Mechanisms and Pathways of Pain Photobiomodulation: A Narrative Review.
Mechanisms and Pathways of Pain Photobiomodulation: A Narrative Review.
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DOI：
10.1016/j.jpain.2021.02.005
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Ibrahim MM
中科院分区：
文献类型：
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作者：
Cheng K;Martin LF;Slepian MJ;Patwardhan AM;Ibrahim MM
越来越多的证据支持光照射可以调节疼痛。因此，光疗越来越多地用于各种疼痛状况的管理。光疗的传递方式和应用因波长、强度和照射途径而异。因此，根据这些参数存在不同的作用机制。皮肤应用红光（660nm）已被证明可以减轻神经病变和复杂的区域疼痛综合征- i的疼痛，然而，在动物模型中，同样波长的红光的视觉应用已被报道会加重患者的偏头痛并导致功能性疼痛的发展。有趣的是，在视觉上暴露在绿光下可以减轻偏头痛和纤维肌痛等各种疼痛症状。皮肤应用通常需要暴露在几分钟左右，而视觉应用则需要暴露在几小时左右。这两种暴露途径都会引起脑干和脊髓的中枢变化，以及背根神经节和伤害感受器的外围变化。本文综述了光生物调节疼痛的机制，为进一步探索光疗在疼痛治疗中的应用奠定了基础。
A growing body of evidence supports the modulation of pain by light exposure. As such, phototherapy is being increasingly utilized for the management of a variety of pain conditions. The modes of delivery, and hence applications of phototherapy, vary by wavelength, intensity, and route of exposure. As such, differing mechanisms of action exist depending upon those parameters. Cutaneous application of red light (660nm) has been shown to reduce pain in neuropathies and complex regional pain syndrome-I, whereas visual application of the same wavelength of red light has been reported to exacerbate migraine headache in patients and lead to the development of functional pain in animal models. Interestingly visual exposure to green light can result in reduction in pain in variety of pain conditions such as migraine and fibromyalgia. Cutaneous application typically requires exposure on the order of minutes, whereas visual application requires exposure on the order of hours. Both routes of exposure elicit changes centrally in the brainstem and spinal cord, and peripherally in the dorsal root ganglia and nociceptors. The mechanisms of photobiomodulation of pain presented in this review provide a foundation in furtherance of exploration of the utility of phototherapy as a tool in the management of pain.