Parkinson’s disease is a movement disorder with cardinal signs of resting tremor, akinesia, and rigidity. These manifest after a progressive death of many dopaminergic neurons of the midbrain. Unfortunately, the progression of this neuronal death has proved difficult to slow and impossible to reverse despite an intense search for the specific causes and for treatments that address the causes. There is a corresponding need to develop approaches that regulate the self-repair mechanisms of neurons, independent of the specific causes of the damage that leads to their death. Red to infrared light therapy (λ=600–1,070 nm) is emerging as an effective, repair-oriented therapy that is capable of stabilising dying neurons. Initially, a space-age anecdote, light therapy has become a treatment for tissue stressed by the known causes of age-related diseases: hypoxia, toxic environments, and mitochondrial dysfunction. Here we focus on several issues relating to the use of light therapy for Parkinson’s disease: 1) What is the evidence that it is neuroprotective? We consider the basic science and clinical evidence; 2) What are the mechanisms of neuroprotection? We suggest a primary mechanism acting directly on the neuron’s mitochondria (direct effect) as well as a secondary, supportive mechanism acting indirectly through systemic systems (indirect effect); 3) Could this be effective in humans? We discuss the pros and cons of this treatment in humans, including the development of a new surgical method of delivery; and 4) What are the advantages of using light therapy? We explore the features that make this therapy a promising potential treatment. In summary, early evidence indicates that light regulates specific neuronal functions and is neuroprotective in animal models of Parkinson’s disease. The stage is set for detailed and rigorous explorations into its use on Parkinson’s disease patients, in particular, whether light slows the disease progression rather than simply mitigating signs.

Introduction

The current “gold standard” treatments for Parkinson’s disease are very effective at attenuating the motor signs, at least initially. However, they do not reliably slow the progression of the disease; neurons continue to die during the course of treatment. The discovery of new therapeutic approaches that offer neuroprotection against parkinsonian insult is therefore paramount. In this context, several recent studies in animal models of Parkinson’s disease, as well as other models of disease (eg, retinal degeneration, stroke, multiple sclerosis, Alzheimer’s disease), have reported that red to infrared light therapy (λ=600–1,070 nm; referred to forthwith as light therapy) can be neuroprotective. There is real potential for the development of light therapy as a treatment option for Parkinson’s disease patients – one that slows the ongoing neuronal death and progression of the disease.

Daniel M Johnstone, Kristina Coleman, Cécile Moro, Napoleon Torres, Janis T Eells, Gar y e Baker, Keyoumars Ashkan, Jonathan Stone, Alim-Louis Benabid, John Mitrofanis.

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