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J Affect Disord. 2019 Jan 15;243:262-273. doi: 10.1016/j.jad.2018.09.048. Epub 2018 Sep 17.

Transcranial and systemic photobiomodulation for major depressive disorder: A systematic review of efficacy, tolerability and biological mechanisms.

Author information

1
Serviço de Psiquiatria, Hospital de Clínicas de Porto Alegre. Rua Ramiro Barcelos 2350, Porto Alegre, RS 90035-903, Brazil. Electronic address: mcaldieraro@hcpa.edu.br.
2
Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital. 1 Bowdoin Square, Boston, MA 02114, USA; Center for Anxiety and Traumatic Stress Disorders, Department of Psychiatry, Massachusetts General Hospital, Boston. 1 Bowdoin Square, MA 02114, USA.

Abstract

BACKGROUND:

Photobiomodulation (PBM) with red and near-infrared light (NIR) -also known as Low-Level Light Therapy-is a low risk, inexpensive treatment-based on non-retinal exposure-under study for several neuropsychiatric conditions. The aim of this paper is to discuss the proposed mechanism of action and to perform a systematic review of pre-clinical and clinical studies on PBM for major depressive disorder (MDD).

METHODS:

A search on MEDLINE and EMBASE databases was performed in July 2017. No time or language restrictions were used. Studies with a primary focus on MDD and presenting original data were included (n = 17). References on the mechanisms of action of PBM also included review articles and studies not focused on MDD.

RESULTS:

Red and NIR light penetrate the skull and modulate brain cortex; an indirect effect of red and NIR light, when delivered non-transcranially, is also postulated. The main proposed mechanism for PBM is the enhancement of mitochondrial metabolism after absorption of NIR energy by the cytochrome C oxidase; however, actions on other pathways relevant to MDD are also reported. Studies on animal models indicate a benefit from PBM that is comparable to antidepressant medications. Clinical studies also indicate a significant antidepressant effect and good tolerability.

LIMITATIONS:

Clinical studies are heterogeneous for population and treatment parameters, and most lack an appropriate control.

CONCLUSIONS:

Preliminary evidence supports the potential of non-retinal PBM as a novel treatment for MDD. Future studies should clarify the ideal stimulation parameters as well as the overall efficacy, effectiveness and safety profile of this treatment.

KEYWORDS:

Depression; Low-level laser therapy; Low-level light therapy; Mitochondria; Near-infrared; Photobiomodulation; Treatment

PMID:
30248638
DOI:
10.1016/j.jad.2018.09.048
[Indexed for MEDLINE]

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