Low Level Laser in the Treatment of Migraine and Traumatic Brain Injury in the Adult population

Pratibha Bansal M.D.,   Romanth Waghmarae M.D. DABA, FIPP. , Louis Banas B.S. , M.S. CLT ; Buffalo, New York,  June 2012

Note: Dr’s Bansal and Waghmarae are Board Certified Pain Management Physicians who have practicing Pain Management in Buffalo, New York for over 20 years.   Louis Banas is a laser specialist who has treated over 2500 hundred patients for chronic pain issues. He has treated over 60 adults for headaches of various types with significant success in most cases.   

Abstract:

Migraine headache due to trauma or otherwise is a major health concern worldwide with massive financial and social impact. Conventional treatments primarily focus on the prevention of further damage to the brain parenchyma, while failing to address the already existent symptoms. Previous clinical studies have shown that Low Level Laser Therapy (LLLT) can significantly reduce pain and induce temporary vasodilation in capillaries.  The authors demonstrate how LLLT can be used to improve the quality of life in patients by treating their current symptoms,. This case report illustrates the use of LLLT in the treatment of several patients with a severe headache and the clinical success achieved in the reduction of pain, as measured by VAS - achievable within 2-8 treatments.

Abstract:

Objective Information and Background.

The following case studies were followed at a Pain Management Clinic in Buffalo New York.  Pain Rehab is staffed with two board certified Pain Management Specialists who will see 300 to 400 patients weekly. Most patients were being seen do to traumatic injuries suffered at work, home or auto accident and in most cases had little or no relief with physical therapy, chiropractic, massage or surgery. Pain Rehab is very progressive in utilizing new and proven technology and reluctantly prescribes opiates and NSAIDS . All patients suffered from moderate to severe, debilitating pain on a daily basis. After a very positive evaluation of laser therapy on patients, a physical therapy clinic was added to the practice, therefore enabling this new modality to be readily available to their patients. Several patients suffering from chronic, debilitating headaches due to trauma or congenital defects were treated during a four month period. (It is important to note that headaches were just part of the overall pain complaints except for two patients noted in cases 4 and 7.) Over twenty patients were treated and only two patients out of twenty did not respond well. The treatments were performed by a laser specialist with four years of laser experience.  Listed below are a few of the significant, more interesting cases.

Case # 1.  A 28 y.o. female suffered severe whiplash in an auto injury and complained of daily, severe headaches with a vas value of 7-8 accompanied by blurred vision for a 12 month period. Laser was applied to bilateral temples and mastoid   for 2 minutes, delivering 15 joules to five sites, which included bilateral temple and mastoid sites and right cervical spine.  Patient was not able tolerate minimal cervical spine treatment. , including 6 joules per site for a 3 minute duration.  Note: Patient is African American and due to nerve damage or skin pigmentation could not tolerate prescribed dosage.   Treatment was given 3 times per week for two weeks at a reduced dosage for a total of six treatments.  Pain levels were substantially reduced and patient now only suffers 2-3 episodes per week with a vas value of 2-3.

Case #2 .  38 y.o. female, auto injury.  Previous physical therapy was unsuccessful. Patient complained of daily headaches 7-8 on the vas scale for two years.  Treatment included bilateral c-spine and right trapezium for 3 minutes time delivering 42.5 joules to each site, for a period of two weeks and levels increase to 72 joules for second week as patient healed and was more able to tolerate the procedure.  Patient received 12 treatments over a three week period and now experiences mild to moderate headaches once or twice per month.

Case 3#.  58 y.o. male was injured on the job and suffered a severe neck and left clavicle injury. Headaches were daily which were debilitating and patient reported a 7-8 level on the vas scale. Treatments of 8 sessions included 76.5 joules applied to left cervical spine and clavicle. 15 joules were applied to left cervical 1 area, after 10 treatments the headaches were entirely eliminated.

Case # 4. A 23 y.o. Female suffered from headaches 3-4 times per week since six years of age.  Patient has a high stress job as customer service representative. One treatment was applied at both temples delivering 15 joules in a two minute session. Patient was headache free for one week. 

Case#5.  A  57 y.o. female, auto injury 17 years ago and had damage to both frontal lobes. 28 Joules was applied to her forehead at two sites. Due to transportation difficulties her treatments are sporadic but after two treatments she now wakes up with minimal or no pain on most mornings.

Case #6.  A 52 y.o. male fell at work and hit back of head. Headaches occur on daily basis since accident 4 months ago.  Two treatments were performed two days apart delivering 25 joules to injured area. Patient states that headaches are significantly reduced and sleep patterns are substantially improved.

Case # 7. A 31 y.o. female former military P.A. presented herself with migraine headaches with a vas value of 7-8 on a daily basis. She has suffered with them since the age of 8.  The patient had seen several specialists including neurologists who were unable to help. The patient had military training as a physician’s assistant and realized she needed detoxing from drug overload which had been prescribed for the problem.   A single laser treatment was administered which included  48 joules at 2 sites on the forehead and 28 joules to four sites which included bilateral temple and mastoid areas.  The patient had significant relief for a 7 day period at which point she felt the change in medications was to blame. She returned for a single visit one day after the relapse and the  procedure was repeated.  The patient reported to be pain free within minutes after the procedure.  She feels she is completely healed.

Technical data:

The system utilized is the Theralase super pulsed Low Level Laser medical system. It  The system is equipped with a multiple probe hand piece (5 x 905 nm wavelength @0-100 mw average power per laser diode and 4 x 660 nm wavelength @25 mw . power per laser diode. (This allows for deep penetration of tissue when necessary with minimal heat transference to the tissue).

Healing pathways- Discussion

The majority of patients seen in this clinic have multiple injuries and headaches are a by-product of some type of trauma. Therefore, it may be safe to assume that vascular insufficiency is the main cause. A recently published a peer review paper concludes that the equipment used utilizes a 905 nm. Wavelength increasing Nitric acid up to 700 percent which expands capillary delivery of oxygenated blood. Currently Dr. Michael Whalen, working at Massachusetts General Hospital, is conducting controlled studies using a low level laser with the hopes of bringing this new technology into the forefront of neuroscience and medicine. These case studies give examples of how LLLT can be used to treat chronic migraines, specifically those that are a result of traumatic brain injuries. LLLT has been shown to reduce pain and inflammation, create a state of vasodilation by activating the nitric oxide pathway and further even promote angiogenesis.

ATP production.  Cold laser has the unique ability to generate the production of ATP Adenosine Tri-phosphate through a process called biostimualtion. Vacuoles (cytochromes and chromaphores) in the mitochondria of the cell absorb specific light wavelengths causing a cascade effect which rejuvenates damaged cells lacking this essential fuel molecule. Although this may be the main pathway for treating the traumatic injures, it is arguable that the nitric oxide production is the primary source of pain reduction.

Summary. LLLT is now becoming a valuable but slowly recognized modality for acute and chronic pain as well as wound care in the United States. It has been used extensively in Canada for over 12 years.

REFERENCES

1.            Faul M, X.L., Wald MM, Coronado VG, Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. 2010.

2.            Finkelstein E, C.P., Miller T and associates, The Incidence and Economic Burden of Injuries in the United States. Oxford University Press, 2006.

3.            Sahni, T., et al., Use of hyperbaric oxygen in traumatic brain injury: retrospective analysis of data of 20 patients treated at a tertiary care centre. Br J Neurosurg, 2012. 26(2): p. 202-7.

4.            Naeser, M.A. and M.R. Hamblin, Potential for transcranial laser or LED therapy to treat stroke, traumatic brain injury, and neurodegenerative disease. Photomed Laser Surg, 2011. 29(7): p. 443-6.

5.            Moriyama, Y., et al., In vivo effects of low level laser therapy on inducible nitric oxide synthase. Lasers Surg Med, 2009. 41(3): p. 227-31.

6.            Wu, Q., et al., Low-level laser therapy for closed-head traumatic brain injury in mice: effect of different wavelengths. Lasers Surg Med, 2012. 44(3): p. 218-26.

7.             Stephan, W. et al . Efficacy of super –pulsed 905 nm Low Level Laser Therapy in the Management of

Traumatic Brain Injury (TBI) World Journal of Neuroscience November 2012  www.scirp.org/journal/wjnsl

For further information, please visit www.theralase.com or call 1-855-494-7246

Efficacy of super-pulsed 905 nm Low Level Laser Therapy (LLLT) in the Management of Traumatic Brain Injury (TBI): A Case Study

RESEARCH

Below you will find my paper recently published in the World Journal of Neuro Science. I have treated over 65 patients for headache/migraine symptoms. The Department of Defense (DOD) has asked me to do anything I can to help resolve major healthcare problem (i.e Traumatic Brain Injury (TBI)) which is of course a major concern for the military.  Shortly after that conversation, a patient was presented to me with a TBI as a result of being hit with a lead pipe 3-4 times. His incapacitating headaches were eliminated in just three treatments. 

As a result of this publication and the positive clinical studies out of Massachusetts, four researchers at the University at Buffalo are preparing to start human trials for Alzheimer’s, Concussion (TBI) and Stroke.  We expect these studies to be done before year-end and if successful will be a major breakthrough in medicine, saving the health care system hundreds of billions of dollars. 

William Stephan, M.D. per 1^st Affiliation, Louis J. Banas, B.S., CLT per 1^st Affiliation, Matthew Bennett, M.D. per 2^nd Affiliation, Huseyin Tunceroglu, MSIV per 3^rd Affiliation

1^st Affiliation: William Stephan M.D., LLC, Buffalo, New York

2^nd.  Affiliation: University of Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York

Email: huseyint@buffalo.edu

Received 04 September 2012.

Abstract

Traumatic brain injury is a major health concern worldwide with massive financial and social impact. Conventional treatments primarily focus on the prevention of further damage to the brain parenchyma, while failing to address the already existent symptoms. Previous clinical studies have shown that Low Level Laser Therapy (LLLT)  can significantly reduce pain and induce temporary vasodilation in capillaries, which the authors hypothesize can be used to improve the quality of life in TBI patients by treating their current symptoms, which are predominately migraine-like headaches. This case report illustrates the use of LLLT in the treatment of a patient with a TBI and the great clinical success achieved in the reduction of pain, as measured by VAS - achievable within five treatments of 10 minutes in duration.

Keywords: Traumatic Brain Injury; Low Level Laser Therapy; LLLT; Chronic Migraines; Headaches

1. INTRODUCTION

Traumatic brain injury (TBI) typically occurs when there is any sudden trauma to the skull that induces damage to the brain. There are many causes of TBIs, but unfortunately no documented cures. According to Faul et al., the annual incidence of TBI in the United States is approximately 1.7 million incidents, which account for 30.5% of injury related deaths[1]. The direct and indirect costs of TBI totaled an estimated 76.5 billion dollars in the United States in 2000 [2]. Traumatic brain injuries play a major role in the health care of our nation, especially in our armed forces, where the men and women serving our country are at a higher risk to suffer a TBI.

Treatment is centered on preventing future insult to the brain, but very little can be done to treat the already existing symptoms. These symptoms, as described by the National Institutes of Health, range from mild to severe and include: headaches, nausea, vomiting, confusion, and blurry vision. Current theory on alleviating the symptoms of TBIs is based on reducing inflammatory and oxidative stress and increasing perfusion to support metabolic needs [3]. A study by Naeser et al. looked at the use of Near Infra Red (NIR) light for the treatment of TBI, stroke, and neurodegenerative disease. Their results were very promising, showing that nightly treatments with NIR LED over a period of months to years improved cognitive abilities [4]. Furthermore, they showed that the use of NIR light increased ATP production, caused vasodilation, and improved perfusion. We believe that the superpulsed 905 nm LLLT system employed in this case study operates through similar mechanisms of action and to support our hypothesis we present a case report of a patient with a traumatic brain injury that was treated with the superpulsed 905 nm LLLT system two years after the injury occurred.

2.   CASE REPORT

A 25 year old man with no pertinent past medical history presented as a new patient. His only complaint was chronic debilitating migraines since a traumatic brain injury which occurred in May of 2010. He was attacked and repeatedly hit over the head with a lead pipe, consequently requiring many sutures and leaving a scar on the brain as evidenced by the MRI performed subsequent to the incident. Since the attack, he has been experiencing excruciating migraines daily which he rates at ranging from 7/10 to 10/10 using a Visual Analog Scale (VAS) reference and physically describes them as: throbbing, squeezing sensations located primarily to the occipital region of his skull. He complains of being unable to have a peaceful night of sleep or to participate in play with his four children, the oldest being 9, due to the constant pain and agony he experiences.

After undergoing multiple previous treatment modalities, which included: medications, vitamin supplements, and chiropractic massage therapies, all of which were unsuccessful at alleviating his symptoms, he had all but given up hope. Willing to try anything to rid himself of the chronic pain, he agreed to undergo LLLT treatment. Using a Theralase® superpulsed LLLT medical laser system equipped with a multiple probe handpiece (5 x 905 nm wavelength @ 0 to 100 mW average power per laser diode + 4 x 660 nm wavelength @ 25 mW average power per laser diode), he was given a total of five treatments delivered over a two week period, with the 905 nm laser diodes set to 50 mW average power. The LLLT was targeted to a total of four areas on the scalp for two and a half minutes each: midline occipital region just below the lamboidal suture, superior aspect of the nape to target the Circle of Willis and over the mastoid processes bilaterally. We selected 905nm wavelength based on a previous scientific study that demonstrated that the 905 nm superpulsed wavelength employed by the system was able to increase inducible Nitric Oxide Synthase (iNOS) expression by 700%, as compared to numerous other wavelengths that showed little or no effect [5]. iNOS has been well documented in numerous clinical studies to cause temporary vasodilation by signaling endothelial cells located in capillary walls to become flaccid and relax. Additional studies have shown that 810 nm and 665 nm wavelengths may also be effective, but those specific wavelengths are not able to produce as much iNOS expression, when compared to 905 nm superpulsed technology [6]. An average power for the superpulsed 905 nm laser diodes was initially chosen to be 50mW based on personal experience, but further clinical investigations may uncover more clinically effective average power settings.

Immediately after the first treatment of only ten minutes in duration, the patient reported a 43% reduction in pain, reporting a VAS of 4/10 from a pre-treatment score of 7/10. He stated the throbbing and squeezing nature of his pain had immediately subsided and that all that was left was more of a dull achy pain. He continued with the treatments over the next week and with each new treatment his pain was further reduced. By the end of the course of 5 treatments, his pain had reduced by over 90% and all that remained was a minor ache that was barely even noticeable. Furthermore, he reported no side effects from the treatment except for a slight sensation of warmth over the area where the laser was placed. He was no longer experiencing constant pain; even his children noticed the difference saying that he looked happier. After two years, he was finally able to achieve a good night’s rest.

3.   DISCUSSION

Low Level Laser Therapy (LLLT) has been used in many acute and chronic conditions, but its effectiveness is yet to be fully documented by human clinical trials for migraine, stroke or TBI. Currently Dr. Michael Whalen, working at Massachusetts General Hospital, is conducting controlled studies using a low level laser with the hopes of bringing this new technology into the forefront of neuroscience and medicine. This case study gives one example of how LLLT can be used to treat chronic migraines, specifically those that are a result of traumatic brain injuries. LLLT has been shown to reduce pain and inflammation, create a state of vasodilation by activating the nitric oxide pathway and further even promote angiogenesis. The present theory is that by increasing blood flow to the brain, and subsequently, increasing oxygen delivery to the brain, the symptoms of a migraine can be mitigated. This case differs from previous studies performed using laser therapy to help patients with TBIs in that the type of laser and the settings used were unique. Specifically, unlike the LED light used by Naeser et al., the therapeutic laser we utilized only required five treatments over two weeks to be effective with immediate results after the first treatment.

It is currently unclear whether or not our patient will need maintenance therapy. He was interviewed at two weeks and 5 months post treatment, does carpentry work with his father   and remains symptom free. He is deeply appreciative of the care he was given and continues to enjoy family life which was impossible before LLLT. More research needs to be done, especially controlled double blind studies to further evaluate the full effectiveness and possible side effects of using LLLT in the treatment of TBIs and migraines, but the latest research has shown that LLLT is an extremely safe and effective technology for a wide range of neural and muscular skeletal conditions.

Note: Mr. Banas has successfully treated over 65 migraine patients not all of whom were victims of a TBI

but except for a few instances gave the a patients life changing , significant relief.

REFERENCES

1.            Faul M, X.L., Wald MM, Coronado VG, Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. 2010.

2.            Finkelstein E, C.P., Miller T and associates, The Incidence and Economic Burden of Injuries in the United States. Oxford University Press, 2006.

3.            Sahni, T., et al., Use of hyperbaric oxygen in traumatic brain injury: retrospective analysis of data of 20 patients treated at a tertiary care centre. Br J Neurosurg, 2012. 26(2): p. 202-7.

4.            Naeser, M.A. and M.R. Hamblin, Potential for transcranial laser or LED therapy to treat stroke, traumatic brain injury, and neurodegenerative disease. Photomed Laser Surg, 2011. 29(7): p. 443-6.

5.            Moriyama, Y., et al., In vivo effects of low level laser therapy on inducible nitric oxide synthase. Lasers Surg Med, 2009. 41(3): p. 227-31.

6.            Wu, Q., et al., Low-level laser therapy for closed-head traumatic brain injury in mice: effect of different wavelengths. Lasers Surg Med, 2012. 44(3): p. 218-26.

Efficacy of super-pulsed 905 nm Low Level Laser Therapy (LLLT) in the management of Traumatic Brain Injury

World Journal of Neuroscience, 2012, 2, ***-*** WJNS
Published Online November 2012 (http://www.SciRP.org/journal/wjns/)
Efficacy of super-pulsed 905 nm Low Level Laser Therapy (LLLT) in the management of Traumatic Brain Injury (TBI): A case study
William Stephan1, Louis J. Banas1, Matthew Bennett2, Huseyin Tunceroglu3
1William Stephan M.D., Limited Liability Company (LLC), New York, USA
2Bennett Health and Wellness, New York, USA
3University of Buffalo School of Medicine and Biomedical Sciences, New York, USA
Email: huseyint@buffalo.edu

ABSTRACT
Traumatic brain injury is a major health concern worldwide with massive financial and social impact. Conventional treatments primarily focus on the pre- vention of further damage to the brain parenchyma, while failing to address the already existent symptoms. Previous clinical studies have shown that Low Level Laser Therapy (LLLT) can significantly reduce pain and induce temporary vasodilation in capillaries, which the authors hypothesize can be used to improve the quality of life in TBI patients by treating their current symptoms, which are predominately migraine- like headaches. This case report illustrates the use of LLLT in the treatment of a patient with a TBI and the great clinical success achieved in the reduction of pain, as measured by VAS—achievable within five treatments of 10 minutes in duration.
Keywords: Traumatic Brain Injury; Low Level Laser Therapy; LLLT; Chronic Migraines; Headaches
1. INTRODUCTION
Traumatic brain injury (TBI) typically occurs when there is any sudden trauma to the skull that induces damage to the brain. There are many causes of TBIs, but unfortu- nately no documented cures. According to Faul et al., the annual incidence of TBI in the United States is approxi- mately 1.7 million incidents, which account for 30.5% of injury related deaths [1]. The direct and indirect costs of TBI totaled an estimated 76.5 billion dollars in the United States in 2000 [2]. Traumatic brain injuries play a major role in the health care of our nation, especially in our armed forces, where the men and women serving our country are at a higher risk to suffer a TBI.
Treatment is centered on preventing future insult to the brain, but very little can be done to treat the already ex- isting symptoms. These symptoms, as described by the National Institutes of Health, range from mild to severe and include: headaches, nausea, vomiting, confusion, and blurry vision. Current theory on alleviating the symp- toms of TBIs is based on reducing inflammatory and oxi- dative stress and increasing perfusion to support meta- bolic needs [3]. A study by Naeser et al. looked at the use of Near Infra Red (NIR) light for the treatment of TBI, stroke, and neurodegenerative disease. Their results were very promising, showing that nightly treatments with NIR LED over a period of months to years improved cognitive abilities [4]. Furthermore, they showed that the use of NIR light increased ATP production, caused vaso- dilation, and improved perfusion. We believe that the superpulsed 905 nm LLLT system employed in this case study operates through similar mechanisms of action and to support our hypothesis we present a case report of a patient with a traumatic brain injury that was treated with the superpulsed 905 nm LLLT system two years after the injury occurred.
2. CASE REPORT
A 25-year-old man with no pertinent past medical history presented as a new patient. His only complaint was chronic debilitating migraines since a traumatic brain injury which occurred in May of 2010. He was attacked and repeatedly hit over the head with a lead pipe, cons- quently requiring many sutures and leaving a scar on the brain as evidenced by the MRI performed subsequent to the incident. Since the attack, he has been experiencing excruciating migraines daily which he rates at ranging from 7/10 to 10/10 using a Visual Analog Scale (VAS) reference and physically describes them as: throbbing, squeezing sensations located primarily to the occipital region of his skull. He complains of being unable to have a peaceful night of sleep or to participate in play with his four children, the oldest being 9, due to the constant pain Published Online November 2012 in SciRes. http://www.scirp.org/journal/wjns
2 W. Stephan et al. / World Journal of Neuroscience 2 (2012) **-**
and agony he experiences.
After undergoing multiple previous treatment modali- ties, which included: medications, vitamin supplements, and chiropractic massage therapies, all of which were unsuccessful at alleviating his symptoms, he had all but given up hope. Willing to try anything to rid himself of the chronic pain, he agreed to undergo LLLT treatment. Using a Theralase® superpulsed LLLT medical laser sys- tem equipped with a multiple probe handpiece (5 × 905 nm wavelength @ 0 to 100 mW average power per laser diode + 4 × 660 nm wavelength @ 25 mW average power per laser diode), he was given a total of five treat- ments delivered over a two week period, with the 905 nm laser diodes set to 50 mW average power. The LLLT was targeted to a total of four areas on the scalp for two and a half minutes each: midline occipital region just below the lamboidal suture, superior aspect of the nape to target the Circle of Willis and over the mastoid processes bilate- rally. We selected 905 nm wavelength based on a previ- ous scientific study that demonstrated that the 905 nm superpulsed wavelength employed by the system was able to increase inducible Nitric Oxide Synthase (iNOS) expression by 700%, as compared to numerous other wave-lengths that showed little or no effect [5]. iNOS has been well documented in numerous clinical studies to cause temporary vasodilation by signaling endothelial cells located in capillary walls to become flaccid and relax. Additional studies have shown that 810 nm and 665 nm wavelengths may also be effective, but those specific wavelengths are not able to produce as much iNOS expression, when compared to 905 nm superpulsed technology [6]. An average power for the superpulsed 905 nm laser diodes was initially chosen to be 50 mW based on personal experience, but further clinical inves- tigations may uncover more clinically effective average power settings.
Immediately after the first treatment of only ten min- utes in duration, the patient reported a 43% reduction in pain, reporting a VAS of 4/10 from a pre-treatment score of 7/10. He stated the throbbing and squeezing nature of his pain had immediately subsided and that all that was left was more of a dull achy pain. He continued with the treatments over the next week and with each new treat- ment his pain was further reduced. By the end of the course of 5 treatments, his pain had reduced by over 90% and all that remained was a minor ache that was barely even noticeable. Furthermore, he reported no side effects from the treatment except for a slight sensation of warmth over the area where the laser was placed. He was no longer experiencing constant pain; even his children no- ticed the difference saying that he looked happier. After two years, he was finally able to achieve a good night’s rest.
3. DISCUSSION
Low Level Laser Therapy (LLLT) has been used in many acute and chronic conditions, but its effectiveness is yet to be fully documented by human clinical trials for mi- graine, stroke or TBI. Currently Dr. Michael Whalen, working at Massachusetts General Hospital, is conduct- ing controlled studies using a low level laser with the hopes of bringing this new technology into the forefront of neuroscience and medicine. This case study gives one example of how LLLT can be used to treat chronic mi- graines, specifically those that are a result of traumatic brain injuries. LLLT has been shown to reduce pain and inflammation, create a state of vasodilation by activating the nitric oxide pathway and further even promote an- giogenesis. The present theory is that by increasing blood flow to the brain, and subsequently, increasing oxygen delivery to the brain, the symptoms of a migraine can be mitigated. This case differs from previous studies per- formed using laser therapy to help patients with TBIs in that the type of laser and the settings used were unique. Specifically, unlike the LED light used by Naeser et al., the therapeutic laser we utilized only required five treat- ments over two weeks to be effective with immediate re- sults after the first treatment.
It is currently unclear whether or not our patient will need maintenance therapy. He was interviewed at two weeks and two months post treatment and remains sym- ptom free. He is deeply appreciative of the care he was given and continues to enjoy family life which was impossible before LLLT. More research needs to be done, especially controlled double blind studies to further eva- luate the full effectiveness and possible side effects of using LLLT in the treatment of TBIs and migraines, but the latest research has shown that LLLT is an extremely safe and effective technology for a wide range of neural and muscular skeletal conditions.
REFERENCES
[1]
Faul, M.X.L., Wald, M.M. and Coronado, V.G. (2010) Traumatic brain injury in the United States: Emergency department visits, hospitalizations, and deaths. *, **-**.
[2]
Finkelstein E, C.P., Miller T and associates, The Inci-dence and Economic Burden of Injuries in the United States. Oxford University Press, 2006. doi:10.1093/acprof:oso/9780195179484.001.0001
[3]
Sahni, T., et al., (2012) Use of hyperbaric oxygen in traumatic brain injury: retrospective analysis of data of 20 patients treated at a tertiary care centre. British Journal of Neurosurgery, 26, 202-207. doi:10.3109/02688697.2011.626879
[4]
Naeser, M.A. and Hamblin, M.R. (2011) Potential for transcranial laser or LED therapy to treat stroke, trau- matic brain injury, and neurodegenerative disease. Pho- Copyright © 2012 SciRes. WJNS
W. Stephan et al. / World Journal of Neuroscience 2 (2012) **-**
Copyright © 2012 SciRes. WJNS
3
tomedicine and Laser Surgery, 29, 443-446. doi:10.1089/pho.2011.9908
[5]
Moriyama, Y., et al. (2009) In vivo effects of low level laser therapy on inducible nitric oxide synthase. Lasers in Surgery and Medicine, 41, 227-231. doi:10.1002/lsm.20745

The laser used in this study was the TLC-1000, super-pulsed multi-probe laser
For more information please call 1-866-843-5273 or visit www.theralase.com