Photobiomodulation in Spinal Cord Injuries
A Review of Literature
Background: The unique privilege of aiding a Neuro-injured individual evaluate Photobiomodulation (PBM) in SCI (spinal cord injury) and TBI (traumatic brain injury) populations was presented recently. As part of the evaluation process, I met with their medical Team prior to discharge from the Neurotrauma Hospital, where they had undergone extensive surgical repair to reduce the emergent-impact of spinal cord and brain injury, as result of a very serious car accident. Once their NeuroTeam confirmed PBM to be safe in SCI and TBI populations, a strategy to complete a home-based clinical trial was established.
The literature review below identifies PBM to provide a comprehensive and complementary approach to managing secondary injury and enhancing recovery for SCI and TBI populations at home. By reducing inflammation, promoting tissue repair, and improving overall well-being, PBM empowers individuals to regain independence and achieve a better quality of life. Integrating PBM into a home-care routine, with appropriate guidance from healthcare providers can be a transformative step in long-term rehabilitation.
Photobiomodulation (PBM), also known as low-level laser therapy (LLLT), is a non-invasive therapeutic intervention that uses red or near-infrared light to stimulate biological processes at the cellular level. For individuals with spinal cord injury (SCI) and traumatic brain injury (TBI), research has shown that PBM’s significant potential in mitigating secondary injury, promoting recovery, and improving quality of life. This report explores the evidence-based benefits of PBM for SCI and TBI populations living at home. Below are several studies that outline the potential benefits of PBM in addressing the unique needs of SCI and TBI populations. More research is required to better understandPBM for clinical application, including in neurotrauma populations. Individuals seeking to utilize PBM are encouraged to consult their regulated health professional for advice and direction.
This blogpost is not an endorsement, and is for informational purposes only.
Study 1: Secondary Injuries of Spinal Cord Injuries
The mechanism of secondary spinal cord injury involves a series of biological changes that begin shortly after the primary spinal cord-level injury and can continue for weeks or months, including:
1. Vascular Damage: The initial injury damages blood vessels in the spinal cord, leading to a lack of oxygen and nutrients (ischemia) in the affected area, which further harms nerve cells.
2. Ionic Imbalance: As nerve cells become damaged, there is an imbalance of ions, especially calcium, in the cells. This disrupts normal cell function and damages cellular structures.
3. Free-Radical Formation: The injury causes an increase in free radicals (unstable molecules) that damage cell membranes, proteins, and DNA, which adds to the injury’s severity.
4. Inflammatory Response: The body sends immune cells, like neutrophils and macrophages, to the injury site to help with repair. However, this response can lead to excessive inflammation, causing additional harm to nerve cells.
5. Neurotransmitter Accumulation: There is an excessive release of neurotransmitters (chemical messengers) like glutamate. Too much glutamate leads to “excitotoxicity,” where nerve cells become overstimulated and damaged.
Together, these changes amplify the damage beyond the initial injury, worsening the loss of motor and sensory function below the injury site. Reference: https://www.ncbi.nlm.nih.gov/books/NBK560721/#:~:text=
Study 2: PBM’s impact on Inflammation & Muscle Recovery after Exercise
A study in the Journal of Biophotonics looks at how photobiomodulation (PBM), a type of light therapy, might help muscles work better, especially for athletes. The researchers found evidence that PBM can boost how muscles function by helping cells produce more energy, reducing stress and inflammation. This could mean faster muscle recovery, better endurance, and overall improved athletic performance. While PBM shows promise for athletes wanting to enhance their performance and recovery, more research is needed to fully understand how it works and to develop standard treatment guidelines. Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC5167494/
Study 3: PBM’s impact on Inflammation and Energy boosting in Muscular Disorders
An editorial in Photo-medicine and Laser Surgery talks about how photobiomodulation therapy (PBMT), a type of light therapy, can benefit muscles. It suggests that PBMT might help improve exercise performance and even assist in treating muscle disorders like muscular dystrophies. According to Ernesto Cesar Pinto Leal-Junior, PBMT can make muscles work better by boosting energy production in cells and reducing inflammation and stress. This means it could help muscles recover faster, become stronger, and endure more, which is great news for athletes. The editorial also hints that PBMT might help people with muscular dystrophies by supporting muscle health, but more research is needed to confirm its effectiveness and figure out the best ways to use it in medical treatments.
Study 4: PBM’s impact on Nerve Cell Energy Production & it’s potential role in Spinal Cord injury
A research article in Frontiers in Pharmacology explores how photobiomodulation (PBM), a type of light therapy, might help people recover from spinal cord injuries. The study shows that PBM can boost the energy production in nerve cells by activating certain pathways that are important for keeping the cell's powerhouses, called mitochondria, healthy. This helps nerve cells survive and function better, aiding in the repair and healing process after a spinal cord injury. The findings suggest that PBM could be a promising treatment option for improving recovery in spinal cord injury patients by focusing on boosting energy and maintaining healthy cells.
Reference: https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.991421/full
Study 5: PBM’s impact on nerve function in Spinal Cord Injury populations
A review by Fatemeh Ramezani and her team looks at how well photobiomodulation (PBM), a type of light therapy, works for treating spinal cord injuries. By examining data from various studies, they evaluate how PBM affects recovery and nerve function in spinal cord injury cases. The results show that PBM can significantly improve movement and help repair nerves, suggesting it could be a promising, non-invasive treatment for spinal cord injuries. The study emphasizes the need for consistent treatment guidelines and more clinical trials to confirm PBM's effectiveness and improve its use in treating these injuries.
Study 6: PBM’s role in NeuroProtection in Spinal Cord Injured populations
A research article in Frontiers in Neuroscience looks at how photobiomodulation (PBM), a type of light therapy, can aid healing after a spinal cord injury by influencing certain brain cells called astrocytes. The study examines two types of astrocytes: A1, which can harm nerve cells, and A2, which helps protect them. The findings show that PBM helps change more A1 astrocytes into A2 astrocytes, creating a more protective environment that supports healing and recovery after a spinal cord injury. This research suggests that PBM could be a promising treatment for improving recovery in spinal cord injury patients by focusing on these cell changes.
Reference: https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2021.768262/full
Study 7: PBM’s impact on Inflammation and its role in nerve repair in Spinal Cord Injured
The study examines how photobiomodulation (PBM), a type of light therapy, affects the regrowth of nerve fibers after oxidative stress, particularly in the context of spinal cord injury. The research shows that PBM not only helps nerve fibers grow back but also encourages immune cells called macrophages to change from a harmful type (M1) to a helpful type (M2). This change is triggered by stimulating a molecule called CCL2 in nerve cells. By creating a more healing-friendly and less inflammatory environment, PBM supports recovery in spinal cord injuries. These findings suggest that PBM could be a promising treatment to improve recovery by targeting both nerve and immune responses. Reference: https://link.springer.com/article/10.1007/s12031-020-01756-9
Study 8: PBM’s impact on inflammation and it’s role in chronic ulcer Wound Management
Photobiomodulation (PBM) uses low-level light, usually red or near-infrared, to help with healing and reduce inflammation. This therapy is noninvasive and has shown promise in treating chronic wounds like skin ulcers, diabetic foot, and pressure ulcers. PBM works by stimulating biological processes in cells, improving blood flow, and reducing infection. Studies show it can aid wound healing and relieve pain, but the results vary widely due to differences in light settings, such as wavelength and intensity. Reference: https://www.sciencedirect.com/science/article/pii/S2666469023000386
Study 9: Efficacy of Photobiomodulation Therapy in Treatment of Pain and Inflammation: A Literature Review
The article examines the effectiveness of photobiomodulation (PBM) therapy—a non-invasive treatment using low-level light—to alleviate pain and inflammation across various conditions. The review highlights PBM’s potential benefits in managing musculoskeletal disorders, fibromyalgia, temporomandibular pain, oral pain, and post-surgical pain and swelling. While the findings suggest that PBM can improve pain thresholds, reduce tender points, and enhance patient well-being, the authors note that results vary due to differences in study designs and PBM parameters. Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC10094541/
Summary: The Role of PBM in Secondary Spinal Cord Injury
Photobiomodulation (PBM) can help reduce the impact of secondary spinal cord injury by using specific light wavelengths (often red or near-infrared) to stimulate healing processes in the cells. Here’s how PBM supports healing and reduces secondary injury:
1. Reduces Inflammation: PBM can help modulate the immune response by decreasing the release of pro-inflammatory molecules and increasing anti-inflammatory ones. This limits excessive inflammation at the injury site, which can otherwise worsen damage to nerve cells.
2. Improves Blood Flow and Oxygen Delivery: By promoting blood vessel dilation, PBM helps improve blood flow to the injured area. This brings in more oxygen and nutrients, helping to counteract the effects of vascular damage that follow the primary injury.
3. Limits Free-Radical Damage: PBM has antioxidant effects, which means it can reduce the production of harmful free radicals. By neutralizing these unstable molecules, PBM protects nerve cells from additional oxidative stress and damage.
4. Restores Ionic Balance and Reduces Excitotoxicity: PBM can help stabilize ion channels in the cell membranes, helping to restore normal calcium levels within cells. This prevents cells from becoming overly stimulated (excitotoxicity), reducing cell death.
5. Boosts Cellular Energy (ATP) Production: PBM activates a cellular enzyme called cytochrome c oxidase in the mitochondria, increasing ATP (energy) production. With more energy, cells have a better chance of surviving and repairing after the injury, which can support overall healing.
6. Stimulates Tissue Repair and Growth: PBM can also stimulate processes like collagen production and blood vessel growth, supporting tissue repair and potentially aiding in the regeneration of nerve cells.
Overall, PBM has been identified to help create a more favourable environment for healing by reducing damaging secondary injury mechanisms and promoting cellular repair processes. This makes it a supportive therapy for minimizing further damage and enhancing recovery after a spinal cord injury.
Highlights of the literature review:
PBM Longterm impact: PBM has been identified to reduce the risk of secondary complications like pressure ulcers, chronic pain syndromes, and long-term neurodegeneration.
Regular use of PBM has been identified to help maintain functional ability while slowing
the progression of secondary injury processes.
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