Light Therapy (Photobiomodulation)
Photobiomodulation is a new potential treatment for concussions being developed by researchers and clinicians. The photobiomodulation devices use light-emitting diodes (LEDs) to deliver light in the visible red and near-infrared wavelengths.
LED light therapy devices - research & current use
Several clinical trials are investigating light therapy for persistent postconcussion symptoms. There is an ongoing remote study at the VA Boston Healthcare System for people who have persistent post-concussion symptoms; you don’t have to be a military veteran to apply for inclusion in the study. A study at the University of Utah for people with symptoms due to repetitive head impacts recently concluded; the results will be published in the fall of 2023. A case study at UCSF found light therapy had positive effects for a pro hockey player with persistent post-concussive symptoms. Several VA Boston case studies showed good outcomes of light therapy for former pro football players with symptoms due to repetitive head impacts.
The VA Boston Healthcare System has a clinical light therapy program for veterans with mTBI; the program has been so successful that the program was presented at the VA’s 2020 Veteran Patient Experience Symposium.
In addition, researchers are studying light therapy for PTSD, Parkinson’s Disease (see also Dr. John Mitrofanis’ book Running in the Light), Alzheimer's Disease, and dementia.
A few earlier studies used the MedX Health devices, which must be purchased through a clinician. A few studies have used expensive, clinic-grade light therapy helmets that the study participants use while at the research site, not at home. All of the studies mentioned in the first paragraph use the Vielight devices, which are available for individuals to purchase online.
How does light therapy work, and is it safe?
Research is showing that near-infrared (NIR) and red light applied through the skull to the brain has numerous positive effects. The effects include increased cerebral blood flow, increased (ATP) energy production, increased neuroprotection and brain repair, and reduced inflammation. A 2019 study found that using light therapy applied to the head has a positive effect on brain wave patterns in just one treatment; read more about the study here.
A series of case studies and small clinical trials have shown light therapy to be helpful for persistent post-concussion symptoms. See our section on the science behind LED light therapy for mild traumatic brain injury.
In terms of safety, the light therapy devices used in research emit non-ionizing forms of light. Non-ionizing light does not carry enough energy to break molecular bonds and ionize atoms. Researchers and clinicians advise against the home use of light devices that are not part of current research studies. There is no information about the effectiveness of light therapy devices that are not being used in research. Different light devices have different outputs, which will have unknown effects. There is potential for harm with the use of untested light therapy devices to treat something as vulnerable as the brain.
How to access Light Therapy devices
Light therapy treatment is still in the research stage. You can Vielight equipment researchers use in studies concerning traumatic brain injuries, including concussions and long-term repetitive head impacts from elite contact sports. The MedX devices may no longer be available; see below. We are unaware of any other photobiomodulation devices used in TBI-related research available for the general public to buy.
MedX
MedX home system - device no longer available.
Vielight
Vielight products are the more accessible of the two brands of devices being used in research and are available to the public. The Vielight devices fit within the FDA category of “Low-Risk Devices, General Wellness.” This FDA category means that no medical claims are made for these devices. The general consumer can purchase the devices directly from the Vielight website.
In earlier clinical trials on light therapy for TBI, two MedX “home system” units were used for the light therapy intervention, but the device has since been discontinued, and there does not appear to be an adequate replacement model.
If you wish to investigate further, the leading clinician and expert on the use of MedX devices for brain injury is Anita Saltmarche, BScN, MHSc, at Saltmarche Health & Associates.
Vielight Neuro Gamma 3
Vielight device types: Neuro Alpha 3, Neuro Gamma 3, and Neuro Duo 3
The redesigned Vielight devices are the Neuro 3 series; the redesign has not affected the light output. What has changed is that the controller, which used to be separate, is now attached to the headset. Some of the research studies began before the Vielight redesign, so we are not always aware if a given study used the Neuro 3 series or the older series.
Research studies have used the Neuro Alpha (10 Hz) or the Neuro Gamma (40 Hz). The Neuro Duo combines both 10 Hz and 40 Hz; a small switch on the controller allows the user to choose either the Alpha or Gamma setting.
Why do the devices shine light up the nose?
The nasal clips attached to the Alpha, Gamma, and Duo devices beam near-infrared light to the underside (ventral) regions of the brain. The ventral areas of the brain are the “deep structures within the brain’s core, which have functions such as long term memory and hormonal regulation.”
The 633 Red Intranasal
The 633 Red Intranasal device beams red wavelength light (continuous, not pulsed) into the blood through the capillaries in the nasal canal. The nasal canal has a particularly high density of blood vessels. It is hypothesized that the red light passes into the blood vessels and improves blood circulation, via its effect on the mitochondria in blood platelets. The theory is that red light has a whole body or systemic effect. Some of the research has included the use of the 633 Red intranasal in addition to the Vielight transcranial headsets, either the Neuro Alpha or the Neuro Gamma.
Vielight Neuro Duo 3: the Alpha and Gamma settings in one device
Vielight Neuro Duo 3
The Vielight Neuro Duo 3 is a relatively new option. It combines the Neuro Alpha 3 (10Hz) and the Neuro Gamma 3 (40Hz) in a combination device. The device has been redesigned; the controller is now attached to the headset, where there is a small switch that allows the user to choose the Alpha or Gamma setting.
You can purchase a separate nose applicator to connect to any of the Vielight headsets so that you can share the device with family or a friend. The Vielight website says that it is OK to share the headset devices with your spouse if “you clean the nasal applicator with a swab of alcohol between each consequent use.”
Clinical Trials
The Boston VA Research Institute, Inc. and the VA Boston Healthcare System have closed their recruiting for their study investigating if transcranial photobiomodulation can improve thinking and memory in people who have suffered one or more mild-to-moderate traumatic brain injuries (TBIs), including concussions and subconcussive impacts. The light therapy device used was transcranial, meaning that you wear it on your head for the 20-minute treatment; treatments are 3x a week.
The University of Utah TBI and Concussion Center and the Department of Neurology will, in the future, be recruiting for several clinical trials on photobiomodulation for concussions, TBI, and populations at risk for repetitive subconcussive impacts, such as athletes and veterans. For more information about their research, see our blog post with an interview of one of the study participants. “Photobiomodulation Therapy to Improve Brain Health and Resiliency, A Pilot Study.”
Subscribe to our Concussion Update Newsletter to be notified of calls for study participants.
The science behind LED light therapy for mild traumatic brain injury
Regulation of the Default Mode Network and other brain networks
Research is finding that concussions cause several networks of the brain to become dysregulated, meaning that regions of the brain are not in sync. Researchers use diffusion MRI to map structural damage to these intrinsic connectivity networks caused by concussions. Studies have found that concussions cause diffuse axonal injury which "produces neurological impairment by disconnecting brain networks."
A 2019 study found that one treatment using the Vielight Neuro Gamma headset positively modulated brain waves. Read about the Default Mode Network (DMN) and light therapy in the 2019 article in Vielight for more information.
A 2018 study found that light therapy improves brain connectivity and cognition; the study discusses the Default Mode Network.
For additional recent studies, see our blog posts A history of research into light therapy as a potential treatment and New research on light therapy shows promise for patients who have suffered repetitive head impacts.
A 2012 study looked at patients with a sports-related concussion. While the concussion patients were resting, they had normal function in the Default Mode Network. But when the concussion patients did light aerobic activity, their Default Mode Network became dysregulated.
Additional positive effects of light therapy on the injured brain
Laboratory studies have found that light therapy (with red and near-infrared light (810nm) light) increases the ATP (or energy production) in hypoxic cells. Hypoxic cells are cells that lack oxygen due to injury or disease.
Studies with humans (in 2009, 2012, 2019, and another in 2019) have found that light therapy widens blood vessels (vasodilation), thus increasing blood flow, in limited, specific areas in the brain. This increased blood flow is related to an enzyme in the mitochondria (the cells’ “powerhouse”) getting rid of toxic nitric oxide due to increased vasodilation.
We recommend the article What is Photobiomodulation for technical explanations of how this therapy works. We also suggest the 2017 article “Photobiomodulation for traumatic brain injury and stroke” and the 2016 article “Shining light on the head: Photobiomodulation for brain disorders,” both by Michael E. Hamblin.
Background on the use of light therapy
Photobiomodulation Therapy, using Low-Level Laser or LED Light Therapy devices, has been used for over 50 years. These medical light therapy devices have been successfully used to enhance wound healing and treat musculoskeletal conditions.
Although larger-scale research studies are needed, the past decade of clinical and research results on photobiomodulation for the brain show promise:
Photobiomodulation for the brain is safe, based on 15 years of clinical application and 10 years of research.
It is an excellent "adjunctive" therapy. Light appears to enhance other clinical therapies such as occupational therapy, physical therapy, and craniosacral therapy.
Researchers recommend it as a first-line treatment – there is some indication that the sooner the treatment is started, the better.
Related information on our blog
This article is for information purposes only. No medical claims are made. By providing the information contained herein, we are not diagnosing, treating, curing, mitigating, or preventing disease or medical condition. Before beginning any treatment regimen, it is advisable to seek the advice of a licensed healthcare professional.
In an interview, RJ discusses his potential CTE and his positive experience as a participant in a University of Utah photobiomodulation (light therapy) study. RJ played high school and college football, experiencing repetitive head impacts and multiple concussions.