good afternoon I’m Dr David Ferriss a physician at Maxwell clinic and I have with me Jeremy Paluch
who is a clinical colleague and one of our nurse practitioners at Maxwell Clinic uh Welcome to our
webinar this afternoon on uh near infrared light therapy uh the title of it is shining a light on
brain health which we’re going to try to give you uh an idea of what that’s about what some of the
research uh involves and how we’re applying that here in patient care at uh at Maxwell clinic so
with that um let’s uh let’s jump in uh we’ll take uh no more than 30 minutes to uh to talk
and then we’ll open it up for any questions that you have uh you can submit those questions uh from
your screen and we’ll answer as many of those as we have time for uh at uh before we conclude
so what is um what we call and refer to uh tpbm uh the little T stands for Trans cranial and the
PBM stands for photobiomodulation it’s a bit of a mouthful till you uh say it a few times but as
the definition that you see here uh States uh transcranial photomod modulation is a form of
light therapy that involves the application of near infrared or red light to the head with the
intention of stimulating mitochondrial activity in brain cells um the mechanism relies on the
ability of certain wavelengths of light in this case uh wavelengths that are part of the near
infrared spectrum of light to penetrate the skin and skull reaching the brain where it can exert
its effects on neurons and other brain cells um I think a lot of people Express surprise when
they learn that you can actually apply near infrared light to the scalp and the skull and
and and learn that it can penetrate those organs and and go as deep as 3 to 5 cenim or about two
inches into the cerebral cortex of the brain so uh it can be very powerful and uh it it has
a growing number of applications we’re going to concentrate today on um applications of of near
infrared light therapy on uh on the brain so I want to take just a minute to talk about how does
photobiomodulation work um there are a number of effects that it has that have been learned through
a growing body of research but the three big ones to remember are that it reduces inflamation in the
uh in the cells of the brain it increases circul ation uh primarily here it’s uh uh near infrared
light therapy uh causes an increase in nitric oxide uh in the brain which is a potent phaso
dilator and that increases um circulation in in the brain and it also activates the mitochondria
of the cells you may recall that mitochondria are the uh organel of the cells that uh provide
energy to to all cells so photobiomodulation increases cellular energy and it does a lot
of other things as well but these are the big three that uh have the primary effect and and
are the reasons why so many different conditions uh respond to photobiomodulation so we’re going
to take a few minutes just to give you a sense of some of the major areas where extensive research
has been done this is still very much a developing body of work um there’s a lot of the the early
studies for all of the 10 areas that you see displayed on this slide which uh neuronic U the
manufacturer of the particular um helmet that we use and that Jeremy will uh explain to you
shortly um they’ve allowed me to uh to use this slide um but let me I want to walk you through
just to give you some sense of the of the research uh that is is growing by Leaps and Bounds in this
area of uh photobiomodulation therapy so starting with Alzheimer’s Alzheimer’s is a huge and growing
problem uh in this country and in other countries uh it extremely de debilitating and exerts a high
toll economically and uh on the quality of life of individuals and and their care uh caregivers
uh photobiomodulation has shown a lot of promising potential for treatment of Alzheimer’s and this is
based on quite a large number of animal and human studies um for for a lot of the measures related
to alzheimer’s uh you need to be able to have an animal model so that you can examine the brains um
mostly mice have been used um before and after therapy to see what impact did it have on the
of what’s going on in in in the brain but just to give you a flavor uh a recent systematic review of
35 different published studies showed that 83% of the studies that were reviewed reported positive
Improvement in cognitive functioning uh after PBM therapy uh only about half of these uh studies
were what we call randomized clinical trials which are something of the the gold standard of
these types of interventions whether it’s a drug or it’s uh a therapy such as photobiomodulation uh
but uh the other the other studies that have been done H have to do with case studies or studies in
which there is not a formal comparison group but careful measurements are made before and
after the the intervention in terms in this case photobiomodulation um PBM which is the acronym
that that we use for photobiomodulation appears also to reduce the levels of
amalo beta proteins in the brain one of the key characteristics of of Alzheimer’s disease um and
stimulates uh autoag and brain cells this is the natural process of of cell death that that occurs
in the body as cells age and need to be replaced it reduces inflammation and it increases level of
of an important factor called brain derived neurotropic factor or bdnf which stimulates
improved neural function that is the connection of neurons with each other and promotes neurogenesis
the creation of new neurons in the brain so um a lot of encouraging uh research coming out of the
Alzheimer’s uh area and I think we’ll see more and more evidence particularly as large clinical
randomized clinical trials can be completed uh long Co I think everyone has heard of uh with
the Advent of the covid virus uh four years ago uh I know we at Maxwell Clinic have seen quite a
number of patients the last few years that have developed what we call Long hul covid these are
individuals that have the infection or in some cases they they were were vaccinated and as a
result of the vaccine they they appear to develop some long-term symptoms and one of the the primary
symptoms is is brain fog a lot of difficulty uh functioning cognitively struggling to focus and
concentrate and uh PBM has u in a growing body of research using PBM to treat symptoms of Long
Haul covid uh has been very successful it’s it’s shown beneficial results uh one study of 20 Long
Haul covid patients who received PBM uh and compared them to 20 Long Haul covid patients
who did not receive PBM demonstrated that the patients that received the photobiomodulation
therapy significantly improved their cognitive function is measured by a test that we call the
mocha the Montreal cognitive assessment this is a test that we use frequently here at Maxwell
Clinic that provides us a good overall sense of the degree if any of of dementia particularly in
in in Alzheimer’s and then a 2023 study involving 14 patients with long haul covid symptoms uh who
were assigned randomly to a PBM treatment or a whole body near infrared treatment where where
they were exposed to near infrared light not just on their their head but and their whole
body demonstrated that both of these means of of therapy were uh were effective and uh
they were able to demonstrate significant uh Improvement in both groups in the subject’s
cognition their executive function the processing speeds of their brains and their self-reported
level of improvement um Parkinson’s disease is another um common neurodegenerative um disease
um of the of the brain and PBM has been shown to be a promising treatment for it as well uh
a small randomized clinical trial demonstrated gate Improvement uh abnormalities of gate and
balance is very common in Parkinson’s as it uh progresses um and they demonstrated gate
Improvement after a 9 Minute uh PBM session twice weekly for just nine weeks uh so that study was
encouraging another small randomized clinical trial demonstrated Improvement not only in gate
but in fine motor skills and cognition after 12 weeks and uh very importantly the patients did
not show evidence of regression for up to one year uh with continued atome um PBM therapy um there’s
also some evidence that photobiomodulation appears to delay further neurod degeneration so in a sense
it’s it’s encouraging that photobiomodulation may help slow down or arrest uh the progression
of Parkinson’s um we don’t have evidence uh sufficient to say conclusively that that is
cas case but some of the studies that have been done are encouraging that that that may
may be in fact true autism is uh is another area where some encouraging results have been
obtained um for individuals that are somewhere on the autism spectrum uh in one nonrandomized
clinical study of 40 participants between the ages of five and 17 all on the autistic spect
uh these individuals received eight five minute near infrared light treatments over
a 4-week period so two treatments a week for four weeks and at the end of that time they they saw a
statistically significant decrease in irritability uh lethargy ssocial withdrawal hyperactivity and
inappropriate speech um several clinical reports of PM so these were individual case studies uh in
individuals with autistic Spectrum uh demonstrated Improvement in a range of Behavioral measures
which uh are common to individuals on the autistic spectrum and this included their uh
social awareness uh communication and motivation uh and a reduction in restricted and repetitive
behaviors that can be common with individual ual with with autism um General Wellness not to leave
out individuals who don’t have a uh a diagnosis of some type of of neurological problem but multiple
Studies have demonstrated that uh healthy adults can benefit from uh ongoing photobiomodulation
which is includes uh improvements in their cognitive function they haven’t reached a state
where they uh they really have any significant dementia they’re still highly functioning but uh
they may as they get older uh have a few memory lapses things that are very common have what are
often referred to as senior moments and um um this has been PBM has been shown to reduce inflammation
enhance mood improve sleep and and improve memory in in a number of these individuals
um ADHD uh very common diagnosis that we see at the uh the Nashville uh at the Maxwell Clinic
um number of Studies have demonstrated a reduction in symptoms of ADHD following PBM therapy um these
symptoms include an improvement in adults capacity to concentrate plan and control symptoms of ADHD
and um one of the things that photo modulation um does is it seems to increase neuroplasticity
of the brain the ability of the brain to um to be receptive and to train more more easily
to change and so we have begun using this on a selected basis uh preceding neuro feedback
sessions which we have long used as an effective therapy for many individual ual with ADHD uh by
preceding their neuro feedback session with a u you know six to 10 minutes of um of photo U
biomodulation so we we don’t have enough data to um to know whether that’s going to improve but we
think there’s good reason of why that may increase the effectiveness of of neural feedback um pdsd uh
we see a lot of as well post-traumatic stress disorder um a randomized clinical trial involving
photobiomodulation and PTSD in 2021 compared a treatment group The individuals received um
photobiomodulation therapy and they were compared to a group that received what we call a sham
therapy to the patient it looks exactly like they are getting the photobiomodulation they
use a helmet they’re exposed to near infrared light uh therapy for the same length of time
and the same frequency is those who are actually getting the treatment and at the end of the uh
of the study um different measurements that were established at Baseline are compared afterwards
to see whether there has been Improvement and uh in this randomized clinical trial and
2021 involving the the Sham treatment group uh significant decrease in PTSD symptoms was
observed at one week and at one month uh of therapy uh another study with PTSD involved
11 individuals with traumatic brain injury ages 26 to 62 they received 18 sessions or
three sessions per week for six weeks and and in these individuals the the researchers were
able to demonstrate significant Improvement in an executive function and verbal learning and
memor so uh again another area uh PTSD in which uh near infrared light therapy May uh may be
helpful um traumatic brain injury uh another area related to PTSD U lot of encouraging work here
a lot of animal Studies have been done with mice uh with TBI and in those Cas in those studies the
researchers um um observed Improvement in neurological function reduction in size of
brain lesions decrease neuroinflammation an increase in brain derived neurotropic Factor
uh which stimulates the formotion of new new neurons uh in the before and the after treatment
of these of these mice uh there are multiple case studies of using PBM for treatment of
concussions with very positive results uh again what PBM has demonstrated in brain injury victims
is an ability to decrease inflammation stimulate neurogenesis that is the production of new neurons
improve mitochondrial function and to decrease oxidative stress and then finally and quickly
uh with depression and anxiety uh two very common mood disorders that we see lots of with depression
uh photobiomodulation appears to be a promising treatment for depression what we don’t have yet
are large randomized clinical trials those are very much needed and hopefully will be done uh
in the next few years but multiple studies do provide strong evidence this time for fol phob
biom modulations increasing mitochondrial energy production and increasing Regional
blood flow that we talked about earlier and this certainly seems to have a very positive effect
in reducing symptoms of of depression and then finally with anxiety uh p p uh photobiomodulation
appears here to be a promising treatment for anxiety but again like depression we really
need some large r randomized clinical trials uh to to be able to say that conclusively um
and to wrap up uh with respect to anxiety there was a a non-randomized clinical trial
study involving 15 individuals with generalized anxiety disorder ages 18 to 70 uh they received
uh photobiomodulation therapy for 20 minutes for eight weeks each day and the researchers observed
decreased anxiety and improved sleep um using a number of valid assessments before and after um
treatment and then finally another nonrandomized clinical trial study involving 10 individuals with
generalized anxiety disorder these individuals received a single 8 Minute uh photobiomodulation
treatment and just that one treatment in these 10 individuals resulted in decreased anxiety
and depression at two weeks and four weeks after that single treatment which is pretty amazing so
hopefully as these non randomize uh as I’m sorry as the as we have more randomized clinical trials
in all of these 10 areas of of research involving photobiomodulation will be able to draw strong
ER and stronger conclusions uh as to the efficacy uh of this uh this technology uh in the treatment
of these disorders so with that um I’m going to uh get rid of these slides and uh turn it over to
Jeremy to um tell you a bit about the specific therapy that we are using at Max Clinic uh a
little bit about that and um how it works and how easy it is to uh to use so Jeremy so I’m acting
as uh Dr Ferris sidekick today did all the heavy lifting kind of analyzing all those uh all that
data for us but you know just to add on a little bit um here’s the helmet here and we’ll kind of
dive into this here in a second this is actually pretty simple and um and it has a lot of potential
this is a pretty Natural Therapy because 1070 nmet light that’s just you’re getting that from sun exposure and this is able to penetrate into your brain like he said actually give energy to your
cells and has potential to um stimulate the growth of new neurons so I think that’s pretty cool so we
have a typically a very multifaceted Approach at maxw care but this is really easy add-on so as
you can see here the title there neuronic neuro radiant 107 and there is 256 LED lights on the
inside now 1070 is above the spectrum that you can actually see so you don’t actually see that
frequency it is plugged in here into a a unit that I’ll get to here in a second and it’s quite simple
put it on your head and then you’ll have the the screen here which I don’t know if you can see that
very well but there is several different settings there’s peace Focus energize and glow those are
the preset settings uh glow is a pretty common one that’s one that we use during the day it is really
pretty broad spectrum it’s good for a majority of the uh it’s it’s good for pretty much everything
actually um you won’t want to use it after sun sets um because it could potentially interfere
with sleeves and I don’t know if you mentioned that that’s really maybe the only side effect
is if you use some of these before before sleep could keep you awake that or if if uh what they
found is if you do too much there is such a thing as too much of a good thing and and so that’s why
most of these protocols that uh that come standard with the the neuronic technology um uh we’re we’re
talking about a maximum of 10 minutes some of the U some of the um modules uh are only three or four
minutes depend depending on the pulse rate and the intensity of the U near infrared light but um yeah
it’s easy to use as Jeremy says you put on the helmet and then uh you Head Start yeah and I am
going to go ahead and do the energize just to make sure we can get through the rest of this webinar
and this is a short three minute one and some of them yeah like you mentioned the glow setting is
10 minutes the piece setting is is nine um so and it’s just that simple you leave it on your head
yep um I’ve noticed uh in in my own uh experience with this technology that sometimes I’ll feel just
a slight warmth uh from the from the helmet uh by the the end of the uh the session but
uh really that uh it’s just important to follow your clinicians uh in instructions on the use of
of one or more of these these different modules they do differ uh in the the how the intensity
and what we call the pulse rate uh as well as the the time that they’re administered in
in uh in a particular uh uh module but uh yeah it’s super simple to uh super simple to to use
yeah and it runs through its time and then it stops automatically if you needed to stop in there there is a button there you can just press stop but this box plugs into the wall
and this uh box plugs into the helmet pretty straightforward so uh you know ways that we’ve
been using this technology the last uh year or so uh as I mentioned previously in conjunction with
Selective neuro feed back patients as a precursor to their um to their neuro feedback session and
and we believe there’s a a likelihood that this will help increase the neuroplasticity of the
brain uh during uh through the near infrared light uh session and perhaps make it more uh
the brain more amenable to the training that it gets with um uh with the neuro feedback uh and so
we’re we’re hopeful that perhaps over time we’ll be able to see that those patients May progress
more quickly than they would with without that um I know a number of our clinics with uh with
a number of patients with uh Alzheimer’s disease or other forms of dementia uh in combination with
other therapies uh are using helmet uh having patients use it uh the helmet on a daily basis
uh at home that’s nice thing about this it can be used at home very safely um and uh we’re we’re
eager to see whether that seems to uh to help to perhaps slow down the progression of some of
these new neurod degenerative um um conditions um or whether and there’s the beep that’s the
alarm that was it Jeremy’s completed uh three minutes using the the energize uh module um and
uh it’s really that uh that simple to use um one thing you do have to be careful about is
not overdoing it uh it’s not recommended that you use more than you do more than two sessions
per day Sometimes some some individuals it’s been found are more sensitive to the effects of near
infrared light than than others and you can get something called overstimulation uh and in which
case you simply back off the the therapy or not do the therapy for a couple of days and then dial it
back in terms of time or intensity uh until that individual um accommodates U to that um jerem
anything else you want to add about uh this U this new technology no I think that’s pretty
much it I like the Simplicity of it um I like the applications that we have for it it’s again
excellent addition to other therapies and really nicely you can take it home and just use it um
at your leisure at home um it is important to to realize particularly with the all of the
um neurologically related conditions that I I gave an overview of with respect to some of the
research um that this is typically just one piece of a of a a total program of of therapy uh at
Maxwell Clinic we always start with lifestyle if you’ve been a patient here you know how important
diet is eating a healthy diet giving the body the nutrients that it it needs um and how important
regular physical activity is uh those are always important um we also know and and many of you will
be aware of the strong gut brain connection if you don’t have a healthy gut you’re not going to
have a healthy brain and that has been well demonstrated in a l large body of published
research over an extended period of time so um I I don’t want anyone leaving this webinar to
think this is a Magic Bullet those typically don’t exist in in medicine but it is a very promising
technology and that’s why uh as we’ve gained some experience with this and continue to gain more we
wanted to devote a webinar to exposing you to this um if you’re interested in uh in finding
out more whether this might be an appropriate um um uh therapeutic um methodology that should be
included in your total plan of of treatment at Maxwell Clinic then uh discuss this with your
uh with your individual clinici um with that if you don’t have anything else Jeremy we’ll we’ll
stop and we’ll look and see if there are any uh questions yeah the last thing I’ll say is I
couldn’t agree more with Dr Ferris like right now I kind of think of this as a supplement kind of
like Diet with you know diet is going to be the most important exercise and things like that are important but we do recommend supplements at times because they can enhance things and I think
that’s kind of how I’m looking at it right now is data looks promising but I think of it as another
add-on to support what we’re already doing yep exactly a really important important Point uh one
question is has any research been done for mental health issues such as bipolar and or schizophrenia
uh a great question um I have not come across any studies specifically related to either uh bipolar
depression or schizophrenia uh so the simple answer is I’m not aware of any that doesn’t mean
that it doesn’t exist but it is not something that has shown up yet in the research that I’ve I’ve
been done um have done thus thus far so um it’s it’s possible um that it might have some benefits
but uh I’m not aware of any uh any research to date that has looked at those two uh conditions
um there’s another question uh should I buy my own Helmet or go to your clinic to use your helmet um
you know most of the individ individuals that we’re seeing at at Maxwell Clinic uh if this if
we think uh this is an appropriate methodology that might uh be of potential benefit to you
as a patient is part of your total treatment plan then uh you know we’ll discuss that with patients
and we’re increasingly where we see opportunity telling them about this technology and suggesting
they may want to try it um some individuals may wish to um to to rent uh a helmet for a month
and just try it and then they and their clinician together can decide does this seem to be beneficial in which case they want to do it uh longterm then they may want to um
um they may want to consider buying one and um uh they can can be purchased um as well uh and we can
handle that for the uh to Pat the patient to make that U simple um I will mention one thing we we
mentioned the uh these four standard uh modules or programs that are part of the neuronic helmet
technology and that have wide versatility there’s also a custom program option and uh that can even
be customized for a patient um based on one’s individual electroencephalogram um tracings so in
those cases where it might be optimal to customize it specifically for a given individual based on
their EEG findings then uh our our neuro feedback uh Department can can do typically their 10-minute
uh um recordings uh with eyes open and eyes closed using uh a helmet with 19 rods and then that data
can be sent to a clinical consultant at neuronic who will customize those settings uh for someone
who wishes to purchase a helmet and and use it uh using that that mode um there’s another question
of could this be helpful for Lyme disease uh or if you’re stuck in fight or flight mode um I have
not seen anything specific in the research to date regarding photobiomodulation and uh it’s use with
retal diseases with tickborne diseases such as as lime but uh possibly in time there may be since
that does have neurological effects uh in chronic lime then um then that’s possible but I’m not
aware of anything this time are you I’m not either I don’t know if there is any but I mean we could
speculate and I don’t want to do that too much speculating on this but depression anxiety brain
fog all can be pretty common in Lyme disease and those are all applications it wouldn’t certainly
wouldn’t be the only treatment of course for Lyme disease but as an add-on potentially that’s all
I can really say right yeah yeah so and then the second part of that questions or if you’re stuck
in fight or flight mode uh these have to do with you know autonomic uh nervous system uh issues
of too much sympathetic activation for someone who’s in fight or or flight there’s certainly
uh you know a number of uh of therapies that can be applied there uh including lifestyle
regular exercise can be really helpful a healthy uh a healthy diet and and um uh and and also uh
uh neural feedback sometimes can be very helpful there um I I would venture to suggest that perhaps
it could be helpful as one piece of a total treatment plan probably not as a sole treatment
for that uh again I haven’t seen research specific to that but this is still very much uh an evolving
uh area of research but one if you look at the curve in terms of number of published
studies uh related to photobiomodulation and its application to clinical problems uh it it’s
looking more and more like a logarithmic curve where the number of published studies each year
keeps going up more and more um we got one more question how long do you think uh you would need
to use uh photobiomodulation therapy before you see any results days or weeks well as I
tried to point out with some of the studies that I referenced uh different Studies have looked at um
um at treatment uh protocols that were one was was a single treatment on one day and and they
saw some benefit I would say for most condition conditions we’re probably looking at weeks or
longer to to see um to see benefit but uh most of the studies across a number of conditions there
seemed to be Improvement most of the studies were not longterm studies they involved two to four
weeks and in in most cases they saw benefit so I don’t think it’s the sort of thing where you would
necessarily have to do this um for for months uh or or years although with neurodegenerative um
conditions such as Alzheimer’s such as Parkinson’s um you know if this turns out to be a therapy that
can be demonstrated to conclusively be of benefit to these individuals and there’s good reason to
think that this will turn out to be the case as we have larger and more randomized clinical trials
that demonstrate Improvement in these conditions that uh these patients would probably want to use
this uh technology over U you know indefinite a longterm therapy to try to uh prevent progression
uh of uh of those diseases so I think there’s a lot to be encouraged about uh there um that’s
all the questions that we have so um thank you for joining us today uh I hope this has been at least
a highlevel introduction to photobiomodulation and some of its um um some of its benefits and
uh if this uh if you are a Maxell care patient and um you know you’re interested or think this
might be of benefit to you uh feel free to bring it up the next time you have a an office visit
with one of our clinicians and they’ll be happy to discuss that with you and see whether it might
be a useful addition to your total uh treatment plan so with that we’ll close and uh thank you for
your attention and uh look forward to seeing you again in a future webinar in the future take care