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Schiffer et al report beneficial effects of transcranial PBM on anxiety and depression after a study in which PBM with an LED array with a peak wavelength at 810 nm and an energy density of also 250 mW/cm2 was used [41]. They calculated that from the supplied dose of 60 J/cm2 at the scalp, an effective 2.1 J/cm2 (3.7 %) reached the dura of the brain. Positive effects of a single treatment session compared to a placebo control group were observed two weeks after PBM, which waned off by the time of a further assessment after four weeks. As stated by Hashimi et al in their article about the role of PBM in neurorehabilitation [21], transcranial photobiomodulation with low level red to near infrared light has already been used on human subjects with moderate Alzheimer’s disease, although no peer reviewed publications exist as of yet. This is slowly changing, with new devices being developed and more individuals being treated [42,43]. 1.2 Minimum Effective and Maximum Tolerated Dose When red-to-near-infrared monochromatic or quasi-monochromatic light is supplied to the cytochrome oxidase in neuronal mitochondria, the photons from this light influence the proton gradient of the mitochondrial membrane and thus modulate ATP production. The effective dose of PBM appears to follow the principle of hormesis, meaning that low doses are stimulatory while higher doses are less effective or even counterproductive. The minimum effective and maximum tolerated dose has been experimentally evaluated in vitro and in vivo, the translation of these results to transcranial application on humans is supported by results from studies on transmission factors and penetration depth of red and NIR light in intermediate tissue. 3 Hormesis The hermetic effect of PBM was shown by Gonzalez-Lima and Barrett in a study on rats, where 660 nm LED arrays with a power density of 9 mW/cm2 showed the highest increase in cytochrome oxidase activity at a dose of 10.9 J/cm2 (13.6 % increase), slightly less at the higher dose of 21.6 J/cm2 (10.3 % increased activity) and finally a point of only non- Enengl, Dungel #neverforget – PBM vs AD: A Systematic Review Page 11 of 25PDF Image | Photobiomodulation Against Alzheimer’s Disease
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