Transcatheter Intracerebral Laser Photobiomodulation Therapy Reduces Dementia and Cognitive Impairment in Patients with Various Stages of Alzheimer's disease
Main Article Content
Abstract
Background: Alzheimer's disease (AD) is the leading neurodegenerative disease associated with dementia and cognitive impairment. A major achievement in AD treatment was the use of lasers with low output power of the red or near-infrared spectral region, which was named Photobiomodulation Therapy (PBMT).
Aims: This study investigates the effect of PBMT on regression of dementia and cognitive impairment among patients with various AD stages.
Methods: For the study, 97 patients with previously diagnosed AD, aged 34-80 (mean age 67.5), 34 (35.05%) men, 63 (64.95%) women, were selected. According to AD severity, the patients were subdivided: preclinical stage TDR-0 - 10 (10.31%), mild stage TDR-1 - 28 (28.87%), moderately severe stage TDR-2 - 42 (43.30%), severe stage TDR-3 - 17 (17.52%).
Test Group - 48 (49.48%) patients, 17 (35.42%) men, 31 (54.58%) women, underwent Transcatheter Intracerebral Laser Photobiomodulation Therapy (PBMT).
Control Group - 49 (50.32%) patients, 16 (32.65%) men, 33 (67.35%) women, underwent conservative treatment with Memantine and Rivastigmine.
Results:
Test Group. Due to angiogenesis and neurogenesis stimulation with Transcatheter Intracerebral Laser Photobiomodulation Therapy (PBMT), all the patients had an improvement in cerebral blood supply and microcirculation and a decrease in cerebral involutive changes. Consequently, all the patients showed reduced dementia and improved cognitive abilities. The vast majority of the patients began to correspond to the group of a milder AD stage.
Control Group. No persistent expressed positive dynamics. Partial improvement was obtained only among patients with early AD stages.
Conclusion: Transcatheter Intracerebral Laser Photobiomodulation Therapy (PBMT) is an effective, physiologically based method of stimulating cerebral angiogenesis and neurogenesis. As a result of such a complex impact, patients with various AD stages have cerebral capillary collateral revascularization, their tissue metabolism improves, and regenerative processes develop in the cerebral tissue. Tissue regeneration leads to an increase in the volume of the temporal and frontoparietal sections. Clinically, this leads to a stable decrease in dementia level, cognitive functions restoration, and improved quality of patients’ life. The resulting clinical effect lasts for many years.
Conservative treatment with Memantine and Rivastigmine is not effective enough.
Keywords:
Alzheimer's Disease, AD, Photobiomodulation Therapy, PBMT, Transcatheter Intracerebral Laser Photobiomodulation Therapy, Reducing dementia, Reducing cognitive impairment
Article Details
How to Cite
MAKSIMOVICH, Ivan V..
Transcatheter Intracerebral Laser Photobiomodulation Therapy Reduces Dementia and Cognitive Impairment in Patients with Various Stages of Alzheimer's disease.
Medical Research Archives, [S.l.], v. 10, n. 7, july 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2938>. Date accessed: 27 apr. 2024.
doi: https://doi.org/10.18103/mra.v10i7.2938.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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24. Maksimovich IV. Dementia and Cognitive Impairment Reduction after Laser Transcatheter Treatment of Alzheimer’s Disease. World Journal of Neuroscience. 2015; 5 (3): 189-203. doi: 10.4236/wjns.2015.53021
25. De la Torre JC. Cerebral Perfusion Enhancing Interventions: A New Strategy for the Prevention of Alzheimer Dementia. Brain Pathology 2016; 26 (5): 618–631. https://doi.org/10.1111/bpa.12405
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28. Bell RD & Zlokovic BV. Neurovascular mechanisms and blood-brain barrier disorder in Alzheimer’s disease. Acta Neuropathologica 2009; 118: 103-113. doi: 10.1007/s00401-009-0522-3
29. Montagne A, Barnes SR, Sweeney MD, Halliday MR, Sagare AP, Zhao Z, Toga AW, Jacobs RE, Liu CY, Amezcua L, Harrington MG, Chui HC, Law M, Zlokovic BV. Blood-brain barrier breakdown in the aging human hippocampus. Neuron. 2015; 85 (2): 296-302. doi: https://doi.org/10.1016/j.neuron.2014.1 2.032
30. Maksimovich IV, Lesnoy MI, Zubov VV. Transluminal laser angioplasty with low-intensity laser radiation. In Application of Lasers in Surgery and Medicine. 1988; Medicine, Samarkand, 21-25.
31. Hashmi JT, Huang YY, Osmani BZ, Sharma SK, Naeser MA and Hamblin MR. Role of low-level laser therapy in neurorehabilitation. Arch Phys Med Rehab. 2010; 12 (2) S 292–305. https://doi.org/10.1016/j.pmrj.2010.10.013
32. Naeser MA, Hamblin MR. Potential for transcraniallaser or LED therapy to treatstroke, traumatic brain injury, and neurodegenerative disease. Photomed Laser Surg. 2011; 29 (7): 443-446. https://doi.org/10.1089/pho.2011.9908
33. Hamblin MR. Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation. Photochem Photobiol. 2017; 94 (2): 199-212. https://doi.org/10.1111/php.12864
34. Liebert A, Bicknell B, Johnstone DM, Gordon LC, Hons BE, MedSc B, Kiat H, MBBS, DMedSc and Hamblin MR. ‘‘Photobiomics’’: Can Light, Including Photobiomodulation, Alter the Microbiome? Photobiomodulation, Photomedicine, and Laser Surgery. 2019; 31 (11):681–693. https://doi.org/10.1089/photob.2019.4628
35. Saltmarche AE, Naeser MA , Ho KF , Hamblin MR, Lim L. Significant Improvement in Cognition in Mild to Moderately Severe Dementia Cases Treated with Transcranial Plus Intranasal Photobiomodulation: Case Series Report. Photomed Laser Surg. 2017; 35 (8): 432-441. https://doi.org/10.1089/pho.2016.4227
36. Hamblin MR, Hennessy M. Photobiomodulation and the brain: a new paradigm. Journal of Optics. 2017; 19 (1): 013003. doi: 10.1088/2040-8986/19/1/013003
37. Hamblin MR. Photobiomodulation for Alzheimer’s Disease: Has the Light Dawned? Photonics. 2019; 6 (3), 77. https://doi.org/10.3390/photonics6030077
38. Salehpour F, Hamblin MR, Di Duro JO. Rapid Reversal of Cognitive Decline, Olfactory Dysfunction, and Quality of Life Using Multi-Modality Photobiomodulation Therapy: Case Report. Photobiomodul Photomed Laser Surg 2019; 37 (3): 159-167. doi: 10.1089/photob.2018.4569
39. Hamblin MR. Mechanisms of photobiomodulation in the brain. In Photobiomodulation in the Brain, Edited by Michael R. Hamblin, Ying-Ying Huang. Academic Press is an imprint of Elsevier, London. 2019; p-p. 97-110. https://doi.org/10.1016/B978-0-12-815305-5.00008-7
40. Maksimovich IV. Transcatheter intracerebral photobiomodulation in degenerative brain disorders: clinical studies (Part 1). In Photobiomodulation in the Brain, Edited by Michael R. Hamblin, Ying-Ying Huang. Academic Press is an imprint of Elsevier, London, 2019; p-p. 515-528. https://doi.org/10.1016/B978-0-12-815305-5.00038-5
41. Maksimovich IV. Transluminal laser angioplasty in treatment of ischemic lesions of a brain. Ph.D. Dissertation, Russian University of Friendship of the People 2004, Moscow.
42. Maksimovich IV, Gotman LN, Masyuk SM. Method of Determining Dimensions of Temporal Brain Lobes in Patients Suffering from Alzheimer’s Disease. Russian Patent, No 2306102. 2006.
43. Maksimovich IV, and Gotman LN. Method of complex radiation diagnostics at preclinical and clinical stages of Alzheimer’s disease. Russian Patent, No. 2315559. 2006.
44. Maksimovich IV. Method and Device for Endovascular Treatment of Alzheimer’s Disease. USA Patent No. 7389776. 2008.
45. Maksimovich IV. The tomography dementia rating scale (TDR) - The rating scale of Alzheimer’s disease stages. Health. 2012; 4 (9A): 712-719. doi: 10.4236/health.2012.429111
46. Maksimovich IV. Method for Endovascular Treatment of Alzheimer’s Disease. Russian Patent, No.2297860. 2006.
47. Morris JC. The Clinical Dementia Rating (CDR): Current Version and Scoring Rules. Neurology. 1993; 11 (43): 2412-2414. https://n.neurology.org/content/43/11/2412.2
48. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12 (3): 189-198. https://doi.org/10.1016/0022-3956(75)90026-6
49. Maksimovich IV. Intracerebral Transcatheter Laser PBMT in the Treatment of Binswanger's Disease and Vascular Parkinsonism: Research and Clinical Experience. Photobiomodul Photomed and Laser Surg. 2019; 37 (10): 606-614. https://doi.org/10.1089/photob.2019.4649
50. Matsunaga S, Kishi T, Iwata N (2015) Combination therapy with cholinesterase inhibitors and memantine for Alzheimer's disease: a systematic review and meta-analysis. Int J Neuropsychopharmacol. 2015; 18 (5): 1-11. https://doi.org/10.1093/ijnp/pyu115
51. Grossberg GT, Farlow MR, Meng X, Velting DM. Evaluating high-dose rivastigmine patch in severe Alzheimer's disease: analyses with concomitant memantine usage as a factor. Curr Alzheimer Res. 2015; 12 (1) 53-60. doi : 10.2174/1567205011666141218122835
2. Ahmad FB, Anderson RA. The Leading Causes of Death in the US for 2020. JAMA. 2021; 325, 18:1829-1830. doi:10.1001/jama.2021.5469
3. Burton EJ, Barber R, Mukaetova-Ladinska EB, Robson J, Perry RH, Jaros E, Kalaria RN, O'Brien JT. Medial temporal lobe atrophy on MRI differentiates Alzheimer's disease from dementia with Lewy bodies and vascular cognitive impairment: a prospective study with pathological verification of diagnosis. Brain. 2009; 132 (1): 195-203. https://doi.org/10.1093/brain/awn298
4. Brenowitz WD, Hubbard RA, Keene CD, Hawes CE. Mixed neuropathologies and estimated rates of clinical progression in a large autopsysample. J Alzheimers & Dementia. 2017;13(6):654-662 doi: 10.1016/j.jalz.2016.09.015
5. Weiner WW, Veitch DP, Aisen PS, Beckett LA, Cairns NJ, Cedarbaum J, Green RC, Harvey D, Jack CR, Jagust W, Luthman J, Morris JC, Petersen RC, Saykin AJ, Shaw L, Shen L, Schwarz A, Toga AW, Trojanowski JQ 2014 Update of the Alzheimer's Disease Neuroimaging Initiative: A review of papers published since its inception. Journal of Alzheimer’s & Dementia 2015; 11, 6 e1–e120. https://doi.org/10.1016/j.jalz.2014.11.001
6. Iadecola C. Neurovascular regulation in the normal brain and in Alzheimer's disease. Nat Rev Neurosci. 2004; 5 (5): 347-360. doi: 10.1038/nrn1387
7. Maksimovich IV. Radiodiagnostics of Alzheimer’s disease. Diagnostics and Intervention Radiology. 2008; 2 (4): 27-38. https://doi.org/10.25512/DIR.2008.02.4.04
8. Zlokovic BV. Neurodegeneration and the neurovascular unit. Nat Med 2010; 16 (12): 1370-1371. doi: 10.1038/nm1210-1370
9. Iadecola C. The overlap between neurodegenerative and vascular factors in the pathogenesis of dementia. Acta Neuropatho 2010; 120 (3): 287-396. doi: 10.1007/s00401-010-0718-6.
10. Zlokovic BV. Neurovascular pathways to neurodegeneration in Alzheimer’s disease and other disorders. Nature Reviews. Neuroscience. 2011; 12, 723-738. doi: 10.1038/nrn3114
11. Maksimovich IV. Dyscirculatory Angiopathy of Alzheimer’s Type. Journal of Behavioral and Brain Science. 2011; 1 (2): 57-68. DOI: 10.4236/jbbs.2011.12008
12. Baloiannis SJ and Baloiannis IS. The vascular factor in Alzheimer’s disease: A study in Golgi technique and electron microscopy. Journal of the Neurological Sciences. 2012: 322 (1-2): 117-121. https://doi.org/10.1016/j.jns.2012.07.010
13. Grammas P, Martinez J, Sanchez A, Sanchez A, Yin X, Riley J, Gay D, Desobry K, Tripathy D, Luo J, Evola M, Alice Y. A new paradigm for the treatment of Alzheimer's disease: targeting vascular activation. J Alzheimers Dis. 2014: 40 (3): 619-630. doi: 10.3233/JAD-2014-132057
14. Kimbrough IF, Robel S, Roberson ED, Sontheimer H. Vascular amyloidosis impairs the gliovascular unit in a mouse model of Alzheimer's disease. Brain. 2015; 138 (12): 3716-3733. https://doi.org/10.1093/brain/awv327
15. Zipser BD, Johanson CE, Gonzalez L, BerzinTM, Tavares R, Hulette CM, Vitek MP, Hovanesian N, Stopa EG. Microvascular injury and blood-brain barrier leakage in Alzheimer's disease. Neurobiol Aging. 2007; 28 (7): 977-986. https://doi.org/10.1016/j.neurobiolaging.2006.05.016
16. De la Torre JC, Stefano GB. Evidence that Alzheimer's disease is a microvascular disorder: the role of constitutive nitric oxide. Brain Res Brain Res Rev. 2000; 34 (3): 119-136. https://doi.org/10.1016/S0165-0173(00)00043-6
17. Baloyannis SJ. Brain capillaries in Alzheimer's disease. Hell J Nucl Med. 2015; 18 (1): Suppl 1-152.
18. Cai Z, Wang C, He W, Tu H, Tang Z, Xiao M, Yan L. Cerebral small vessel disease and Alzheimer's disease. Clin Interv Aging. 2015; 23 (10): 1695-1704. https://doi.org/10.2147/CIA.S90871
19. Richetin K, Steullet P, Pachoud M, Perbet R, Parietti E, Maheswaran M, Eddarkaoui S, Bégard S, Pythoud C, Rey M, Caillierez R, Q Do K, Halliez S, Bezzi P, Buée L, Leuba G, Colin M, Toni N & Déglon N. Tau accumulation in astrocytes of the dentate gyrus induces neuronal dysfunction and memory deficits in Alzheimer’s disease. Nature Neuroscience. 2020; 23:1567-1579. doi: 10.1038/s41593-020-00728-x.
20. Maksimovich IV and Polyaev YuA. The importance of early diagnosis of dyscircular angiopathy of Alzheimer’s type in the study of heredity of Alzheimer’s disease. Journal of Alzheimer’s & Dementia 2010; 6, 4S, (21): e43-e44. https://doi.org/10.1016/j.jalz.2010.08.133
21. Maksimovich IV. Certain new aspects of etiology and pathogenesis of Alzheimer’s disease. Advances in Alzheimer’s Disease. 2012; 1 (3): 68-76. doi: 10.4236/aad.2012.13009
22. Kalaria R. Small vessel disease and Alzheimer’s dementia: Pathological considerations. Cerebrovascular Diseases. 2002; 13: 48-52. doi: 10.1159/000049150
23. Brown WR, Thore CR. Review: cerebral microvascular pathology in ageing and neurodegeneration. Neuropathol Appl Neurobiol 2011; 37 (1): 56-74. https://doi.org/10.1111/j.1365-2990.2010.01139.x
24. Maksimovich IV. Dementia and Cognitive Impairment Reduction after Laser Transcatheter Treatment of Alzheimer’s Disease. World Journal of Neuroscience. 2015; 5 (3): 189-203. doi: 10.4236/wjns.2015.53021
25. De la Torre JC. Cerebral Perfusion Enhancing Interventions: A New Strategy for the Prevention of Alzheimer Dementia. Brain Pathology 2016; 26 (5): 618–631. https://doi.org/10.1111/bpa.12405
26. Love S, Miners JS. Cerebral Hypoperfusion and the Energy Deficit in Alzheimer's Disease. Brain Pathology. 2016; 26 (5): 607–617. https://doi.org/10.1111/bpa.12401
27. Nelson AR, Sweeney MD, Sagare AP, Zlokovic BV. Neurovascular dysfunction and neurodegeneration in dementia and Alzheimer's disease. Biochim Biophys Acta. 2016; 1862 (5): 887-900. https://doi.org/10.1016/j.bbadis.2015.12.016
28. Bell RD & Zlokovic BV. Neurovascular mechanisms and blood-brain barrier disorder in Alzheimer’s disease. Acta Neuropathologica 2009; 118: 103-113. doi: 10.1007/s00401-009-0522-3
29. Montagne A, Barnes SR, Sweeney MD, Halliday MR, Sagare AP, Zhao Z, Toga AW, Jacobs RE, Liu CY, Amezcua L, Harrington MG, Chui HC, Law M, Zlokovic BV. Blood-brain barrier breakdown in the aging human hippocampus. Neuron. 2015; 85 (2): 296-302. doi: https://doi.org/10.1016/j.neuron.2014.1 2.032
30. Maksimovich IV, Lesnoy MI, Zubov VV. Transluminal laser angioplasty with low-intensity laser radiation. In Application of Lasers in Surgery and Medicine. 1988; Medicine, Samarkand, 21-25.
31. Hashmi JT, Huang YY, Osmani BZ, Sharma SK, Naeser MA and Hamblin MR. Role of low-level laser therapy in neurorehabilitation. Arch Phys Med Rehab. 2010; 12 (2) S 292–305. https://doi.org/10.1016/j.pmrj.2010.10.013
32. Naeser MA, Hamblin MR. Potential for transcraniallaser or LED therapy to treatstroke, traumatic brain injury, and neurodegenerative disease. Photomed Laser Surg. 2011; 29 (7): 443-446. https://doi.org/10.1089/pho.2011.9908
33. Hamblin MR. Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation. Photochem Photobiol. 2017; 94 (2): 199-212. https://doi.org/10.1111/php.12864
34. Liebert A, Bicknell B, Johnstone DM, Gordon LC, Hons BE, MedSc B, Kiat H, MBBS, DMedSc and Hamblin MR. ‘‘Photobiomics’’: Can Light, Including Photobiomodulation, Alter the Microbiome? Photobiomodulation, Photomedicine, and Laser Surgery. 2019; 31 (11):681–693. https://doi.org/10.1089/photob.2019.4628
35. Saltmarche AE, Naeser MA , Ho KF , Hamblin MR, Lim L. Significant Improvement in Cognition in Mild to Moderately Severe Dementia Cases Treated with Transcranial Plus Intranasal Photobiomodulation: Case Series Report. Photomed Laser Surg. 2017; 35 (8): 432-441. https://doi.org/10.1089/pho.2016.4227
36. Hamblin MR, Hennessy M. Photobiomodulation and the brain: a new paradigm. Journal of Optics. 2017; 19 (1): 013003. doi: 10.1088/2040-8986/19/1/013003
37. Hamblin MR. Photobiomodulation for Alzheimer’s Disease: Has the Light Dawned? Photonics. 2019; 6 (3), 77. https://doi.org/10.3390/photonics6030077
38. Salehpour F, Hamblin MR, Di Duro JO. Rapid Reversal of Cognitive Decline, Olfactory Dysfunction, and Quality of Life Using Multi-Modality Photobiomodulation Therapy: Case Report. Photobiomodul Photomed Laser Surg 2019; 37 (3): 159-167. doi: 10.1089/photob.2018.4569
39. Hamblin MR. Mechanisms of photobiomodulation in the brain. In Photobiomodulation in the Brain, Edited by Michael R. Hamblin, Ying-Ying Huang. Academic Press is an imprint of Elsevier, London. 2019; p-p. 97-110. https://doi.org/10.1016/B978-0-12-815305-5.00008-7
40. Maksimovich IV. Transcatheter intracerebral photobiomodulation in degenerative brain disorders: clinical studies (Part 1). In Photobiomodulation in the Brain, Edited by Michael R. Hamblin, Ying-Ying Huang. Academic Press is an imprint of Elsevier, London, 2019; p-p. 515-528. https://doi.org/10.1016/B978-0-12-815305-5.00038-5
41. Maksimovich IV. Transluminal laser angioplasty in treatment of ischemic lesions of a brain. Ph.D. Dissertation, Russian University of Friendship of the People 2004, Moscow.
42. Maksimovich IV, Gotman LN, Masyuk SM. Method of Determining Dimensions of Temporal Brain Lobes in Patients Suffering from Alzheimer’s Disease. Russian Patent, No 2306102. 2006.
43. Maksimovich IV, and Gotman LN. Method of complex radiation diagnostics at preclinical and clinical stages of Alzheimer’s disease. Russian Patent, No. 2315559. 2006.
44. Maksimovich IV. Method and Device for Endovascular Treatment of Alzheimer’s Disease. USA Patent No. 7389776. 2008.
45. Maksimovich IV. The tomography dementia rating scale (TDR) - The rating scale of Alzheimer’s disease stages. Health. 2012; 4 (9A): 712-719. doi: 10.4236/health.2012.429111
46. Maksimovich IV. Method for Endovascular Treatment of Alzheimer’s Disease. Russian Patent, No.2297860. 2006.
47. Morris JC. The Clinical Dementia Rating (CDR): Current Version and Scoring Rules. Neurology. 1993; 11 (43): 2412-2414. https://n.neurology.org/content/43/11/2412.2
48. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12 (3): 189-198. https://doi.org/10.1016/0022-3956(75)90026-6
49. Maksimovich IV. Intracerebral Transcatheter Laser PBMT in the Treatment of Binswanger's Disease and Vascular Parkinsonism: Research and Clinical Experience. Photobiomodul Photomed and Laser Surg. 2019; 37 (10): 606-614. https://doi.org/10.1089/photob.2019.4649
50. Matsunaga S, Kishi T, Iwata N (2015) Combination therapy with cholinesterase inhibitors and memantine for Alzheimer's disease: a systematic review and meta-analysis. Int J Neuropsychopharmacol. 2015; 18 (5): 1-11. https://doi.org/10.1093/ijnp/pyu115
51. Grossberg GT, Farlow MR, Meng X, Velting DM. Evaluating high-dose rivastigmine patch in severe Alzheimer's disease: analyses with concomitant memantine usage as a factor. Curr Alzheimer Res. 2015; 12 (1) 53-60. doi : 10.2174/1567205011666141218122835