Traumatic Brain Injury Recovery with Photobiomodulation: Cellular Mechanisms, Clinical Evidence, and Future Potential

Abstract

Traumatic Brain Injury (TBI) remains a significant global health challenge, lacking effective pharmacological treatments. This shortcoming is attributed to TBI's heterogeneous and complex pathophysiology, which includes axonal damage, mitochondrial dysfunction, oxidative stress, and persistent neuroinflammation. The objective of this study is to analyze transcranial photobiomodulation (PBM), which employs specific red to near-infrared light wavelengths to modulate brain functions, as a promising therapy to address TBI's complex pathophysiology in a single intervention. This study reviews the feasibility of this therapy, firstly by synthesizing PBM's cellular mechanisms with each identified TBI's pathophysiological aspect. The outcomes in human clinical studies are then reviewed. The findings support PBM's potential for treating TBI, notwithstanding variations in parameters such as wavelength, power density, dose, light source positioning, and pulse frequencies. Emerging data indicate that each of these parameters plays a role in the outcomes. Additionally, new research into PBM's effects on the electrical properties and polymerization dynamics of neuronal microstructures, like microtubules and tubulins, provides insights for future parameter optimization. In summary, transcranial PBM represents a multifaceted therapeutic intervention for TBI with vast potential which may be fulfilled by optimizing the parameters. Future research should investigate optimizing these parameters, which is possible by incorporating artificial intelligence.

Keywords: cellular mechanisms; clinical studies; parameters; pathophysiology; photobiomodulation; power; pulse frequency; traumatic brain injury.

Figure 1

Schematic structure of the manuscript’s reviews and discussion, starting with a review of the pathophysiological aspects of traumatic brain injury (TBI), matching with photobiomodulation (PBM) research on cellular mechanisms, supported by clinical data in the literature, and ending with discussions on future research for parameters to improve outcomes for TBI.

Figure 2

Summary of the identified pathophysiological aspects of traumatic brain injury (TBI) from a trauma source that are addressable with photobiomodulation (PBM).