Barriers To Popularizing Nir As A Neuroprotective Modality For Pd
Figure 2. Alternative sites for implantation of NIR delivery device apart from the ventral midbrain. Wirelessly powered NIR delivery devices in the 3rd ventricle and the sphenoid sinus , both of which are close to the ventral midbrain. Insertion of the device into the 3rd ventricle can be achieved safely via a straight trajectory traversing the Foramen of Monroe. Insertion of the NIR device within the SS in the posterior part of the nasal cavity can be achieved using an endoscopic endonasal approach. Abbreviations: FoM, foramen of Monroe NIR, near-infrared SNpc, substantia nigra pars compacta SS, sphenoid sinus.
Aids Daytime Sleepiness And Other Sleep Disorders
Humans rest and wake based on a daily cycle called the circadian rhythm. Both light and melatonin play a role in the regularity of the cycle. Many people with PD suffer from sleep disturbances. It is thought that NIr may play a role in improving healthy sleep patterns.3
People with Parkinson’s often experience excessive daytime sleepiness, general fatigue, nighttime sleep disturbances, and depression all of which can affect healthy sleep and the circadian rhythm. According to research reported in the February 2017 JAMA Neurology Journal, light therapy significantly reduced daytime sleepiness, improved sleep quality, decreased overnight awakenings, improved daytime alertness and activity level, and improved motor symptoms in people with Parkinson’s.6
Different kinds of light therapy have been used effectively for other sleep, psychiatric, and medical conditions for decades. NIr continues to be studied in the clinical setting in order to determine how it can best be applied in treating Parkinson’s and other medical conditions. Long-term, large scale controlled studies will help to better evaluate the efficacy of NIr as way to mitigate symptoms as well as possibly slow or limit or reverse disease progression.
Does Blue Light Therapy Have Side Effects
Blue light therapy is generally safe, but its important to consider the potential side effects of blue light used in photodynamic treatment.
Since photodynamic blue light therapy increases the skins sensitivity, skin may swell, turn red, peel, blister or scab after treatment. You also need to take precautions in the two days following a photodynamic skin treatment:
- Stay out of strong, direct light.
- Wear protective clothing.
- Avoid surfaces that may reflect strong light.
As long as you receive your treatment from a trained provider and take the proper precautions, photodynamic blue light therapy should help improve your skin, not damage it.
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Diy Helmets Sent Around Australia
The Dorset Community Shed started making its own light bucket helmets last year after hearing of people’s success using the lights.
Mervyn Chilcott said the shed has made 78 buckets since last April and has more on order.
“We start off with a rubbish bin, cut the top off and line it with LED lights that we bring in from China,” he said.
“They’ve gone all over Tasmania and different parts of Australia and they are definitely making a difference in the quality of life.
“They mightn’t be curing Parkinson’s, but they’re certainly giving quality of life to people with Parkinson’s and other people with brain disorders.”
Experts warn red light treatment should not be used without consulting with a health professional first.
And even though it will take time before the results are known, those using the lights said they will keep using them anyway.
“With the work that’s now being done on using light therapy, I think it will open up much broader opportunities and possibilities for the medical profession that haven’t yet been discovered,” Mr Burr said.
How Does Light Therapy Work
Light therapy, or Photobiomodulation , is the non-thermal delivery of waves of light energy with a therapeutic benefit.At an optimal wavelength, intensity and exposure time, light aimed at human tissue sets off a series of biochemical events that can result in chronic pain relief, reduced inflammation, and even increased dopamine and serotonin production in the colon.
The PDCare Laser therapy increases gut fermentation of dietary fibre, which in turn facilitates the production of helpful gut metabolites .SCFAs are important for manufacturing the neurotransmitters dopamine and serotonin that are in short supply in a Parkinsons patient . In essence, the gut takes on an even greater load and compensates for the reduction of dopamine production in the brain.
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Mitochondrial Dysfunction And Parkinsons Diseasenear
- 1Department of Physiology, National University of Singapore, Singapore, Singapore
- 2Division of Neurosurgery, Department of Surgery, University Surgical Cluster, National University Hospital, Singapore, Singapore
- 3Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- 4Department of Research, National Neuroscience Institute, Singapore, Singapore
The Potential Of Light Therapy In Parkinson’s Disease
Accepted for publication 10 December 2013
18 February 2014Volume 2014:4Pages 114
Introduction
The current gold standard treatments for Parkinsons disease are very effective at attenuating the motor signs, at least initially. However, they do not reliably slow the progression of the disease neurons continue to die during the course of treatment. The discovery of new therapeutic approaches that offer neuroprotection against parkinsonian insult is therefore paramount. In this context, several recent studies in animal models of Parkinsons disease, as well as other models of disease , have reported that red to infrared light therapy can be neuroprotective. There is real potential for the development of light therapy as a treatment option for Parkinsons disease patients one that slows the ongoing neuronal death and progression of the disease.
Overview of Parkinsons disease
Current therapies for Parkinsons disease
Dopamine drug therapy
In general, these drug treatments have very good early symptomatic effects, but their longer-term neuroprotective or disease modifying effects are far from clear. For example, although drugs such as selegiline and rasagiline have been tested as putative neuroprotective agents in clinical trials, their ability to actually stop neuronal death and slow the pathology of the disease has yet to be demonstrated.26
Surgical treatment
Putative neuroprotective treatments
What is light therapy and how does it offer neuroprotection?
Cell survival
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In Depth: Dr Greg Willis
“In the early years of dopamine theory it was generally accepted that the more severe the cell loss, the more severe the dopamine deficiency and the more severe the Parkinsons disease. However, this position has been very gradually eroded by the ongoing demonstration that this relationship is a poor one. In fact, recent work has demonstrated that Parkinsons disease can develop with only 30% loss of dopamine 715-725, 2010) suggesting that it is not only the level of dopamine that is important. This has important implications for treating the disease and is consistent with our approach using coordinated drug and light treatment.”
Willis’ understanding of the mechanisms of Parkinson’s Disease is a little different from the standard, accepted picture. He argues that it is not just about the lack of production of dopamine but that the balance between dopamine and melatonin, the substance responsible for making us sleepy, is whats broken. It is this imbalance, he argues, which can cause many of the symptoms of PD. so it’s not just that there isn’t enough dopamine in the system, but there is actually too much melatonin, relatively speaking.
In his latest paper with co-workers, Dr Willis provides a good description of the protocol his clinic employs:
The same article also covers issues with why bright light therapy might not initially work for every person with PD:
Nir For Alzheimer’s Disease
The majority of the studies reporting beneficial effects of NIr treatment in Alzheimer’s disease or dementia have been in transgenic animal models, in particular those displaying -amyloid , or tau pathologies .1). In general, with either acute or more chronic NIr treatment, these studies have reported reductions in -amyloid plaques, neurofibrillary tangles of hyperphosphorylated tau protein, inflammation and oxidative stress, together with increased ATP levels and improved overall mitochondrial function. In addition, NIr reduced the characteristic cognitive deficits associated with the CD1 and APP/PS1 transgenic mouse models. One in vitro study reported that, after internalization of -amyloid into human neuroblastoma cells, NIr treatment increased ATP levels and overall cell number, while reducing -amyloid aggregates .
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How Does Nir Work To Neuroprotect
The mechanisms that underpin NIr-induced neuroprotection are not entirely clear, although they appear to operate in at least two different biological levels. First, NIr acts at a cellular level, activating intracellular cascades that ultimately contribute to the survival of the target, and possibly neighboring, cells and/or stimulating neurogenesis. Second, NIr appears capable of triggering systemic protective mechanisms this presumably involves as yet unidentified circulating cellular or humoral factors that can transduce protective effects to the brain .
The putative NIr protective mechanisms in the brain. Direct NIr stimulation of the mitochondria of the damaged neurons or endothelial cells. This stimulation would repair the damage leading to neuronal protection. NIr may also stimulate neurogenesis in the hippocampus and/or synaptogenesis in the damaged neurons indirect stimulation via circulating immune cells and/or bone marrow stem cells leading to neuronal protection. The latter is similar to the so-called abscopal effect in the treatment of cancer metastasis. We suggest that the primary mechanism is the direct effect, of neurons and/or of endothelial cells, while the systemic indirect effect forms a secondary supportive mechanism.
Shining A Light On Non
Parkinsons is frequently associated with motor-related symptoms, but non-motor symptoms such as sleeplessness, cognitive defects, and mental health issues are equally or more prevalent, especially in later stages of the disease. BLT, or bright light therapy, can help alleviate both categories of symptoms.
Research on the topic is relatively new. But a 2018 study in Trends in Neurosciences stated BLT significantly improves motor dysfunction including bradykinesia, rigidity, tremor, nocturnal movements, dyskinesia and postural imbalance. It went on to affirm the efficacy of BLT in reducing depression, anxiety, and multiple forms of sleep problems including insomnia, prolonged daytime sleeping, and discontinuity in the sleep cycle.
The reasons for BLTs effectiveness are believed to be linked to the restoration of circadian functions, which can be compromised by dopamine-based therapy. Yet regardless of the reason, BLT is now understood to provide multiple benefits.
Recent reports indicate that private-sector companies are developing light therapy devices for home use and medically directed home care professionals will be optimally positioned to help administer it.
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The Integrated Care Management Model By Seniorbridge
Home care services vary widely in the services they provide.
SeniorBridge offers an integrated care management practice model that involves two components:
NOTE: We have full COVID-19 safety protocols in place to keep clients, families and associates safe.
Nir For Parkinson’s Disease
Mainly due to the existence of effective toxin-based in vitro and in vivo models, there have been considerably more reports on the beneficial effects of NIr for Parkinson’s disease .2). The first studies to report neuroprotection by NIr after parkinsonian insult demonstrated that NIr treatment reduced cell death, increased ATP content and decreased levels of oxidative stress in rat striatal and cortical cells exposed to the parkinsonian toxins rotenone and MPP+ in vitro . In cultures of human neuroblastoma cells engineered to overexpress -synuclein, NIr increased mitochondrial function and reduced oxidative stress after MPP+ exposure . Further, in hybrid cells bearing mitochondrial DNA from Parkinson’s patients, mitochondrial movement along axons improved substantially after NIr treatment, with movement restored to near control levels .
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Linking Mitochondrial Dysfunction With Pd
The mitochondrial theory of PD is based on observations in which disease processes impairing oxidative phosphorylation, mitochondrial biogenesis or mitophagy manifest as phenotypes that share common Parkinsonian features. The first link between PD and mitochondrial dysfunction was conceived by Langston after observing rapidly developing Parkinsonian features in intravenous drug abusers who were exposed to 1-methyl-4-phenyl-1,2,3,4-tetrahydropyridine , a toxin whose metabolite 1-methyl-4-phenylpyridinium inhibits mitochondrial complex I . Once in the central nervous system, MPP+ is taken up by the dopamine active transporter and induces the selective degeneration of SNpc dopaminergic neurons. This phenomenon has been successfully reproduced in MPTP-treated rodents and nonhuman primates, popularizing these animal models for PD research . Complementing the findings in MPTP, rotenone, a pesticide that inhibits mitochondrial complex I, produced similar PD-like locomotor deficits in treated animals. Despite it having widespread uptake in the central nervous system, the toxic effects of rotenone are most pronounced in SNpc dopaminergic neurons, reinforcing the belief that neurons with greater susceptibility to energy perturbances would be affected the most . Further evidence is gleaned from epidemiological studies, which identified rotenone-exposed agrarian populations to be at greater risk of developing PD .
What Parkinson’s Locks Away
Parkinsons is both a neurological and movement disorder which occurs when brain cells producing dopamine slowly begin to die off.When dopamine levels get too low, neurons start to fire more randomly, leading to the classic symptoms of Parkinsons tremour, rigidity and/or stiff muscles, slowness of movement and unstable posture.Additionally, patients may experience problems sleeping, decreased sense of smell, depression or anxiety and problems with more typical brain functions such as planning, making decisions or paying attention.
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Not A Mainstream Treatment
Those in the profession of medically directed home care have long known that light can elevate mood, help restore sleep patterns, and introduce energy into the homes of people facing chronic and debilitating conditions. The advancement of light-related therapies shows the potential of a new way for us to help people facing Parkinsons disease, Alzheimers, and perhaps other conditions yet to be discovered.
This is still not considered a mainstream treatment, said Christina Hahn, RN, MSN and Care Manager Supervisor for SeniorBridge. But if and when it becomes one, we can assist with therapy sessions in and outside the home in accordance with the doctors orders.
Direct Stimulation Of Cells
There is a large body of work reporting that a number of molecular and cellular systems are influenced by NIr. At a cellular level, NIr displays a biphasic dose-response curve, suggesting that NIr is a low-level stressor of cells and that the activation of endogenous cellular stress response systems is likely to be central to its efficacy . The main direct target of NIr appears to be cytochrome c oxidase, a key enzyme of the mitochondrial respiratory chain .2A). This enzyme is a photoacceptor of light in the NIr range NIr exposure produces a redox change in cytochrome c oxidase which causes a transient change in mitochondrial membrane potential, leading to increase ATP production and a burst in low levels of reactive oxygen species . This, in turns, triggers a cascade of secondary downstream signaling pathways that collectively stimulate endogenous cell protection and repair mechanisms . This modulation of multiple molecular systems appears capable of both conditioning neurons to resist future damage and accelerating repair of neurons damaged by a previous or continuing insult .
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Light Therapy May Promote Daytime Alertness And Better Sleep In Parkinson’s
In a new study, when people with Parkinsons disease who experienced daytime excessive sleepiness were exposed to bright light twice a day, using light boxes similar to those available in drug stores, they were more alert in the daytime and slept better at night. This research funded by the Parkinsons Foundation appears in the February 20 online edition of JAMA Neurology.
Daytime sleepiness is a common symptom of PD as well as a side effect of its medications. Many people with PD also have trouble falling asleep and staying asleep at night. Though light therapy has been proven helpful to healthy older adults, and others with similar sleep difficulties, it has not been rigorously explored in Parkinsons. Researchers led by Aleksandar Videnovic, M.D., M.Sc., at Massachusetts General Hospital in Boston, tested whether light therapy also could help people with Parkinsons maintain a healthy sleep-wake cycle.
The study enrolled 31 people with PD who had excessive daytime sleepiness, as determined by a standard rating scale. Study participants had lived with PD for six years on average. None of the participants had sleep apnea or rapid-eye-movement sleep behavior disorder.
Results
What Does It Mean
Researchers note that exposure to the outdoors, or even participation in a structured activity could explain why people in the low-light group also benefitted.
References
An Overview Of Red Light Therapy
Red light therapy is often used as an umbrella term that encompasses both red light and near-infrared light. Other terms that are commonly used for this treatment method are photobiomodulation and low-level light therapy .
The major difference between red light and NIR light is the depth to which they can penetrate tissue and bone. Red light can absorb into the bodys tissues up to about 1-2cm . NIR light wavelengths absorb about 4cm .
Red light therapy has been shown in hundreds of clinical studies to have a wide variety of therapeutic effects on the human body. The treatment is administered to bare skin and t forehead via powerful light-emitting diode bulbs.
Light photons are absorbed into the skin and underlying tissue where they interact with mitochondria, the energy factories inside most cells. Mitochondria, in turn, are stimulated to produce adenosine triphosphate , which is the primary fuel for cells. This process is much like photosynthesis, whereby plants absorb energy from the sun to make glucose for their food.
Because of the difference in wavelengths, red light and NIR light are suitable for different types of therapies. Red light soaks into the skin where it stimulates collagen and elastin production, along with forming capillaries and reducing inflammation. Its shorter wavelengths can’t absorb deeper into the body, so its the ideal therapy for chronic skin conditions, hair loss, and for reversing the signs of aging.
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