Photobiomodulation Radiant Intervention for Stress in Epilepsy

WHO claims that epilepsy effects over 50 million people world-wide. First line treatment for seizures has been medication for well over 50 years with mixed results. There are many types of seizures, and the medications prescribed hope to target the type diagnosed, but while they may control the seizures to some effect, they also are riddled with side effects that create further duress. Other interventions may include surgery, vagal nerve stimulation (VNS) and other neurostimulation methodologies, diet and other lifestyle changes, and behavioral modification1. Comorbidities of epilepsy include anxiety, stroke, depression, ADHD, and possibly physical health compromises due to falling2. Stress often precipitates epileptic seizures, whether the syndrome is congenital, metabolic, electrophysiological, or environmental in nature3, 4.

Turner5 highlights a need for better interventions for this population, and the current proposal hopes to learn if photobiomodulation (PBM), a modern intervention which has shown promise in many syndromes, including anxiety, Parkinson's disease, pain and inflammation6 can reduce perceived stress, which in turns informs a healthier lifestyle for people with epilepsy (PWE) and reduce the effects of this disease. Since this intervention is quite new, few research projects have been published in this area.

Light is a fascinating phenomenon. Most people can identify color, and this is because of how it vibrates7. It's the vibration that causes us to feel warmed (yellows) or cooled (blues) since the speed of the vibration is stimulating neuronal communication. It's a brilliant innovation to use this property in photobiomodulation (PBM), which is the use of near-infra red light, as a clinical tool to enhance brain function on a cellular and chemical level. It is understood that what light therapy provides is a mitochondrial stimulatory mechanism that ultimately increases blood and cerebral spinal fluid (CSF) flow, cerebral oxygenation, and ATP production, as well as promote brain stabilization and self-regulation, and reduces inflammation8. It has been shown that the emitted light does, in fact, penetrate the skull and reach the desired cortical levels of the brain to facilitate the necessary mechanism to fulfill its goals9, 10.

The positive effects on mitochondrial health with PBM, and this interaction with epileptic brain behaviors11, as well as with neurodegenerative diseases12, 13, Parkinson's14, inflammation15, and TBI16 among others has been shown. In this study, we are primarily looking at if PBM can facilitate reduction of perceived stress in the PWE population. It is prudent to establish that we are not treating epilepsy because the device we're using is not FDA-cleared for brain-based procedures. However, current literature supports this, and present anecdotal evidence advises this intervention to be very successful and validates the proposed rigorous investigation.

The current study aims to use PBM to reduce stress in participants with epilepsy as a complementary therapeutic modality for improving quality of life and reducing suffering. PWE will be recruited to 4 clinical sites within the U.S. (Cincinnati, Houston, Miami, Warren, OH) and provided with PBM 3x/weekly for forty-five, 20-minute sessions, which may last between 15 and 20 weeks. They will have intake (T0), baseline (T1), mid (T2) post (T3) and 6-month follow-up (T4) assessment sessions in addition to the 45 PBM sessions.