利用光生物调节改善帕金森病的临床症状和体征:五年随访。

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY BMC Neurology Pub Date : 2024-10-09 DOI:10.1186/s12883-024-03857-z
Ann Liebert, Brian Bicknell, E-Liisa Laakso, Sharon Tilley, Gillian Heller, Hosen Kiat, Geoffrey Herkes
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引用次数: 0

摘要

背景:帕金森病是一种进行性神经退行性疾病,以临床运动症状和非运动症状为特征,严重影响生活质量。目前迫切需要能够减缓、阻止甚至逆转现有症状发展或延缓新症状出现的疗法。在动物实验和小型临床试验中,光生物调节疗法已显示出缓解帕金森病某些症状的潜力:评估光生物调制疗法在帕金森病患者群中持续治疗五年后的长期疗效:方法:在之前发表的一项研究中,最初的 12 名参与者中有 8 人同意在 5 年后接受重新评估。其中七名参与者在五年内坚持每周三次在家自行应用光生物调制疗法。一名参与者在一年后停止了治疗。对参与者进行了一系列临床运动体征评估,包括 MDS-UPDRS-III、活动能力和平衡能力测量。对认知能力进行了客观评估,对生活质量和睡眠质量则使用自我报告问卷进行了评估。采用 Wilcoxon Signed Ranks 检验来评估基线(治疗前)和五年后结果指标的变化,α值设为 0.05:在继续接受光生物调节治疗的七名参与者中,有一人被初步诊断为多系统萎缩,因此被排除在小组分析之外。与基线相比,其余六名参与者的步行速度、步幅长度、定时上下行走测试、动态平衡测试和认知能力均有显著改善,除MDS-UPDRS-III无变化和一项静态平衡测试(单腿站立,睁眼站立在未受影响的腿上)有所下降外,其他测试均无显著改善。六名参与者中有五人的 MDS-UPDRS-III 评分有所改善或没有下降,大多数参与者的所有其他结果指标均有所改善或没有下降。光生物调控疗法没有不良反应:这项研究提供了一个信号,即光生物调控疗法可以安全地减轻一些帕金森病患者的重要临床运动症状和非运动症状,而且这种改善可以维持数年。基于家庭的光生物调节疗法有可能辅助标准疗法来控制症状,并有可能延缓帕金森病症状的发展:澳大利亚-新西兰临床试验注册中心,注册号:ACRN12618000038291p,注册日期:2018年1月12日。
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Improvements in clinical signs and symptoms of Parkinson's disease using photobiomodulation: a five-year follow-up.

Background: Parkinson's disease is a progressive neurodegenerative disease characterized by clinical motor signs and non-motor symptoms that severely impact quality of life. There is an urgent need for therapies that might slow, halt or even reverse the progression of existing symptoms or delay the onset of new symptoms. Photobiomodulation is a therapy that has shown potential to alleviate some symptoms of Parkinson's disease in animal studies and in small clinical trials.

Objective: To assess long-term effectiveness of photobiomodulation therapy in a cohort of Parkinson's disease individuals after five years of continuing therapy.

Methods: Eight participants of the initial 12 in a previously published study agreed to be reassessed after five years. Seven of these participants had continued home-based, self-applied photobiomodulation therapy three times per week for five years. One participant had discontinued treatment after one year. Participants were assessed for a range of clinical motor signs, including MDS-UPDRS-III, measures of mobility and balance. Cognition was assessed objectively, and quality of life and sleep quality were assessed using self-reported questionnaires. A Wilcoxon Signed Ranks test was used to evaluate change in outcome measures between baseline (before treatment) and after five years, with the alpha value set to 0.05.

Results: Of the seven participants who had continued photobiomodulation therapy, one had a preliminary diagnosis of multisystem atrophy and was excluded from the group analysis. For the remaining six participants, there was a significant improvement in walk speed, stride length, timed up-and-go tests, tests of dynamic balance, and cognition compared to baseline and nonsignificant improvements in all other measures, apart from MDS-UPDRS-III, which was unchanged and one measure of static balance (single leg stance, standing on the unaffected leg with eyes open) which declined. Five of six participants either improved or showed no decline in MDS-UPDRS-III score and most participants showed improvement or no decline in all other outcome measures. No adverse effects of the photobiomodulation therapy were reported.

Conclusions: This study provides a signal that photobiomodulation therapy might safely reduce important clinical motor signs and non-motor symptoms in some Parkinson's disease patients, with improvements maintained over several years. Home-based photobiomodulation therapy has the potential to complement standard therapies to manage symptoms and potentially delay Parkinson's symptom progression.

Trial registration: Australian New Zealand Clinical Trials Registry, registration number ACTRN12618000038291p, registered on 12/01/2018.

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来源期刊
BMC Neurology
BMC Neurology 医学-临床神经学
CiteScore
4.20
自引率
0.00%
发文量
428
审稿时长
3-8 weeks
期刊介绍: BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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