[Re-establishing access to care for the most disadvantaged in rural areas]. / Renouer avec l'accès aux soins des plus démunis en milieu rural.

Inhabitants of rural areas are not spared deprivation. In May 2013 Médecins du Monde created a Health and Coordination Support Network in Auvergne with the aim of reintegrating them into the general healthcare system.

A systematic review of the effect of photobiomodulation on the neuroinflammatory response in animal models of neurodegenerative diseases.

This systematic review examines the effect of photobiomodulation (PBM), the application of red to near infrared light on body tissues, on the neuroinflammatory response and oxidative stress in animal models of neurodegenerative diseases. The research question and search protocol were prospectively registered on the PROSPERO database. Neurodegenerative diseases are becoming ever more prevalent in the ageing populations across the Western world, with no disease-modifying or neuroprotective treatment options being available. Hence there is a real need for the development of effective treatment options for patients. Inflammatory responses and oxidative stress within the central nervous system have a strong correlation with neuronal cell death. PBM is a non-invasive therapeutic option that has shown efficacy and promising effects in animal models of neurodegenerative disease; many studies have reported neuroprotection and improved behavioural outcomes. To the best of our knowledge, there has been no previous study that has reviewed the anti-inflammatory and the antioxidant effect of PBM in the context of neurodegeneration. This review has examined this relationship in animal models of a range of neurodegenerative diseases. We found that PBM can effectively reduce glial activation, pro-inflammatory cytokine expression and oxidative stress, whilst increasing anti-inflammatory glial responses and cytokines, and antioxidant capacity. These positive outcomes accompanied the neuroprotection evident after PBM treatment. Our review provides further indication that PBM can be developed into an effective non-pharmacological intervention for neurodegenerative diseases.

Exploring the Effects of Near Infrared Light on Resting and Evoked Brain Activity in Humans Using Magnetic Resonance Imaging.

We explore whether near infrared light can change patterns of resting (task-negative) and/or evoked (task-positive; eg finger-tapping) brain activity in normal, young human subjects using fMRI (functional magnetic resonance imaging). To this end, we used a vielight transcranial device (810 nm) and compared the scans in subjects after active- and sham-light sessions. Our fMRI results showed that, while light had no effect on cerebral blood flow and global resting state brain activity (task-negative), there were clear differences between the active- and sham-light sessions in the patterns of evoked brain activity after finger-tapping (task-positive). The evoked brain regions included the putamen, primary somatosensory and parietal association cortex, and the overall effect of the light was to suppress or reduce their activity. We also found that while light had no effect on the resting functional connectivity of the putamen and primary somatosensory cortex and the rest of the brain, it did have an effect on the functional connectivity of parietal association cortex. In summary, our fMRI findings indicated that transcranially applied light did have a major impact on brain activity in normal subjects, but only when the brain region was itself functionally active, when undertaking a particular task. We suggest that these light-induced changes, particularly those in parietal association cortex, were associated with attention and novelty, and served to deactivate the so-called default mode network. Our results lay the template for our planned fMRI explorations into the effects of light in both Alzheimer's and Parkinson's disease patients.

"Buckets": Early Observations on the Use of Red and Infrared Light Helmets in Parkinson's Disease Patients.

Background: Parkinson's disease is a well-known neurological disorder with distinct motor signs and non-motor symptoms. Objective: We report on six patients with Parkinson's disease that used in-house built photobiomodulation (PBM) helmets. Methods: We used "buckets" lined with light-emitting diodes (LEDs) of wavelengths across the red to near-infrared range (i.e., 670, 810, and 850 nm; n = 5) or an homemade intranasal LED device (660 nm; n = 1). Progress was assessed by the patients themselves, their spouse, or their attending medical practitioners. Results: We found that 55% of the initial signs and symptoms of the six patients showed overall improvement, whereas 43% stayed the same and only 2% got worse. We also found that PBM did not target a specific sign or symptom, with both motor and nonmotor ones being affected, depending on the patient. Conclusions: In summary, our early observations are the first to note the impact of PBM on patients' signs and symptoms over an extended period, up to 24 months, and lays the groundwork for further development to clinical trial.