I've made the point in numerous places that the photobiomodulation dose response curve is not like American capitalism, more is not always better. Here is a very good basic science example that helps support this view. Researchers used different amount of light energy on human skin cells to see how they'd respond. The key result was that the lower power settings produce the most positive change in cell proliferation activity. 

Majority people who are now using the Neuradiant 1070+, as well as the Vielight Neuro devices, report benefit from shorter periods of stimulation and do not experience any of the typical overdose responses including headaches, increased sense of congestion and pressure, agitation, irritability, dizziness, and fatigue. This has informed the Neuradiant's titration protocol to start with 3 minutes, then wait 5-10 minutes before continuing for another 3 minutes. The stimulation location, pulse frequency, and intensity are each both programmed based on clinical history, telehealth consultation and quantitative EEG analysis.  The dosing schedule often increases over time and can even exceed 20 minutes in some cases to as much as 30 minutes twice daily but always with an eye to recognizing signs of overdose and then adjusting accordingly. 

PBM dosing is an evolving process and will become more specific as we evolve our real time neurometric acquisition and anlalytic capability. 

What my colleagues and I have been saying for quite some time is now being supported by independent research findings about the value of brainwave biofeedback training as a way to reduce neuroinflammation resulting from chemotherapy. Women being treated for breast cancer engaged in neurofeedback training 3 times a week for up to 9 weeks for a total of 18, 30-minute training sessions. Quantitative EEG and neuropsychological testing was done before and after the training sessions were completed and indicated significant improvement in a range of cognitive and executive function measures. The sample size is too small to draw conclusions but is compelling enough to warrant larger studies.  Quietmind Fdn. IRB reviewed a study conducted in 2013 by Jean Alvarez and her colleagues using neurofeedback for breast cancer patients using a different method of neurofeedback and similar results were obtained. We're encouraged to see these findings now coming out of a major academic research university and hope that it will lead to larger trials and hopefully FDA approval and insurance reimbursement. 

https://neurosciencenews.com/neurofeedback-chemo-brain-21313/

There is always been a strong debate around the appropriate dosing scheme for achieving the best clinical results with PBM. The paper attached here is showing that lower doses of red light stimulation were more effective in producing positive biological responses including cell proliferation and healthy growth and viability. This lends itself to the idea that the body can use small amounts of stimulation to then self regulate and organize its own healing responses. This aligns with many holistic and integrative health traditions as well as the behavioral medicine models that underpin therapeutic approaches like neurofeedback, acupuncture and homeopathy. 

Our experience has long supported these findings as more and more people begin to use the Neuradiant PBM technology. We see a growing percentage of people needing only very brief exposures to the stimulation in order the see significant improvements in cognitive, motor and mood stability. Treatment times can be as brief as 30 seconds to 1 minute a day for people with Parkinson's disease and traumatic brain injury. I find myself repeatedly directing people to cut the dose time in half and reduce the duty cycle to 25-50% instead of the 75% maximum for pulsed stimulation. 

I think this allows for a more nuanced model of stimulation delivery that supports the already more targeted method of dosing that incorporates the use of Quantitative EEG assessment. 

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A recent paper published in Frontiers of Neuroimaging titled 'Synergistic photobiomodulation with 808-nm and 1064-nm lasers to reduce the b-amyloid neurotoxicity in the in vitro Alzheimer’s disease models' (see below) helps to facilitate the application of photobiomodulation with greater specificity and thereby improving clinical efficacy. The paper is a good piece of in vitro (outside the body) evidence for how these two critically important wavelengths influence neuronal cellular metabolic functioning. The findings suggest "...A synergistic PBM effect (with the 808- and 1,064-nm lasers) effectively inhibited the fAb-induced neurotoxicity of neuroblastoma by promoting the viability of neuroblastoma and regulating the intracellular Ca2+ levels of microglia. Moreover, the downregulation of Ca2+ led to microglial polarization with an M2 phenotype, which promotes the fAb phagocytosis, and resulted in the upregulated expression of anti-inflammatory factors and downregulated expression of inflammatory factors.

This underscores the validity of previous studies and approaches that are using transcranial photobiomodulation (tPBM) to mitigate both hypoperfusion and inflammation of people struggling with neurodegeneartive conditions, e.g. Alzheimer's, Parkinson's and ALS.

These bench science insights create important opportunities to further enhance tPBM's clinical efficacy by using these two wavelengths to their greatest therapeutic advantage. Neuronic Devices Ltd. and Quietmind Foundation are now working with our academic research partners in the USA and UK on the next generation tPBM applications that will reflect the results of our applied clinical research in this area. 

The Lancet has published on the persistent neurodegenerative and neuropsychiatric disorders of those with 'long COVID'. Brain fog is the most prevalent symptoms which we know is amenable to treatment with photobiomodulation and neurofeedback. 
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00260-7/fulltext#seccestitle150 

The effect of photobiomodulation on the brain during wakefulness and sleep
Frontiers in Neuroscience (2022) DOI: 10.3389/fnins.2022.942536​
Cecile Moro1, Audrey Valverde1, Marjorie Dole1,Jaimie Hoh Kam1, Catherine Hamilton2, Ann Liebert3,
Brian Bicknell4, Alim-Louis Benabid1, Pierre Magistretti1,5 and John Mitrofanis1,6*

I'm very glad to see this paper detailing the differences in response to PBM during sleep and wakefulness as it directs our attention to new and creatively therapeutic applications of this remarkable tool. The model of combined PBM and Neurofeedback (NFB) treatment used in our lab and clinical practice is initially centered on renormalization of circadian rhythm. The paper recognizes the default mode network's impaired functionality in dementia which supports our advocating the integration of neurofeedback training with photobiomodulation to resolve both tissue-level and neural connectivity aspects of neurodegenerative disorders.

PBM has been shown to increase cortical perfusion thereby reversing the decline in glymphatic functioning that's associated with neurodegeneration. The authors speculate that biophotonic emissions are a part of the neural communication network and increase in influence during sleep. Traditional Chinese medicine (TCM) described how our organs and comprehensive functional systems as having activity and repair cycles and that some critical repair activity initiates when we are asleep, e.g. the liver repairs itself between 1-3am but only if we are asleep during that period. (www.nirvananaturopathics.com/blog/).  The glymphatic system only recently identified in western medical literature, is now describing how the body organizes both repair and detoxification functions that are in line with the TCM's temporal rhythm model. 

Unfortunately, there was no mention in this paper concerning the use of 1070nm as an effective wavelength for photobiomodulation by noting the effective range was from 600-1000nm. There is now rather compelling evidence for 1070nm being more effective at increasing CCO and oxygenated hemoglobin as was shown in work from Hanli Liu's lab at UT-Arlington (Pruitt, 2021) and from Baylor Research Institute and Quietmind Foundation in modifying both cognitive and behavioral symptoms of early to mid-stage Alzheimer's disease. (Nizamutdinov, 2021)  Quietmind Fdn. will be initiating case studies using the Neuradiant 1070 4Q PBM system being promoted by Neuronic Devices Ltd. to evaluate the use of PBM during wakefulness and sleep and collect EEG, HRV, and other relevant biometric data.  

References: 
Pruitt, T.; Carter, C.; Wang, X.;Wu, A.; Liu, H. Photobiomodulation at Different Wavelengths Boosts Mitochondrial Redox Metabolism and Hemoglobin Oxygenation: Lasers vs. Light-Emitting Diodes In Vivo. Metabolites 2022, 12, 103. https://
doi.org/10.3390/metabo12020103

Nizamutdinov, D, etal., Transcranial Near Infrared Light Stimulations Improve Cognition in Patients with Dementia Aging and Disease • Volume 12, Number 4, July 2021 960.

We must become aware and begin to address the need for longer term neurological damage having been caused by COVID19. This video outlines the basis for serious concern for the future of many millions of people who are struggling with these conditions. Luckily Quietmind Foundation and our colelagues at Durham University and Neuronic Devices Ltd.  are working to foster recognition for the use of intranasal and transcranial infrared photobiomodulation as a simple, low-cost, safe and reliable way for people to help themselves protect against infection, decrease the intensity of the disease and to help mitigate the longer-term neurological damage. We're seeing that about 25% of people worldwide who have been infected with COVID 19 are at risk of developing these longer-term neurological symptoms. Research on the use of 1070nm light stimulation has shown to be effective in helping reduce the effects on brain cells and blood vessels that are the places where the virus is causing damage. 

Please listen to Michelle Monje, MD, PhD
Stanford Univ. Neuro-oncologist and Neuroscientist
https://youtu.be/szyHCvtsJ_c

Then please read the paper below to see how photobiomodulation can be a significant step we all can take to help prevent COVID 19 related injury to ourselves and our family members.

For more information on using infrared light to help protect yourself against long COVID 19 click here https://www.quietmindfdn.org/equipment or neuronic.online

This recent paper from researchers at Cambridge U showed that amyloid buildup in cells increases intracellular temperature that damages cell viability. The idea that a buildup of any kind around something increasing ambient temperature is very reasonable and points to cortical perfusion as a therapeutic target,i.e., increase the system's temperature regulatory capacity. 

Spilt, (2008) showed In patients with dementia, cerebral blood flow was 108 mL/min lower than that in subjects of the same age with optimal cognitive function (551 vs 443 mL/min, P < .001). Moore and others at showed the changes in cortical functioning in relation to changes in blood flow. It was also made clear that the function of increased perfusion during neuronal firing was to support temperature regulation, i.e., drawing heat aware to prevent damage.(www.scientificamerican.com/article/blood-flow-may-be-key-player/)

Our efforts at QMF with photobiomodulation (PBM) show that increasing cortical perfusion and vascular flexibility using LED-based transcranial 1070nm photobiomodulation can signiticantly improve motor, cognition and behavioral symptoms of people diagnosed with probable Alzheimer's, FTD, Parkinson's disease and Lewy Body Dementia. I see this as good reason to question the amyloid hypothesis' centrality, i.e., suggesting it is the cause of Alzheimer's and other dementias, given that, 1) the percentage of amyloid plaques within the brains of non-demented age-adjusted individuals had the same percentage of amyloid plaques found within the brains of AD patients [1], and 2) no relationship was found between the number of amyloid plaques located in the brains of AD patients and their degree of dementia severity [2 (J Alzheimers Dis. 2022; 85(4): 1419–1422. 

Clearly amyloid aggregation will increase temperature like a blanket keeps the body warm, however, our primary therapeutic task is to both flush amyloid out of the system by improving glymphatic drainage and improving cortical perfusion thereby reducing overall inflammation and better oxygenate damaged tissue.

Photobiomodulation Therapy and the Glymphatic System: Promising Applications for Augmenting the Brain Lymphatic Drainage System
Article in International Journal of Molecular Sciences · March 2022 DOI: 10.3390/ijms23062975

This is an important resource for those who are working with people diagnosed with neurodegenerative, neuropsychiatric or neurodevelopmental challenges. The key points are that there is a drainage system for the central nervous system that can become blocked and this leads to development of cognitive and behavioral symptoms associated with neurodegenerative disorders, including Alzheimer's and Parkinson's disease. The glial cells that support and protect the neurons are supported by this system to provide a way to discharge waste products from the brain. Sleep has now been shown to be the key driver in supporting the efficient operation of the glymphatic system. 

Photobiomodulation is now been shown to positively influence the glymphatic processes by improving cortical perfusion and oxygenation as well as improving vascular flexibility of the brain's microcapillary system and acts to maintain, protect and optimize the clearance of neural waste products. Previous research has demonstrated that 1064nm stimulation is significantly more effective than 810nm wavelength at producing specific biological activity that is associated with both perfusion and tissue level oxygenation as well as improving cellular energy metabolism by increasing production of adenosine triphosphate (ATP) through accelerating neural and glial cell mitochondrial activation. 

The Neuradiant 1070 PBM helmet selectively delivers cortical 1070nm LED light stimulation to specific brain regions and can thereby provide effective penetration and cellular activation thus supporting the glymphatic drainage process. For more information on the Neuradiant 1070 see neuronic.online

We've sold about 170 units over the last 16 months and I'm impressed by the number of people who are reporting rather quick positive response to using the new model Neuradiant 1070 4Q transcranial photobiomodulation system. The most common response has been improved sleep and decreased brain fog which has been among the top 5 most often reported areas of change from previous users of the 1070nm stimulation. We've had 3 returns of the total number sold which is a testament to the value folks are seeing in using this technology. 

Clinicians like Rick Abbey, Ph.D a neuropsychologist in Palo Alto have noted on social media and in personal discussions that his clients are regularly reporting positive responses to using the Neuradiant units in their efforts to overcome a wide range of cognitive, behavioral and learning-based challenges. The team at Neuronic are noting testimonials appearing on on Trust Pilot acknowledging the ease of use and rapid changes in functioning among users of the new 1070 4Q system. I've even been called by family members who used the unit on their loved ones to report remarkable almost immediate changes in focus and attention and verbal behavior who were in very advanced stages of dementia. This is not all that unusual if you think about neurodegeneration as a failing battery's ability to hold a charge. So, if you infuse the battery with a strong charge using high levels of concentrated sunlight, you reinvigorate it's ability to drive activities that required more 'juice' than it could previously deliver. The more often you boost the battery (brain tissue) with this type of charge, the more flexible and capable it becomes at holding the charge for longer periods of time.

If you then add neurofeedback training to the protocol you are then upgrading the wiring system that supports the transmission of the power to all the other systems in the body with a corresponding overall functional improvement in cognition,, movement, and self expression. Our work now is on integrating these functions more efficiently wherein we'll drive the stimulation based on changes in the overall central nervous system's functional efficiency.

​We're getting there.