光疗与自闭症儿童

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红外线
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自闭症谱系障碍(ASD)

自闭症谱系障碍(ASD)是一种复杂的神经系统发育综合征,临床上以语言障碍、社会参与功能障碍、语言、刻板动作和行为以及各种认知障碍为特征。

光线对人的影响很深。不同颜色的灯光会影响我们的情绪,缺乏自然光会导致抑郁症。这一点尤其适用于自闭症患者。

患有自闭症的孩子特别容易因为灯光而产生情绪变化。颜色圆润的灯光,如蓝色,可以帮助孩子放松和发挥创造力。而闪烁、嗡嗡作响或颜色刺眼的灯光,则会使他们感到困惑,甚至受到伤害。因此,在孩子的房间里,灯光的可控性和监控性非常重要。

除了人造照明,自然照明也有其效果。事实证明,自然照明对自闭症儿童有好处。季节性情感障碍,或称SAD,是由冬季缺乏自然光引起的,会滋生行为问题和抑郁症。自然光已被证明可以缓解这些症状。

光疗的作用不仅仅是缓解这些症状。自然光可以帮助调节孩子的昼夜节律。这些节奏支配着我们身体的"内部主时钟"。例如,它们告诉我们什么时候该睡觉了。缺乏自然光会导致我们的节律失调。因此,治疗可以使失眠的孩子在没有辅助工具的情况下入睡,并在白天变得更加警觉,还有其他好处。

治疗的最佳时间是在早晨,孩子起床后不久。即使只在光照下呆30分钟,也能改善他们的情绪和睡眠习惯。一开始可能无法达到30分钟,所以在积累的同时,下午再进行一次治疗也会有帮助。但晚上的治疗可能会产生负面影响,使孩子的生活习惯恶化,更难入睡。

临床研究

A study examined the efficacy of low-level laser therapy, a form of photobiomodulation, to treat irritability associated with an autistic spectrum disorder in children and adolescents aged 5–17 years. Twenty-one of the 40 participants received eight 5-min procedures administered to the base of the skull and temporal areas across a 4-week period (test, i.e., active treatment participants). All the participants were evaluated with the Aberrant Behavior Checklist (ABC), with the global scale and five subscales (irritability/agitation, lethargy/social withdrawal, stereotypic behavior, hyperactivity/noncompliance, and inappropriate speech), and the Clinical Global Impressions (CGI) Scale including a severity-of-illness scale (CGI-S) and a global improvement/change scale (CGI-C). The evaluation took place at baseline, week 2 (interim), week 4 (endpoint), and week 8 (post-procedure) of the study. The adjusted mean difference in the baseline to study endpoint change in the ABC irritability subscale score between test and placebo participants was -15.17 in favor of the test procedure group. ANCOVA analysis found this difference statistically significant (F = 99.34, p < 0.0001) compared to the baseline ABC irritability subscale score. The study found that low-level laser therapy could be an effective tool for reducing irritability and other symptoms and behaviors associated with the autistic spectrum disorder in children and adolescents, with positive changes maintained and augmented over time.

在诊断和治疗应用中,存在着大量关于低能激光治疗(LLLT)能力的文献,这是一种光生物调控的形式,可以穿透颅骨。低能激光通过颅骨,很可能存在治疗效果。低能激光系统采用所谓的量子光学诱导透明(QIT)效应。这种效应,电磁诱导透明(EIT),控制着致密介质的光学特性,可以将透明度对比度提高5倍。因此,即使是中等强度的光,也可以穿透颅骨、脊柱或关节。由于QIT效应,放射线应能到达肌肉、结缔组织甚至骨骼等深层组织层,实现无创经颅治疗。

结论

该研究结果有力地说明了光疗的应用不仅影响了儿童和青少年自闭症障碍特征的所有关键可评价行为的可观、统计学意义和临床意义的改善,而且在完成程序管理协议后的6个月内继续影响症状的渐进和有意义的改善。

LLLT可以通过采用非电离光,包括激光、发光二极管或可见光红色(600-700nm)和近红外(780-1100nm)光谱的宽带光来达到治疗效果。LLLT是一个非热过程,当色团分子暴露在一个合适的光波长下时,就开始了。色团负责与生物化合物(如血红蛋白、肌红蛋白和细胞色素)相关的颜色。当色团吸收光子时,一个电子就会转变成激发态。当光子使细胞色素-C-氧化酶的抑制性信号分子一氧化氮(NO)解离时,LLLT的生理效应就发生了,增加了:电子运输、线粒体膜电位生产线粒体产物如ATP、NADH、RNA和细胞呼吸。主导假说是光子使抑制性一氧化氮从酶中解离出来,导致电子传输、线粒体膜电位和ATP的产生增加。

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