光通过多种机制改善认知损伤

Light Treatment for Cognitive Improvement Through Multiple Mechanisms

认知功能是大脑的重要能力,但在神经病理状况或疾病中受损时易出现认知损伤。目前,针对认知损伤患者的有效治疗和康复措施尚不明确。光疗作为一种无创物理疗法,受到越来越多的关注。本文旨在介绍光疗在与神经精神疾病相关认知损伤中的临床应用现状,特别是在阿尔茨海默病(Alzheimer’s disease,AD)、轻度认知功能损害(mild cognitive impairment,MCI)、脑损伤后认知障碍(post-traumatic cognitive impairment,PTCI)以及精神分裂症相关的认知损伤(cognition impairments associated with schizophrenia,CIAS)方面。光疗影响认知的机制是多方面的,包括调节昼夜节律、神经保护和修复、改善血液循环、调节神经递质、抗炎作用、神经可塑性、减少氧化应激等。此外,光疗还被认为与脑电活动、神经环路、神经营养因子以及神经递质有关。这些机制对于理解光疗如何改善认知损伤具有重要意义。最后,文章将讨论光疗在临床应用中的局限性原因,包括光照参数的标准化和个体差异的影响等。光疗在临床应用中的局限性包括光照参数标准化、个体差异、缺乏长期随访数据、研究设计差异以及缺乏标准化的治疗方案等。克服这些局限性需要进一步研究和标准化的努力,以确保光疗在认知损伤治疗中的可靠性和有效性。

Cognitive function is a crucial aspect of brain functioning,but it can be compromised in various neurological pathologies and diseases,resulting in cognitive deficits.Currently,effective treatments and rehabilitation measures for cognitive impairment patients remain limited.Light treatment,as a non-invasive physical therapy,has emerged as a promising approach and has garnered increasing attention.This article provides an overview of the clinical application status of light treatment in cognitive impairment associated with neurological and psychiatric disorders,with a specific focus on Alzheimer’s Disease(AD),mild cognitive impairment(MCI),post-traumatic cognitive impairment(PTCI),and cognitive impairments linked to schizophrenia(CIAS).The mechanisms of improving effects of light treatment on cognition are multifaceted,including the regulation of circadian rhythms,neuroprotection and repair,enhancement of blood circulation,modulation of neurotransmitters,anti-inflammatory effects,promotion of neuroplasticity,and reduction of oxidative stress.Light treatment is believed to influence brain electrical activity.The inconsistent finding on the effects of 40 Hz light stimulation on cognitive impairment associated with neurodegenerative diseases may be related to the inconsistency between the light treatment paradigm and the animal model.The organic or structural damage of neurons during the middle or late stages of the disease limits the preventive and ameliorative effects of light treatment.Additionally,light treatment can improve cognitive function by affecting the activity of neural circuits.ipRGC-SCN-CA1 and ipRGC-vLGN/IGL-Re-CA1 neural circuits were reported to involved in the cognition-improving effects of light treatment.Several neurotransmitters(acetylcholine,dopamine,norepinephrine,serotonin,gamma-aminobutyric acid),neurotrophic factors(brain-derived neurotrophic factor,nerve growth factor,and vascular endothelial growth factor)and hormones(corticotropin releasing hormone(CRH)and cortisol)also participated in the mechanisms of light treatment.Understanding these underlying mechanisms is crucial for comprehending the beneficial effects of light treatment on cognitive impairment.The article also discusses the limitations of light treatment in clinical applications,including standardizing light parameters and the impact of individual differences.The limitations of light treatment in clinical applications encompass standardized light parameters,individual differences,lack of long-term follow-up data,differences in research designs,and the absence of standardized treatment protocols.Overcoming these limitations requires further research and standardization efforts to ensure the reliability and effectiveness of light treatment in the management of cognitive impairment.This review aims to enhance our understanding of the advancements in light treatment for improving cognitive impairment and elucidate the underlying mechanisms involved.It also provides theoretical support for optimizing parameters and techniques in light treatment for cognitive impairment,thereby promoting its clinical application.Ultimately,this will contribute to further exploration of the potential of light treatment in the management of cognitive impairment associated with neurological and psychiatric disorders and advance related research endeavors.