Affiliations: [a] Centro de Pesquisa Experimental (CPE) e Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre –RS, Brasil | [b] Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Psiquiatria e Medicina Legal, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Porto Alegre –RS, Brasil | [c]
Harvard Medical School, Boston, MA, USA
| [d] MGH Division of Neuropsychiatry, Massachusetts General Hospital, Boston, MA, USA
Correspondence:
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Correspondence to: Marco Antonio Caldieraro, Serviço de Psiquiatria, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350 4° andar, Porto Alegre –RS, 90035-903, Brazil. Tel.: +55 (51) 33598294; Fax: +55 (51) 33598294; E-mail: [email protected].
Abstract: Background:Major depressive disorder (MDD) is prevalent and has significant impact on individuals and society. Cognitive symptoms are frequent in MDD and insufficiently treated by antidepressant medications. Transcranial photobiomodulation (t-PBM) is a novel device therapy which shows promise as an antidepressant and pro-cognitive treatment. To date, despite the encouraging results, the optimal stimulation parameters of t-PBM to treat MDD are not established, and clinical studies are very heterogeneous in terms of these parameters. While the literature provides guidance on the appropriate fluence to achieve therapeutic results, little is known on the other parameters. Objective:To evaluate the relationship between different parameters and the antidepressant effect of t-PBM. Methods:We reviewed clinical studies on MDD and on depressive symptoms comorbid with other diseases. We calculated the standardized effect size of the change in symptoms severity before and after t-PBM and we performed a descriptive analysis of the reviewed papers. Results:The greatest effect sizes for the antidepressant effect were found in studies using pulse-wave t-PBM with high peak irradiance (but low average irradiance) over large skin surface. One well-designed and sufficiently powered, double-blind, sham-controlled trial indicated that t-PBM with low irradiance over a small skin surface is ineffective to treat depression. Conclusion:The use of t-PBM for Alzheimer’s disease and for dementia is still at its inception; these dosimetry lessons from the use of t-PBM for depression might serve as guidance.
