Effects of intravascular photobiomodulation on cognitive impairment and crossed cerebellar diaschisis in patients with traumatic brain injury: a longitudinal study.

The association between intravascular photobiomodulation (iPBM) and crossed cerebellar diaschisis (CCD) and cognitive dysfunction in patients with traumatic brain injury (TBI) remains unknown. We postulate that iPBM might enable greater neurologic improvements. The objective of this study was to evaluate the clinical impact of iPBM on the prognosis of patients with TBI. In this longitudinal study, patients who were diagnosed with TBI were recruited. CCD was identified from brain perfusion images when the uptake difference of both cerebella was > 20%. Thus, two groups were identified: CCD( +) and CCD( -). All patients received general traditional physical therapy and three courses of iPBM (helium-neon laser illuminator, 632.8 nm). Treatment assemblies were conducted on weekdays for 2 consecutive weeks as a solitary treatment course. Three courses of iPBM were performed over 2-3 months, with 1-3 weeks of rest between each course. The outcomes were measured using the Rancho Los Amigos Levels of Cognitive Functioning (LCF) tool. The chi-square test was used to compare categorical variables. Generalized estimating equations were used to verify the associations of various effects between the two groups. p < 0.05 indicated a statistically significant difference. Thirty patients were included and classified into the CCD( +) and CCD( -) groups (n = 15, each group). Statistics showed that before iPBM, CCD in the CCD( +) group was 2.74 (exp 1.0081) times higher than that of CCD( -) group (p = 0.1632). After iPBM, the CCD was 0.64 (exp-0.4436) times lower in the CCD( +) group than in the CCD( -) group (p < 0.0001). Cognitive assessment revealed that, before iPBM, the CCD( +) group had a non-significantly 0.1030 lower LCF score than that of CCD( -) group (p = 0.1632). Similarly, the CCD( +) group had a non-significantly 0.0013 higher score than that of CCD( -) after iPBM treatment (p = 0.7041), indicating no significant differences between the CCD( +) or CCD( -) following iPBM and general physical therapy. CCD was less likely to appear in iPBM-treated patients. Additionally, iPBM was not associated with LCF score. Administration of iPBM could be applied in TBI patients to reduce the occurrence of CCD. The study failed to show differences in cognitive function after iPBM, which still serves as an alternative non-pharmacological intervention.

Five-day, low-level laser therapy for sports-related lower extremity periostitis in adult men: a randomized, controlled trial.

Periostitis in the lower leg caused by overexercise is a universal problem in athletes and runners. The purpose of this study was to observe the functional improvement of the lower limbs upon rehabilitation low-level laser therapy (LLLT). All medical data were gathered from enrolled adults with sports-related lower leg pain. A total of 54 patients underwent triple-phase bone scans using skeletal nuclear scintigraphy, which confirmed periostitis in their lower limbs. The patients were then randomly divided into two groups: one group received laser therapy (N = 29) and the other group (N = 25) received an equivalent placebo treatment (a drug or physical therapy). Treatment protocol commenced with rehabilitation intervention and LLLT was performed three times daily for 5 days at a dosage of 1.4 J/cm(2). A Likert-type pain scale was used to evaluate the severity of pain. Balance function, including postural stability testing (PST) and limits of stability (LOS), was also performed to evaluate the function outcome. Patients experienced a significant improvement in pain by day 2 or day 5 after starting LLLT, but here was no significant difference in pain scale between the measurements before (baseline) and after LLLT. Comparing the PST, the group differences of dynamic vs. static testings ranged from -18.54 to -50.22 (compared 12, 8, 4, 3, 2, 1 to 0, all p < 0.0001), and the PST after LLLT were 3.73 units (p = 0.0258) lower than those of before LLLT. Comparing the LOS, the group differences of dynamic vs. static testing were similar to those in PST, and the relationship between LOS and groups only varied with the direction control during dynamic testing in direction at backward/right vs. right (p < 0.0001). LLLT had a positive effect on proprioception in patients with lower limb periostitis. Larger, better controlled studies are needed to determine what specific effects LLLT has on the function of proprioception.

Cerebellar diaschisis and contralateral thalamus hyperperfusion in a stroke patient with complex regional pain syndrome.

We present a right-hemispheric stroke patient with complex regional pain syndrome (CRPS). The regional cerebral blow flow (rCBF) as determined using single photon emission computed tomography (SPECT) showed contralateral increase of tracer uptake in the left thalamus accompanied by crossed cerebellar diaschisis (CCD) in the left cerebellum. After rehabilitation, the CRPS in the right upper extremity recovered, although hemiplegia persisted on the left limbs. The rCBF determined a second time using SPECT showed that uptake was normal in the bilateral thalami, basal ganglia and bilateral cerebella. At a 6-month follow-up, the CRPS had not recurred. Our findings show that analysis of rCBF by SPECT is useful for the clinical evaluation and follow-up of CRPS. To the best of our knowledge, this is the first reported case with this particular pattern of symptoms amd symptom resolution.

Efficacy of near-infrared irradiation on intractable hiccup in custom-set acupoints: evidence-based analysis of treatment outcome and associated factors.

OBJECTIVE: The condition intractable hiccup (IH) is generally an incapacitating disorder indicating neurologic or non-neurologic disorders. Linearly polarized, near-infrared irradiation (SL) is shown to be effective in the treatment of IH where it is applied on custom-set acupoints. The aim of this study was to investigate the treatment efficacy of IH by SL on the acupoints and to survey the relationship between IH and comorbid-related factors. MATERIAL AND METHODS. A total of 35 patients with IH were enrolled prospectively and divided into central and non-central groups. All patients received SL using an SG-type lens unit on the relevant acupoints and were followed-up for up to 6 months for efficacy of the novel therapy. RESULTS: There was no significant difference between patients with IH produced by central or non-central origins (p=0.7105) regarding the therapeutic effect of SL; however, the effects of age, bed-shaking, gun-waving motion and nasogastric (NG)-tube placement were significant. The severity index of IH was analyzed and found to be associated with the seasons. For those patients with elevated levels of aspartate aminotransferase (ASAT) after therapy, it took a significantly shorter (p=0.0029) period of time to treat IH with this novel therapy (p=0.0029). Thirty-four patients had complete resolution of IH within a few days of beginning SL, with partial resolution in 1 patient only. CONCLUSIONS: Without potential side effects, SL on custom-set acupoints could be a complementary therapy for patients with IH regardless of central or non-central origins.

Resolution of intractable hiccups after near-infrared irradiation of relevant acupoints.

BACKGROUND: Intractable hiccups are occasionally encountered in the presence of stroke but are usually difficult to manage. METHODS: We describe two stroke patients with intractable hiccups that were refractory to pharmacological treatment but were well resolved by application to relevant acupoints with the modality linear polarized near-infrared ray equipment on PC 6 (Nei Guan), ST 36 (Zu San Li), and DU 9 (Chih Yang), which are the empirical acupoints aimed at regulating gastrointestinal mobility and function of the thoracic organ. RESULTS: The first patient who received the treatment for only one time came out with a dramatic termination of intractable hiccups 3 hours later and with no recurrence thereafter. We applied the same treatment on the second patient once a day for 8 consecutive days, which led to progressive amelioration of intractable hiccups. CONCLUSIONS: This is the first report about the complete resolution of intractable hiccups due to stroke using near-infrared irradiation to acupoints, rather than using conventional pharmacologic therapy, traditional acupuncture, or moxibustion. Consequently, these findings suggest that linear polarized near-infrared ray irradiation, with its noninvasive properties, might be an alternative treatment for intractable hiccups after stroke.