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Licensed Unlicensed Requires Authentication Published by De Gruyter December 9, 2019

Therapeutic potential of intranasal photobiomodulation therapy for neurological and neuropsychiatric disorders: a narrative review

Farzad Salehpour EMAIL logo , Sevda Gholipour-Khalili , Fereshteh Farajdokht , Farzin Kamari , Tomasz Walski , Michael R. Hamblin , Joseph O. DiDuro EMAIL logo and Paolo Cassano

Abstract

The application of photobiomodulation therapy (PBMT) for neuronal stimulation is studied in different animal models and in humans, and has shown to improve cerebral metabolic activity and blood flow, and provide neuroprotection via anti-inflammatory and antioxidant pathways. Recently, intranasal PBMT (i-PBMT) has become an attractive and potential method for the treatment of brain conditions. Herein, we provide a summary of different intranasal light delivery approaches including a nostril-based portable method and implanted deep-nasal methods for the effective systemic or direct irradiation of the brain. Nostril-based i-PBMT devices are available, using either lasers or light emitting diodes (LEDs), and can be applied either alone or in combination to transcranial devices (the latter applied directly to the scalp) to treat a wide range of brain conditions such as mild cognitive impairment, Alzheimer’s disease, Parkinson’s disease, cerebrovascular diseases, depression and anxiety as well as insomnia. Evidence shows that nostril-based i-PBMT improves blood rheology and cerebral blood flow, so that, without needing to puncture blood vessels, i-PBMT may have equivalent results to a peripheral intravenous laser irradiation procedure. Up to now, no studies were conducted to implant PBMT light sources deep within the nose in a clinical setting, but simulation studies suggest that deep-nasal PBMT via cribriform plate and sphenoid sinus might be an effective method to deliver light to the ventromedial part of the prefrontal and orbitofrontal cortex. Home-based i-PBMT, using inexpensive LED applicators, has potential as a novel approach for neurorehabilitation; comparative studies also testing sham, and transcranial PBMT are warranted.

  1. Conflict of interest statement: F.S. is on the Scientific Advisory Board and consultant of Niraxx Light Therapeutics Inc., and a consultant of ProNeuroLIGHT LLC. T.W. was supported by the European Union’s Horizon 2020 Research and Innovation Programme, under the Marie Skłodowska-Curie Grant Agreement No 713690, and by the Science Foundation Ireland (SFI) and the European Regional Development Fund (Grant Number 13/RC/2073). P.C.’s salary was supported by the Harvard Psychiatry Department (Dupont-Warren Fellowship and Livingston Award), by the Brain and Behavior Research Foundation (NARSAD Young Investigator Award) and by the Photothera Inc. unrestricted grant. Drug donation from TEVA. Travel reimbursement from Pharmacia-Upjohn. P.C. has received consultation fees from Janssen Research and Development. P.C. has filed a provisional patent related to the use of near-infrared light in psychiatry. PhotoMedex, Inc. supplied four devices for a clinical study. P.C. is/has 1. Received unrestricted funding from Litecure Inc. to conduct a study on transcranial photobiomodulation for the treatment of major depressive disorder; 2. Received unrestricted funding from Cerebral Sciences to conduct a study on transcranial photobiomodulation for the treatment of generalized anxiety disorder; 3. Co-founded, member of the board of directors and consultant of Niraxx Light Therapeutics Inc., a company focused on the development of new modalities of treatment based on near-infrared light. M.R.H. was supported by US NIH Grants R01AI050875 and R21AI121700. M.R.H. is on the following Scientific Advisory Boards: Transdermal Cap Inc., Cleveland, OH, USA; Photothera Inc., Carlsbad, CA, USA; BeWell Global Inc., Wan Chai, Hong Kong; Hologenix Inc., Santa Monica, CA, USA; LumiThera, Inc., Poulsbo, WA, USA; Vielight, Toronto, ON, Canada; Bright Photomedicine, São Paulo, Brazil; Quantum Dynamics LLC, Cambridge, MA, USA; Global Photon Inc, Bee Cave, TX, USA; Medical Coherence, Boston, MA, USA; NeuroThera, Newark, DE, USA; JOOVV Inc., Minneapolis–Saint Paul, MN, USA; AIRx Medical, Inc., Pleasanton, CA, USA; FIR Industries, Inc., Ramsey, NJ, USA; UVLRx Therapeutics, Oldsmar, FL, USA; Ultralux UV Inc., Lansing, MI, USA; Illumiheal&Petthera, Shoreline, WA, USA; MB Laser Therapy, Houston, TX, USA. M.R.H. has been a Consultant for: Lexington int., Boca Raton, FL, USA; USHIO Corp., Japan; Merck KGaA, Darmstadt, Germany; Philips Electronics Nederland B.V.; Johnson & Johnson Inc., Philadelphia, PA; Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany. M.R.H. is a stockholder in Global Photon Inc., Bee Cave, TX, USA and Mitonix, Newark, DE, USA. J.O.D. was a paid business consultant for ProNeuroLIGHT LLC, Kerrville, TX, USA. The other authors have no conflicts of interest to disclose.

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Received: 2019-06-29
Accepted: 2019-09-22
Published Online: 2019-12-09
Published in Print: 2020-04-28

©2020 Walter de Gruyter GmbH, Berlin/Boston

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