Light Therapy (Photobiomodulation)
Photobiomodulation is a new treatment for concussions being developed by researchers and clinicians which utilizes lasers and LED light devices to deliver light in the visible and infrared spectrum. Photobiomodulation treatment is a neuroplastic therapy which assists the brain with healing and functional recovery.
Our professional contributor Anita Saltmarche, BScN, MHSc, has reviewed this article for accuracy and contributed some of the content.
The basics of light therapy (photobiomodulation)
LED light therapy devices
In the past decade, researchers and clinicians have been studying the use of medical grade light devices to affect healing in the brain for post-concussion syndrome, PTSD, and Alzheimer's. Numerous clinical trials are ongoing, with initial findings from clinical trials showing positive results. The studies use either the MedX Health devices or Vielight devices. The MedX Health devices emit a combination of infrared and visible red energy, and the Vielight emits near-infrared light. Both devices have small consoles to control the delivery of the light. In the clinical trials, the treatments involve the light therapy devices placed on the head, so the light enters through the skull, rather than through the eyes. We are focusing on LED medical devices because most of the research on concussion treatment has been done using this technology.
Low-level laser therapy devices
Low-level laser therapy devices are also being used for concussions. We will be adding information about this treatment in the near future.
All the medical photobiomodulation devices use non-ionizing forms of light, which means that the light does not carry enough energy to break molecular bonds and ionize atoms. This is compared to ionizing forms of light which break the bonds between molecules and ionizes atoms, such as gamma rays from radioactive materials and X-rays.
Please note that our professional consultant Anita Saltmarche strongly advises against the use of non-medical grade light devices for treatment of concussions or post-concussion syndrome. These are her reasons:
There is no information about the effectiveness of non-medical light devices. Different light devices have different outputs which will have unknown effects.
There is potential for harm with the use of non-medical devices to treat something as vulnerable as the brain.
Additional information concerning light therapy for military veterans with a concussion on our Veterans page.
History and research findings for light therapy for concussions
Photobiomodulation Therapy, using Low-Level Laser or LED Light Therapy devices has been used for over 50 years. These medical light therapy devices have been successfully used to enhance wound healing and to treat musculoskeletal conditions. The clinical benefits of using photobiomodulation include accelerated healing and an increase in local blood flow and decreased pain, swelling, and edema. Research indicates that light therapy "is used to increase wound healing and tissue regeneration, to relieve pain and inflammation, to prevent tissue death, to mitigate degeneration in many neurological indications."
Photobiomodulation is a relatively new therapy to treat brain injuries as well as neurological and cognitive disorders. Clinicians have been using light therapy with their patients for 15 years and publishing research regarding these treatments for 10 years. Although larger-scale research studies are needed, the past decade of clinical and research results on photobiomodulation for the brain show promise:
Photobiomodulation for the brain is safe, based on15 years of clinical application and 10 years of research.
Photobiomodulation is effective - small-scale research studies suggest that light therapy can have positive clinical outcomes for concussions and TBI.
It is an excellent "adjunctive" therapy - it appears to enhance other clinical therapies such as occupational therapy, physical therapy, and craniosacral therapy.
Researchers recommend it as a "first-line treatment" - there is some indication that the sooner the treatment is started, the better.
Researchers have seen many people who have shown improvements when using light therapy for longer-term concussion symptoms.
Testimonials from concussion patients who have used photobiomodulation treatment can be found on Anita Saltmarche's website.
Scroll down for the science behind light therapy
How to access Light Therapy (Photobiomodulation)
Although light therapy for concussions and post-concussion syndrome is still in the research stage, individual concussion patients can purchase the same equipment that researchers are using in clinical trials for their personal use - either Vielight or MedX.
Vielight products are the more accessible of the two brands of devices being used in research. Vielight devices have been deemed "general wellness devices" by the FDA and Health Canada so anyone can purchase the devices directly from the Vielight website. The clinical trials using Vielight devices focus on the treatment of Alzheimer's, but the researchers believe the Vielight will have a positive effect on concussion symptoms.
From the "Device Specific Questions" section of the FAQ page: "The Neuro is better for people suffering from traumatic brain injury and neurodegenerative conditions."
The Neuro Alpha is an integrated device with four transcranial clusters on a headset and a connected intranasal device, both delivering light pulsed at 10-Hertz. Vielight offers an 80% refund policy valid within 6 months from the time of purchase.
The Vielight Neuro Duo is a new option. It combines the Neuro Alpha (10Hz) and the Neuro Gamma (40Hz) in a combined device. It has two separate control units, one transcranial headset, and one intranasal applicator.
There is ongoing research into the use of 40Hz pulsed near-infrared light as a possible treatment for Alzheimer's. The reason we bring up this device is the utility of having a device that several family members might use. An elderly family member battling early to moderate Alzheimers might use the 40Hz and another family member might use the 10Hz for concussion symptoms. Concussion Alliance is NOT recommending the use of 40Hz for a brain injury.
When you use the Vielight promo code, Vielight gives Concussion Alliance a small commission which helps keep all our content available for free.
MedX consoles are classified as medical devices. Your purchase of a MedX device will be through a clinician who can help you with setting the equipment to the appropriate dosage of pulsed or non-pulsed light, duration, etc.
To find a clinician to work with, contact MedX through their contact form - scroll to the bottom of the MedX page to find the form.
In order to replicate the clinical trials, in which light is applied at opposite points of the head with two LED clusters, you need to buy two of the home systems. These MedX Home Systems have one LED cluster powered by an adjustable console; they are approximately $1,100 each. There is no tax for U.S. citizens.
Saltmarche also recommends the Vielight intranasal device to use in combination with the MedX consoles.
For more detailed information about these products, scroll down the page.
The Science behind LED light therapy for mild traumatic brain injury
Regulation of the Default Mode Network and other brain networks
"Photobiomodulation involves the absorption of photons by neurons (in the brain), a mechanism that involves brain bioenergetics."
Research is finding that concussions cause several networks of the brain to become dysregulated, meaning that they are not in sync with each other as a normal brain would be. This is because concussions cause diffuse axonal injury which "produces neurological impairment by disconnecting brain networks." Researchers can use diffusion MRI to map structural damage to these intrinsic connectivity networks caused by concussions.
One theory about photobiomodulation is that by placing a pair of LED clusters on the head in such a way that the clusters span two parts of a brain network, the light treatments help that network get back in sync. Margaret A. Naeser proposes that the specific placement of the LED clusters may positively affect the regulation of the default mode network (DMN), the salience network (SN), and the central executive network (CEN). (Read the section 5.2 Naeser case series.) The MedX clusters were placed in pairs over six areas of the brain correlating to brain networks in the 2014 study of concussion patients. The study found significant positive improvement in cognitive function, improved sleep, fewer PTSD symptoms, and better social functioning.
Of particular interest to athletes, a 2012 study found that after a single concussion, the Default Mode Network functioned normally while patients were resting, but became altered (dysregulated) during light aerobic activity.
Additional positive effects of light therapy on the injured brain
The most useful overviews of photobiomodulation that we have found are the 2017 article Photobiomodulation for traumatic brain injury and stroke by Michael E. Hamblin and the 2016 article Shining light on the head: Photobiomodulation for brain disorders, also by Michael E. Hamblin. In these articles, Mr. Hamblin reviews the scientific understanding of the actual mechanisms by which transcranial photobiomodulation (light therapy applied to the scalp) helps the brain heal, including:
Increase in cellular response to stimulus in cell signaling and messenger molecules
Decrease in inflammatory response, reduction in neuroinflammation
Increase in cerebral blood flow and increased tissue oxygenation
Repair of tissue damage due to antioxidant effect
Increase in neurogenesis - the formation of new brain cells
Increase in lymphatic flow and a reduction of edema in the brain
Decrease in neuronal toxicity and neuronal cell death
Production of adenosine triphosphate (ATP) with improved cellular energy storing
Using the Vielight intranasal LED in conjunction with the MedX clusters
Vielight Intranasal LED
The most recent clinical trials are incorporating intranasal LED devices along with the placement of LED lights against the head. The Vielight 810 Infrared (Brain) is an intranasal device that Anita Saltmarche recommends using in conjunction with the MedX clusters for the head. The intranasal device delivers light energy at 10-hertz pulse rate to the deep ventral areas of the brain.
"Before and after qEEG (quantitative electroencephalography) images show the Vielight 810 inducing restorative activity in the brain."
The intranasal LED device is "hypothesized to deliver photons to the hippocampus" and to increase melatonin production.
How to use MedX equipment
In order to hold the MedX LED clusters against your head, you put on a stretchy skullcap (or a pair of tights or stockings) and slip the consoles underneath the skullcap. You place the two clusters at specific opposing points of the head and turn the device on. Depending on the treatment setting, the device turns off in about five minutes. Then you move the two clusters to additional opposing points on the head. The protocol calls for a total of six pairs of opposing points, so the treatment takes about 35 minutes. The recommendation is to do the treatment three times a week. You can also apply the clusters to your neck and shoulders (we hold them on with a towel draped around the neck) which provides treatment to areas commonly painful for people with concussions and post-concussion syndrome.
The MedX console can be adjusted so that the LED cluster gives a continuous beam of light or pulsed light at different hertz, and adjusted for the length of time before it shuts off. Saltmarche will explain how to adjust the settings for the protocol she recommends.
Comparing MedX and Vielight Home Light Therapy Devices
See our blog post comparing light therapy devices.
A short history of research into light therapy for concussions and post-concussion syndrome
Margaret Naeser Ph.D., L.Ac. is one of the leading researchers in the use of photobiomodulation for traumatic brain injury and post-concussion syndrome. In 2011 she was the lead author of Improved Cognitive Function After Transcranial, Light-Emitting Diode Treatments in Chronic, Traumatic Brain Injury: Two Case Reports published in Photomedicine and Laser Surgery. In the conclusion she writes:
Transcranial red/NIR LED may be an inexpensive, noninvasive treatment, suitable for home treatments, to improve cognitive function in TBI patients, as well as to reduce symptom severity in PTSD patients.
Also in 2011, Margaret Naeser authored this article with Michael R. Hamblin, Ph.D.: Potential for Transcranial Laser or LED Therapy to Treat Stroke, Traumatic Brain Injury, and Neurodegenerative Disease in Photomedicine and Laser Surgery.
In humans, two chronic, mTBI cases showed improved cognition following a series of TLT treatments with red/NIR LED cluster heads.
Margaret Naeser then worked with a team in Boston on the first clinical trial of light therapy for mTBI. The results were published in 2014 in the Journal of Neurotrauma: Significant Improvements in Cognitive Performance Post-Transcranial, Red/Near-Infrared Light-Emitting Diode Treatments in Chronic, Mild Traumatic Brain Injury: Open-Protocol Study.
A 2016 publication discusses current, ongoing studies of traumatic brain injury patients either with transcranial LEDs (against the scalp) or with intranasal only LEDs. The hypothesis is that near-infrared LED light delivered through the nose reaches the hippocampus and also increases melatonin production. Results for the intranasal only LEDs have been similar to the results from the earlier transcranial LED studies. After the intranasal treatments, the patients had improved cognition, verbal memory, and total sleep time. (Read the section 5.2 Naeser case series.)
Dr. Margaret Naeser is currently heading up a study at the Boston VA: Transcranial, Light-emitting Diode (LED) Therapy to Improve Cognition in Gulf War Veterans Illnesses. In this study, she is using a LED helmet created by Photomedex as well as the Vielight intranasal diodes.
Ross Zafonte, DO, at the Spaulding Rehabilitation Network in Boston is currently conducting an LED clinical trial Effects of Light Emitting Diodes (LEDs) on Memory for TBI Patients.