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New Low Level Laser Therapy Research on Spinal Cord Injuries: My issue with the dosage of LLLT.

Effects of Intravascular Laser Irradiation of Blood in Mitochondria Dysfunction and Oxidative Stress in Adults with Chronic Spinal Cord Injury

Shih-Fong Huang, Yun-An Tsai, Shi-Bei Wu, Yau-Huei Wei, Po-Yi Tsai, and Tien-Yow Chuang. Photomedicine and Laser Surgery. October 2012, 30(10): 579-586. doi:10.1089/pho.2012.3228.

The above study delves into intravascular laser irradiation of blood (ILIB) in order to produce a more positive outcome for those with spinal cord injuries. I have an issue with the levels of illumination, (higher than necessary,) however many researchers seem to feel that “more is better”, and in my opinion that is wrong:

Table 2. Parameters Involved in Determining the ILIB Dose

Irradiation time or energy delivered
Irradiation parameter Measurement Comment
Wavelength 632.8 nm Visible red low-level laser
Power output 4 mW Measured at the tip of the fiberoptic needle by optical power and energy meter
Irradiance (intensity or power intensity) 2.04 W/cm2 Irradiance=Power (W)/area (cm2), the diameter of optical fiber aperture=0.5 mm; area=3.14×(0.025×0.025)=0.00196 cm2; irradiance=0.004/0.00196=2.04 W/cm2
Energy 14.4 J Energy(joules)=Power (W)×Time(sec)=0.004 (W)×3600 (sec)=14.4 J
Energy density (fluence) 7346.93 J/cm2 Fluence=Power×time/area=0.004(W)×3600 (sec)/0.00196 cm2=7346.93 J/cm2
Irradiation time 3600 sec One hour per each treatment
Treatment interval 15 times Fifteen times over 3 weeks

The good thing is that they limited the Power output to 4 mW. Total J should have been kept under 4J. Given the one hour time period per treatment, (too much, in my opinion,) they should have used perhaps 1 mW instead of 4 mW, if they wanted an illumination for one hour. That would have brought the total Joules per treatment to under 4 J per treatment. Too much illumination at 14.4 J won’t harm, but may decrease the ultimate effect.

Otherwise, at a power output of 4 mW, the time should have been kept under 15 minutes. The problem with this alternative approach is that the energy density would still be 7346.93 J/cm2, which is way too much, in my opinion. It would have the effect of “stunning” the blood cells passing through the illumination, decreasing the positive potential for the outcomes being reached for.

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