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	<title>The DelRe Protocols &#187; TLT</title>
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		<title>Potential for Transcranial Laser or LED Therapy to Treat Stroke, Traumatic Brain Injury, and Neurodegenerative Disease</title>
		<link>http://thedelreprotocols.com/potential-for-transcranial-laser-or-led-therapy-to-treat-stroke-traumatic-brain-injury-and-neurodegenerative-disease/</link>
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		<pubDate>Tue, 02 Aug 2011 16:21:52 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[The DelRe Protocols Blog]]></category>
		<category><![CDATA[brain injury]]></category>
		<category><![CDATA[harvard medical school]]></category>
		<category><![CDATA[led therapy]]></category>
		<category><![CDATA[neurodegenerative disease]]></category>
		<category><![CDATA[stroke]]></category>
		<category><![CDATA[TLT]]></category>
		<category><![CDATA[Transcranial Laser]]></category>
		<category><![CDATA[transcranial light therapy]]></category>

		<guid isPermaLink="false">http://thedelreprotocols.com/?p=454</guid>
		<description><![CDATA[An Editorial&#8230; Potential for Transcranial Laser or LED Therapy to Treat Stroke, Traumatic Brain Injury, and Neurodegenerative Disease <p>Margaret A. Naeser, Ph.D., L.Ac.,1,2 and Michael R. Hamblin, Ph.D.3,4,5</p> <p>An Excerpt:</p> <p style="text-align: left;">&#8220;In an early study with TLT, (transcranial light therapy,) to treat acute stroke in rats, significant beneficial results were obtained whether TLT was [...]]]></description>
			<content:encoded><![CDATA[<h2>An Editorial&#8230;</h2>
<h2>Potential for Transcranial Laser or LED Therapy to Treat Stroke, Traumatic Brain Injury, and Neurodegenerative Disease</h2>
<p>Margaret A. Naeser, Ph.D., L.Ac.,1,2 and Michael R. Hamblin, Ph.D.3,4,5</p>
<p>An Excerpt:</p>
<p style="text-align: left;"><span style="font-size: large;">&#8220;In an early study with TLT, (</span>transcranial light therapy,<span style="font-size: large;">) to treat acute stroke in rats,</span> <span style="font-size: large;">significant beneficial results were obtained whether TLT was</span> <span style="font-size: large;">applied in a bilateral, ipsilesional or contralesional manner.12</span> <span style="font-size: large;">TLT (808 nm) significantly improved recovery ( p &lt; 0.01) at 3</span> <span style="font-size: large;">weeks following ischemic stroke when treated once, at 24 h</span><br />
<span style="font-size: large;">post-stroke (contralesional; power density, 7.5mW/cm2 to</span> <span style="font-size: large;">brain tissue).9 The number of newly formed neuronal cells,</span> <span style="font-size: large;">assessed by double immunoreactivity to BrdU and tubulin</span> <span style="font-size: large;">isotype III, as well as migrating cells (doublecortin immunoreactivity),</span> <span style="font-size: large;">was significantly elevated in the ipsilesional SVZ.</span> <span style="font-size: large;">There was no significant difference in the stroke lesion area</span> <span style="font-size: large;">between control and laser-irradiated rats. The authors suggested</span> <span style="font-size: large;">that an underlying mechanism for the functional benefit</span> <span style="font-size: large;">post-TLT was possible induction of neurogenesis. Other</span><br />
<span style="font-size: large;">studies have also suggested that because improvement in</span> <span style="font-size: large;">neurologic outcome may not be evident for 2–4 weeks in the</span> <span style="font-size: large;">post-stroke rat model, delayed benefits may be caused, in part,</span> <span style="font-size: large;">by induction of neurogenesis and migration of neurons.13,14</span><br />
<span style="font-size: large;">A recent study with embolized rabbits showed a direct</span> <span style="font-size: large;">relationship between level of cortical fluence (energy density,</span> <span style="font-size: large;">J/cm2) delivered, and cortical ATP content.15 Five minutes</span> <span style="font-size: large;">following embolization (right carotid), rabbits were exposed</span></p>
<p style="text-align: left;"><span style="font-size: large;">1VA Boston Healthcare System, West Roxbury, Massachusetts.</span><br />
<span style="font-size: large;">2Department of Neurology, Boston University School of Medicine, Boston, Massachusetts.</span><br />
<span style="font-size: large;">3Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.</span><br />
<span style="font-size: large;">4Department of Dermatology, Harvard Medical School, Boston, Massachusetts.</span><br />
<span style="font-size: large;">5Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts.</span><br />
<span style="font-size: large;">Photomedicine and Laser Surgery</span></p>
<p><span style="font-size: large;">to 2 min of NIR TLT using 808-nm laser on skin surface,</span> <span style="font-size: large;">posterior to bregma at midline. Three hours later, the cerebral</span> <span style="font-size: large;">cortex was excised. Use of continuous wave (CW) TLT</span> <span style="font-size: large;">(7.5mW/cm2, 0.9 J/cm2) resulted in a 41% increase in cortical</span> <span style="font-size: large;">ATP. Use of 100-Hz pulsed wave (PW) TLT (37.5mW/</span> <span style="font-size: large;">cm2, 4.5 J/cm2) resulted in a 157% increase in cortical ATP.</span><br />
<span style="font-size: large;">Surprisingly, the increased cortical ATP level of 157% was</span> <span style="font-size: large;">higher than that measured in naive rabbits that had never</span> <span style="font-size: large;">suffered stroke. The authors suggested in future studies,</span> <span style="font-size: large;">greater improvement might be achieved by optimizing</span> <span style="font-size: large;">length of treatment, and mode of treatment (PW, perhaps at</span> <span style="font-size: large;">100 Hz).</span><br />
<span style="font-size: large;">TLT has been shown to significantly improve outcome in</span> <span style="font-size: large;">human acute stroke patients, when applied at *18 h poststroke,</span> <span style="font-size: large;">over the entire surface of the head (20 points in 10/20</span> <span style="font-size: large;">EEG system) regardless of stroke location.16–18</span></p>
<p style="text-align: left;"><span style="font-size: large;">Significant</span> <span style="font-size: large;">improvements ( p &lt; 0.04) were observed in the moderate and</span> <span style="font-size: large;">moderate–severe stroke patients only (n = 434), who received</span> <span style="font-size: large;">the real laser protocol (vs. sham), but not in severe stroke</span> <span style="font-size: large;">patients.17</span><br />
<span style="font-size: large;">To date, there are no TLT studies to treat chronic stroke</span> <span style="font-size: large;">patients. The use of laser light to stimulate acupuncture</span><br />
<span style="font-size: large;">points on the body (instead of needles) to treat paralysis in</span> <span style="font-size: large;">chronic stroke patients ( &gt; 10 months post-stroke onset) has</span> <span style="font-size: large;">resulted in similar levels of improvement, following a series</span> <span style="font-size: large;">of 20 or 40 laser (or needle) treatments.19–21 A 20-mW, 780-</span> <span style="font-size: large;">nm, CW laser with 1-mm diameter aperture (Unilaser,</span><br />
<span style="font-size: large;">Denmark) was used (51–103 J/cm2 per point). Overall, 5/7</span> <span style="font-size: large;">(71.4%) of the patients showed improvement, with an increase</span> <span style="font-size: large;">of 11–28% in isolated, active range of motion for</span> <span style="font-size: large;">shoulder abduction, knee flexion, and/or knee extension.</span><br />
<span style="font-size: large;">The two patients who showed no improvement had severe</span> <span style="font-size: large;">paralysis, with results similar to TLT results with severe,</span> <span style="font-size: large;">acute stroke patients.17 Therefore, stroke patients with paralysis</span> <span style="font-size: large;">improved when the paralysis was not severe, although</span> <span style="font-size: large;">a reduction in spasticity has been observed in severe</span> <span style="font-size: large;">cases (M.A.N., personal observation). Stroke patients with</span> <span style="font-size: large;">only mild or moderate hemiparesis (including only hand</span> <span style="font-size: large;">paresis) appear to have the best potential for improvement.</span><br />
<span style="font-size: large;">On brain CT scan, these mild–moderate cases have smaller</span> <span style="font-size: large;">areas of infarction adjacent to the body of the lateral ventricle,</span> <span style="font-size: large;">than those with severe paralysis in whom the lesion is</span> <span style="font-size: large;">often adjacent to the body of the lateral ventricle, closer to the</span> <span style="font-size: large;">SVZ, possibly impeding potential for neurogenesis. Depth of</span> <span style="font-size: large;">white matter lesion appears to be more important regarding</span> <span style="font-size: large;">potential for recovery than is the overall size of the cortical</span> <span style="font-size: large;">lesion.19–22 (See also: www.bu.edu/naeser/acupuncture)&#8221;</span></p>
<p style="text-align: left;"><span style="font-size: large;">Link:</span></p>
<p style="text-align: left;"><span style="font-size: large;"><a href="http://www.liebertonline.com/doi/pdfplus/10.1089/pho.2011.9908" target="_blank">http://www.liebertonline.com/doi/pdfplus/10.1089/pho.2011.9908</a></span></p>
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		<item>
		<title>Stroke&#8230;.A New Way to Help</title>
		<link>http://thedelreprotocols.com/stroke-a-new-way-to-help/</link>
		<comments>http://thedelreprotocols.com/stroke-a-new-way-to-help/#comments</comments>
		<pubDate>Thu, 04 Jun 2009 03:15:19 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[The DelRe Protocols Blog]]></category>
		<category><![CDATA[coherent light]]></category>
		<category><![CDATA[low level laser]]></category>
		<category><![CDATA[Neurothera]]></category>
		<category><![CDATA[stroke]]></category>
		<category><![CDATA[TLT]]></category>
		<category><![CDATA[transcranial laser therapy]]></category>

		<guid isPermaLink="false">http://thedelreprotocols.com/?p=246</guid>
		<description><![CDATA[<p>NeuroThera(R) is what was used in a study of Transcranial Laser Therapy. As far as I can tell from the patent, they use a 100 mw unfocused coherent light. Since the patent is going to be as broad as possible, I did not see reference to wavelengths chosen, or whether it is pulsed or not. [...]]]></description>
			<content:encoded><![CDATA[<p><span style="font-size: large;">NeuroThera(R) is what was used in a study of Transcranial Laser Therapy. As far as I can tell from the patent, they use a 100 mw unfocused coherent light. Since the patent is going to be as broad as possible, I did not see reference to wavelengths chosen, or whether it is pulsed or not. Although a 100 mw red laser will penetrate up to 2 inches, much of the coherence of the light is lost, and my take on this is that the blood is treated, stimulated, and carries bio-stimulating effects to the surrounding tissues. If that is the case, then a standard 5 mw red laser pointer from Office Depot may work almost as well, for this and many other conditions. It is a matter of the math. It just takes longer to deliver the same amount of energy. While it would be foolish to try this during an acute stroke event, some may want to try it afterwards, when stable. This would be considered as a high unknown risk.</span></p>
<h2><span style="font-size: large;">A New Treatment for Stroke is Showing Promise</span></h2>
<p><span style="font-size: large;">Here are a couple of excerpts of a press release about clinical trials of putting the unfocused laser against the skin of the skull, illuminating the brain within 24 hours of a stroke, and continuing such treatment for a period of less than 3 months.</span></p>
<p><span style="font-size: large;">&#8220;TLT is one of the most promising new therapies that we&#8217;ve seen in a long time, especially as it may expand the treatment window for ischemic stroke to 24 hours. We look forward to commencing NEST-3 to further investigate TLT,&#8221; stated Professor Werner Hacke, M.D., Ph.D., Chairman of Neurology at the University of Heidelberg, who will join Professor Zivin as Co-Chairman of the NEST-3 Steering Committee.</span></p>
<p><span style="font-size: large;">A post-hoc analysis of 434 patients who suffered moderate to moderately severe strokes showed a favorable outcome in 51.6% of patients in the TLT group compared to 41.9% of patients in the sham group. This 9.7% treatment effect was statistically significant (p-value 0.044).</span></p>
<p><span style="font-size: large;">Source: <a href="http://www.reuters.com/article/pressRelease/idUS262817%2B20-Feb-2009%2BPRN20090220" target="_blank">http://www.reuters.com/article/pressRelease/idUS262817%2B20-Feb-2009%2BPRN20090220</a></span></p>
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