Significant improvements in 4 former football players with possible CTE: transcranial photobiomodulation case studies

Jul 14

two photos, on the left, the Vielight transcranial photobiomodulation device, on the right, the device on a model of a head

By Malayka Gormally. This article was initially published in the 2/3/23 edition of our Concussion Update newsletter; please consider subscribing.

In a study published in the Journal of Alzheimer's Disease Reports, researchers write that “this is the first report of a potential treatment modality to mitigate symptoms of Possible CTE.” The study is a case-series report of four former football players (3 professionals) who met the NIH criteria for Possible CTE and were treated with transcranial photobiomodulation (tPBM), a specific kind of light therapy. After treatment, all four demonstrated significant cognitive improvement in neuropsychological tests, including executive function, attention, verbal learning and memory, visuospatial memory, and verbal fluency. The participants’ scores on mood/behavior questionnaires significantly improved in domains of PTSD, depression, sleep, and pain. The researchers found that functional MRI imaging supported these clinical improvements and noted, “Instead of continuing to worsen over time, these cases improved with tPBM.”

For these case studies, the 18 in-office treatments involved either the MedX Health LED cluster heads that deliver red and near-infrared (the first player) or the Thor Photomedicine helmet that delivers near-infrared (three players). The in-office treatment lasted for six weeks, 3x a week, each lasting 22-40 minutes. All four players decided to do ongoing home treatments using the 40 Hz Vielight Neuro Gamma and the Vielight Red Intranasal. Our blog post, based on an earlier poster presentation, details the case studies of the first and third players in this study. Our page, Light Therapy/Photobiomodulation, provides background information on this therapy modality.

For two of the players, the improvements held after the cessation of in-office treatments–similar to findings in earlier open clinical trials with mTBI patients. Two players lost much of their gains after the cessation of the in-office treatments. However, they regained most or all their improvements with the implementation of at-home treatments. The researchers point out that the pattern with the latter two players “is similar to the pattern of response to tPBM in dementia, but not in chronic mTBI.” The need for long-term photobiomodulation “suggests presence of a neurodegenerative disease, e.g., possible CTE. Each case improved again, after tPBM home treatments.” The first player in this study made a video detailing his experience with tPBM.

The same group of researchers is recruiting study participants for an ongoing study, “Investigational Research Light Therapy to Improve Thinking and Memory for Traumatic Brain Injury.” People who have suffered at least one mild traumatic brain injury (a concussion) or moderate traumatic brain injury (TBI) at least six months ago are eligible for the study. The study is fully remote and open to U.S. citizens. See our blog post to learn more.

The researchers suggested several potential mechanisms for how tPBM might be having these positive effects:

Improved cellular oxygenation and respiration due to “increased production of ATP by mitochondria in cortical neurons.”
Increased vasodilation in brain blood and lymphatic vessels, plus “reduced inflammation and oxidative damage” due to “release of nitric oxide” from compromised brain cells.
Increased BDNF (brain-derived neurotrophic factor), a key molecule related to memory and learning.
Augmentation of brain glymphatic drainage. The glymphatic system is involved in waste clearance; improvements in this system may positively affect the clearance of p-tau, which is accumulated in the brain CTE patients.

The players were ages 55, 57, 65, and 74. Two study participants were former NFL players, one was a former Canadian Football league player, and one played through college; their years playing football ranged from 11 to 16, and their age of first exposure to football ranged from age 7 to 14. This study was not sham-controlled, meaning the players knew they were getting the tPBM treatments, and the researchers could not control for the placebo effect. They suggest future studies with sham and real tPBM devices used at home.

Lee Benson wrote an article for the Desert News in September 2022 about a related study of photobiomodulation by the University of Utah. (An abstract of the study’s findings, in the form of a poster, was published in the Archives of Clinical Neuropsychology.) “‘It’s not a miracle drug, I’m still not perfect,’ says the former boxer and football player [study participant Christian Smith] who spent years leading with his head. “But I’m in control again and I’m enjoying life. I feel positive that I can contribute, that I have value again, that I am worth something. To me it is a miracle. You don’t realize how bad you were until you get good again.” Lead researcher Dr. Elizabeth Wilde stated that “It wasn’t just an occasional here and there who indicated it worked for them. It was really consistent across the board. That’s exciting.” See our blog post to learn more.