From: [email protected]
[mailto:[email protected]]
Sent: Thursday, July 02, 2009 3:07 PM
To: [email protected]
Subject: LASER THERAPY'S NEUROREGENERATIVE INFLUENCE
HEALING THERAPIES NEWSLETTER
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LASER THERAPY'S NEUROREGENERATIVE INFLUENCE
(Adapted from June 2009 PN/Paraplegia News article)
When I was PVA's research director in the 1990s, a physical therapist
excitedly told me how one of her patients with quadriplegia had regained
impressive function after laser therapy (LT). She asked for my advice in
moving her approach forward. Although I tried to be helpful, her
paradigm-expanding, energy-based methodology just didn't fit into the
prevailing thinking of the drug-emphasizing, biomedical establishment.
Although the establishment supports meritorious approaches, it was not
designed for quantum-leap innovations generated by outsiders. Because I now
believe LT can exert substantial neuroregenerative influences, I regret I
wasn't more proactive.
Lasers
Basically, lasers amplify light by producing coherent light beams. Because
low-energy lasers represent a noninvasive, non-heat-producing, painless
mechanism to stimulate regenerative processes, they are finding numerous
therapeutic applications. Laser energy affects many physiological processes,
including cellular respiration and gene expression.
Intriguing research documents LT's potential to treat various neurological
injuries and insults, including peripheral-nerve, spinal-cord, and head
injuries; and stroke. For example, research shows that laser irradiation
induces sprouting and outgrowth of neurites (e.g., budding axons and
dendrites), and stimulates the production of nerve growth factors.
Of special interest for SCI is LT's enhancement of functional recovery after
stem-cell transplantation. Many SCI-focused transplantation programs are
emerging throughout the world, and successful outcomes seem to be dependent
on a host of factors; LT may be one of them.
Spinal-Cord & Peripheral Nerve Injuries
1) Israel's Dr. Shimon Rochkind believes that LT is best used to augment
cell transplantation. For example, Rochkind's team examined the effects of
combining the implantation of embryonic spinal-cord cells with LT on
recovery after SCI in rats. Results indicated that the best recovery of limb
function and gait performance, nerve-signal conduction, and tissue growth
occurred when cell implantation was combined with laser irradiation; i.e.,
each therapy by itself was less effective.
In another study, Rochkind evaluated the effects of laser irradiation on
axonal regeneration across a transected peripheral nerve bridged with a
biodegradable polymer. Such polymers may ultimately play an important role
in SCI by paving over the pothole laden injury pathway to make it more
regeneration friendly. Briefly, rats were irradiated at both the
reconstructed peripheral injury location and the corresponding spinal-cord
sections. Compared to controls, laser-treated rats had more myelinated (i.e.
insulated) axons going across the polymer bridge, signal conduction, and
functional recovery.
In another study, Rochkind evaluated LT's effectiveness in patients with
incomplete peripheral-nerve or brachial-plexus-nerve injuries (nerve network
that conducts signals from the spine to the arms). Specifically, 18
subjects, injured at least six months earlier, were randomly assigned to
receive either transcutaneous laser irradiation or treatment from an
identical looking placebo device. Subjects were treated for 21 consecutive
days at the injury site and corresponding spinal-cord segments. Compared to
controls, the laser-irradiated subjects improved in motor function.
2) Drs. Kimberly Byrnes, Juanita Anders and colleagues (Bethesda, MD) have
shown that laser irradiation alters gene expression in rats after acute SCI
and exerts an anti-inflammatory effect on the injured cord. These influences
reduces secondary injury and, in turn, some of the barriers inhibiting
axonal regeneration.
Especially relevant to the promising olfactory-tissue-transplantation
procedures discussed recently (August & November 2008 PN), the investigators
showed that laser irradiation alters gene expression of the
regeneratively-endowed olfactory ensheathing cells (OECs). This alteration
enhances the expression of key growth factors and extracellular-matrix
proteins that support neuronal regeneration. The findings support LT's use
in combination with OEC transplantation.
In a recent article, Dr. Anders et al compared the effects of LT in rats
with injuries created by either 1) cutting a portion of the cord (i.e.,
hemisection) or 2) an impact-caused contusion (most common sort of injury).
Immediately after injury, rats were irradiated through the skin at the
injury site for 14 consecutive days. Compared to controls, LT augmented
axonal survival and re-growth, and functional recovery for both injury
types.
3) France's Albert Bohbot has developed a real-world program that combines
LT with acupuncture, another therapy with function-restoring potential
(www.laserponcture.eu <http://www.laserponcture.eu/> ). Although laser
stimulation of acupuncture points is not new, Bohbot has refined the
technology with a focus on treating a variety of neurological disorders,
including SCI.
Key to his therapy is a network of acupuncture points that relate meridians
(through which acupuncture's life-force qi energy flows) to dermatome levels
(i.e., a region of skin sensation that corresponds to a specific spinal-cord
area). Bohbot believes energy stimulation through this network promotes
functional recovery.
He has treated numerous people with chronic SCI, many of which have regained
impressive function. Bohbot's patients include those who have been
recipients of transplanted regeneratively endowed cells or tissue, including
OECs, patient-derived olfactory tissue, and bone-marrow-derived stem cells.
(see resources below)
Stroke
Evidence indicates that LT improves outcomes after ischemic stroke
(neurological damage caused by interruption of brain's blood flow). For
example, in an international, multicenter clinical trial, 120 patients were
randomized to receive transcranial LT (i.e., through the skull) or treatment
from a sham device within 24 hours of stroke onset. After 90 days, 70% of
the LT subjects had improvements compared to only 51% of the controls.
In a recent, even larger study, 660 patients with acute ischemic stroke were
randomized to receive either transcranial LT or sham treatment. In the LT
group, 120 achieved a favorable outcome compared to 101 controls.
Head Injury
Dr. A. Oron and colleagues (Israel) have shown that transcranial LT reduces
head injury in rats when administered four hours after trauma. In an
anecdotal case, a university teacher improved cognitive function after
starting transcranial LT seven years after a head injury from an auto
accident. Specifically, her ability to focus attention on her computer
improved from ~20 minutes to three hours. However, she regresses if
treatment is not maintained.
Conclusion
Ralph Waldo Emerson said "build a better mousetrap, and the world will beat
a path to your door." Perhaps for many things - but when it comes to new
therapies, it is more apropos to say the world may limp to your door
sometime in the distant future. Preferring the status quo, the biomedical
establishment is slow to embrace much needed innovation. Innovators are
routinely slapped down and must pass through a daunting professional
gauntlet to advance their ideas. This, indeed, has been the case for some of
laser therapy's pioneers. Fortunately, a critical mass of new thinking has
now percolated into the scientific community's collective consciousness -
making it more difficult to dismiss the therapy's neuroregenerative
potential.
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