of 40 mW, at an energy density of 10 J/cm(2). The irradiation was performed daily for a maximum of 21 days. The same procedure was done in G2, but the probe was turned off. Five animals in each group were euthanized on days 7, 14 and 21 and submitted to histomorphometric analysis. RESULTS: In both groups the growth plate was radiographically visible at all moments from both craniocaudal and mediolateral views. On the 21st day percentage of femoral longitudinal length was higher in G2 than G1 compared to basal value while hypertrophic zone chondrocyte numbers were higher in G1 than G2. Calcified cartilage zone was greater in G1 than in G2 at all evaluation moments. Angiogenesis was higher in G1 than in G2 at 14th and 21st days. CONCLUSION: The low-level laser therapy negatively influenced the distal femoral growth plate.
Acta Cir Bras 2012 Feb 27(2) 117-22
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The systemic effect of 830-nm LED phototherapy on the wound healing of burn injuries: A controlled study in mouse and rat models.
Lee GY, Kim WS
Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Dermatology.
Background: The present controlled study assessed the systemic effect of 830-nm LED phototherapy in rodent models. Materials and methods: Two HR-1 hairless mice and 3 HWY/Slc hairless rats were divided into two groups: the treatment group (Tx Group, one mouse, two rats) and the control group (Con Group, one mouse, one rat). All animals received an identical 12 mm x 12 mm control burn over three sites on the dorsum with a fractional ablative CO(2) laser. Wounds were protected with a film-type dressing. The abdomen of the Tx Group subjects was irradiated with an 830-nm LED array immediately post CO(2) treatment and then at 1, 5 and 6 days post laser irradiation. Wound healing was assessed macroscopically from the clinical photography. Results: At the 2-day post-laser assessment, the healing process in the wounds in the Tx Group was already apparent compared with the Con Group. At the final evaluation (post-burn day 7), no site on the Con Group (six wounds) showed 100% healing, recovery was over 70% in four and lower than 50% in two sites. Of the nine Tx Group sites, 100% recovery was seen in three sites, over 70% in five sites and one wound was exacerbated through trauma. Conclusions: LED phototherapy on the abdomen produced faster wound healing of the uniform burn wounds than in animals with the same burn wounds that did not receive LED phototherapy, strongly suggesting the systemic effect of phototherapy.
J Cosmet Laser Ther 2012 Apr 14(2) 107-10
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Effect of low-level laser therapy on healing of tenotomized Achilles tendon in streptozotocin-induced diabetic rats.
Nouruzian M, Alidoust M, Bayat M, Bayat M, Akbari M
Department of Anatomical sciences and Biology, Medical Faculty, Shahid Beheshti University, MC, PO Box 19395/4719, Tehran, 1985717443, Iran, hamidrr2003@yahoo.com.
Diabetes mellitus (DM) is associated with musculoskeletal damage. Investigations have indicated that healing of the surgically tenotomized Achilles tendon was considerably augmented following low-level laser therapy (LLLT) in non-diabetic, healthy animals. The aim of the present study was to evaluate the effect of LLLT on the Achilles tendon healing in streptozotocin-induced diabetic (STZ-D) rats via a biomechanical evaluating method. Thirty-three rats were divided into non-diabetic (n = 18) and diabetic (n = 15) groups. DM was induced in the rats by injections of STZ. The right Achilles tendons of all rats were tenotomized 1 month after STZ injections. The two experimental groups (n = 6 for each group) of non-diabetic rats were irradiated with a helium-neon (He-Ne) laser at 2.9 and 11.5 J/cm(2) for ten consecutive days. The two experimental groups of diabetic rats (n = 5 for each group) were irradiated with a He-Ne laser at 2.9 and 4.3 J/cm(2) for ten consecutive days. The tendons were submitted to a tensiometric test. Significant improvements in the maximum stress (MS) values (Newton per square millimeter) were found following LLLT at 2.9 J/cm(2) in both the non-diabetic (p = 0.031) and diabetic (p = 0.019) experimental groups when compared with their control groups. LLLT at 2.9 J/cm(2) to the tenotomized Achilles tendons in the non-diabetic and diabetic rats significantly increased the strength and MS of repairing Achilles tendons in our study.
Lasers Med Sci 2012 Feb 28
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Infrared low-level diode laser on serum chemokine MCP-1 modulation in mice.
Fukuda TY, Tanji MM, de Jesus JF, da Silva SR, Sato MN, Plapler H
Experimental Surgery, Federal University of Sao Paulo (UNIFESP), Rua Botucatu, 740-Vila Clementino, Sao Paulo, Sao Paulo, Brazil, CEP: 04023-062, tfukuda10@yahoo.com.br.
The effect of the low-level laser therapy (LLLT) in the modulation of cells related to inflammatory processes has been widely studied, with different parameters. The objective was to investigate the immediate and cumulative effect of infrared LLLT on chemokine monocyte chemotactic protein-1 (MCP-1) modulation in mice. Fifty-two isogenic mice were distributed in seven groups: control (n = 10, no surgical procedure), laser I (n = 7, surgical procedure and a single LLLT exposure 12 h after the surgery), laser II (n = 7, surgery followed by two LLLT exposures, 12 and 36 h after surgery), and laser III (n = 7, surgery followed by three LLLT exposures, 12, 36, and 60 h after surgery). For each group, a sham group (n = 21) underwent surgery without laser application. The animals in the laser groups received an infrared diode continuous laser exposure (AsGaAl, 780 nm wavelength, power of 20 mW, energy density of 10 J/cm(2), spot size of 0,04 cm(2)) on three points (20 s per point), and a final energy of 0.4 J. The animals were sacrificed 36 h (laser I and sham I groups), 60 h (laser II and sham II), and 84 h (laser III and sham III groups) after surgery. The MCP-1 concentrations were measured by cytometric bead array. There was no significant difference between the three periods in the sham group (p = 0.3). There was a lower concentration of MCP-1 in the laser III group compared to the laser I group (p = 0.05). The infrared LLLT showed a cumulative effect in the modulation of chemokine MCP-1 concentration. Three LLLT exposures were necessary to achieve the MCP-1 modulation.
Lasers Med Sci 2012 Mar 14
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The effect of He-Ne and Ga-Al-As laser light on the healing of hard palate mucosa of mice.
Fahimipour F, Mahdian M, Houshmand B, Asnaashari M, Sadrabadi AN, Farashah SE, Mousavifard SM, Khojasteh A
Iran Center for Dental Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Low-level laser therapy (LLLT) has been used to accelerate wound healing, yet questions remain concerning its therapeutic applications. This study aimed to compare the healing efficacy of helium-neon (He-Ne) red light (laser) and gallium aluminum arsenide (Ga-Al-As) infrared lasers at two different doses on hard palate wounds. In a randomized controlled study, 75 adult male mice were divided into five groups of 15 each, after undergoing identical surgical procedures; a control group, with no laser irradiation; HD1 and HD2 groups, treated with He-Ne laser (wavelengths 632.8 nm, power 5 mW, and spot size 0.02 cm(2)) at doses of 4 J/cm(2) and 7.5 J/cm(2) respectively; and GD1 and GD2 groups, treated with Ga-Al-As laser (wavelengths 830 nm, peak power 25 mW, and spot size 0.10 cm(2)) at the doses of 4 J/cm(2) and 7.5 J/cm(2), respectively. Five animals from each group were killed on the third, seventh, and 14 days after surgery, and biopsies were made for histological analysis. On the 3rd and 7th day after the surgery, the number of polymorphonuclear cells (PMN) in HD1, HD2, GD1, and GD2 groups was significantly lower than that of the control group. On the 7th and 14th day, the fibroblasts and new blood vessels counts and collagen density fibers in HD1, HD2, GD1, and GD2 groups were also significantly higher than that of the control groups, and the fibroblast counts and collagen density fibers in HD1 and HD2 groups were higher than that of the GD1 and GD2 groups. LLLT with He-Ne laser compared to Ga-Al-As laser has a positive healing effect on hard palate gingival wounds in mice regardless of the radiation dose.
Lasers Med Sci 2012 Mar 14
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Low-Level Laser Therapy Enhances the Stability of Orthodontic Mini-Implants via Bone Formation Related to BMP-2 Expression in a Rat Model.
Omasa S, Motoyoshi M, Arai Y, Ejima KI, Shimizu N
1 Department of Orthodontics, Nihon University School of Dentistry , Chiyoda-ku, Tokyo, Japan .
Abstract Objective: The aim of this study was to investigate the stimulatory effects of low-level laser therapy (LLLT) on the stability of mini-implants in rat tibiae. Background data: In adolescent patients, loosening is a notable complication of mini-implants used to provide anchorage in orthodontic treatments. Previously, the stimulatory effects of LLLT on bone formation were reported; here, it was examined whether LLLT enhanced the stability of mini-implants via peri-implant bone formation. Materials and methods: Seventy-eight titanium mini-implants were placed into both tibiae of 6-week-old male rats. The mini-implants in the right tibia were subjected to LLLT of gallium-aluminium-arsenide laser (830 nm) once a day during 7 days, and the mini-implants in the left tibia served as nonirradiated controls. At 7 and 35 days after implantation, the stability of the mini-implants was investigated using the diagnostic tool (Periotest). New bone volume around the mini-implants was measured on days 3, 5, and 7 by in vivo microfocus CT. The gene expression of bone morphogenetic protein (BMP)-2 in bone around the mini-implants was also analyzed using real-time reverse-transcription polymerase chain reaction assays. The data were statistically analyzed using Student’s t test. Results: Periotest values were significantly lower (0.79- to 0.65-fold) and the volume of newly formed bone was significantly higher (1.53-fold) in the LLLT group. LLLT also stimulated significant BMP-2 gene expression in peri-implant bone (1.92-fold). Conclusions: LLLT enhanced the stability of mini-implants placed in rat tibiae and accelerated peri-implant bone formation by increasing the gene expression of BMP-2 in surrounding cells.
Photomed Laser Surg 2012 Mar 9
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[Infrared cold laser radiation as an antimutagen]
Shurygina IP, Belichenko NI, Mashkina EV, Pavlov NB, Bogacheva MA, Shkurat TP.
RussiaAbstract Effects of infrared cold laser radiation (IRCLR) on mutagenesis and proliferation of the corneal epithelium were studied with laboratory white mice subjected to instigated circulatory hypoxia of the brain. The experiment was to reveal whether IRCLR influences the frequency of chromosomal rearrangements and to allow calculation of the corneal cells mitotic index for circulatory brain hypoxia. Laser radiation was shown to reconstitute the normal frequency of chromosomal aberrations as well as the mitotic cycle in epithelial cells of the mice cornea. Data of the experiment are promising from the standpoint of antihypoxic use of IRCLR in ophthalmology.
http://www.ncbi.nlm.nih.gov/pubmed/19711865
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Adaptive Responses of Individual Tissue Structures of Rat Gingival Mucosa to Exposure to Low-Intensity 890-nm Laser Irradiation.
Giniatullina ER, Golovneva ES, Giniatullin RU, Kravchenko TG
Center of Specialized Medical Aid, Chelyabinsk State Institute of Laser Surgery, Chelyabinsk, Russia. main@cgilh.chel.su.
Adaptive reactions develop in rat gingival mucosa 1 min after single exposure to low-intensity 890-nm laser: the number of mast cells, degree and index of their degranulation, the diameter of blood vessels and their total area considerably increased. These parameters returned to normal after 1 day, while on days 3-7 they were below the control.
Bull Exp Biol Med 2011 Jul 151(3) 321-3
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Effects of low-level laser irradiation on proliferation and osteoblastic differentiation of human mesenchymal stem cells seeded on a three-dimensional biomatrix: in vitro pilot study.
Leonida A, Paiusco A, Rossi G, Carini F, Baldoni M, Caccianiga G
Department of Periodontology, University of Milano-Bicocca, Piazza Santo Stefano 5, Milan, Italy, leo.doc73@libero.it.
Mesenchymal stem cells (MSCs) from bone marrow are a recent source for tissue engineering. Several studies have shown that low-level laser irradiation has numerous biostimulating effects. The purpose of this trial was to evaluate the effects of Nd:Yag laser irradiation on proliferation and differentiation of MSCs induced into the osteoblastic lineage. MSCs were collected from adult human bone marrow, isolated, and cultured in complete medium (alpha-MEM). Subsequently, they were treated with osteogenic medium, seeded in three-dimensional collagen scaffolds, and incubated. We used six scaffolds, equally divided into three groups: two of these were irradiated with Nd:Yag laser at different power levels (15 Hz, 100 mJ, 1.5 W, and one with a power level of 15 Hz, 150 mJ, 2.25 W), and one was left untreated (control group). Evaluations with specific staining were performed at 7 and 14 days. After 7 days, proliferation was significantly increased in scaffolds treated with laser, compared with the control scaffold. After 14 days, however, laser irradiation did not appear to have any further effect on cell proliferation. As concerns differentiation, an exponential increase was observed after 14 days of laser irradiation, with respect to the control group. However, this was a pilot study with very limited sample size, we conclude, that low-level laser irradiation might lead to a reduction in healing times and potentially reduces risks of failure.
Lasers Med Sci 2012 Mar 25
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Effect of laser irradiation on adrenoreactivity of pial arterial vessels in rats.
Shuvaeva VN, Gorshkova OP, Kostylev AV, Dvoretsky DP
Department of Blood Circulation Physiology, I. P. Pavlov Institute of Phy
