Abstract
C
The past few decades have brought significant improvements in our understanding of the pathophysiology underlying the damage after severe brain and peripheral injuries; however, current treatment options remain unsatisfactory, 1,2 prompting the medical community to search for new experimental therapeutic approaches and effective solutions that can enhance recovery.
TBI and the high incidence of peripheral nerve injuries (PNIs) caused by trauma is a major medical problem worldwide. TBI includes skull fractures, intracranial hemorrhages, elevated intracranial pressure, and cerebral contusions. Unlike stroke, the prevalence of which is tied with an increasing age of onset, TBI and traumatic PNI are much more common in younger populations. Recently, PBM has garnered a greater interest as an alternative to existing approaches to treat TBI and PNI, as the search for conventional therapeutic treatments has been relatively unsuccessful or unsatisfactory.
Naeser and Hamblin 3 review the use of PBM as a possible treatment for TBI. There are several contributing processes that have been proposed to lead to the beneficial effects of PBM in treating TBI such as stimulation of neurogenesis and a decrease in inflammation and neuroprotection. Both animal and clinical trials for ischemic stroke are outlined. In addition, PBM has been shown to be effective at increasing memory, learning, and the overall neurological performance in rodent models with TBI. Oron et al. 4 showed the beneficial effects of PBM in significantly reducing long-term neurological deficits. These promising results may soon lead to PBM becoming a more widely used treatment for TBI.
Recent developments in peripheral nerve (PN) reconstructive techniques and intensive rehabilitation treatment enabled to reduce nerve recovery time. The current treatments, such as physiotherapy, occupational therapy, and electrical stimulation, are still insufficient, especially in cases of severe nerve injury. In the majority of cases, patients remain with a loss of sensory and motor functions, which lead to severe occupational and social consequences. Among the various proposed therapeutic methods, PBM received an increasing attention for enhancing nerve repair.
The beneficial effect of PBM on injured PNs was already published extensively. 5 In addition, since one of the main goals of restorative medicine is muscle preservation and decrease in muscle degeneration and progressive atrophy, which are a major challenge in patients with severe PNI, PBM has also been found effective in potentially promoting this cause. 6
CNS and PNIs and disorders affect millions of people worldwide, representing a major cause for morbidity and disability, and pose substantial costs for society from a global perspective. After a growing number of traffic and work accidents, natural disasters, and military activity, patients are forced to deal with lifelong disabilities, associated with progressive memory deficits, cognitive impairment, and personality changes in cases of TBI, as well as with loss of sensory and motor functions and intractable pain in cases of PNI. All these require intensive post-traumatic rehabilitation treatments.
The scientific and clinical communities are waiting for innovative therapies to be successfully applied in this field of medicine. Successful outcome will have a substantial impact on patient care, lifelong health, and well-being. The goals described in this special issue are aimed to develop new treatment methods that can enhance recovery and take a step forward to clinical application of PBM for CNS and PNS injuries and disorders.