Let There Be Light

Light Therapy for Parkinson’s Disease Gives New Hope

On a crisp and clear Tasmanian autumn day two years ago, when the sun was high in the sky but the air was cold on the ground, retired federal politician Max Burr was sitting in front of his computer at his house in Launceston, Australia, desperately seeking some help.
Burr, a Federal Liberal MP from 1975 to 1993, had been diagnosed with Parkinson’s disease in 2012 and required a steady increase in medication. By this stage the disease had affected many aspects of his life: his balance was uncertain, he could no longer write or play the piano, and he’d lost his sense of smell. “And my voice was very timid – imagine that for a politician,” Burr says to me when we speak over the phone.
Much to his dismay, he had recently been told by his geriatrician, Hobart-based Dr Frank Nicklason, that his condition was deteriorating and he needed to increase the dosage of his medication. Concerned about potential side effects Burr refused. “I said to Frank, ‘No, I’ll find other methods’,” Burr tells me.
With the tenacity of a seasoned politician, Burr, 78, opened his laptop and began to Google. Before long he found a research paper on the use of photobiomodulation – the term used for light’s ability to modulate key biological processes at a cellular or even genetic level – in animal testing for Parkinson’s disease, published by Sydney University’s Professor John Mitrofanis.
“The paper showed that the use of 670 nm infrared light was protective of neurons in Parkinson’s,” Burr said. “So I sent John an email and said, ‘Look, this is all very interesting, I wouldn’t mind having a crack at it’.”
Parkinson’s disease – first described by English surgeon James Parkinson in his 1817 work “An Essay on the Shaking Palsy ” – is a combination of movement disorders including tremor, muscle rigidity, impaired balance and slowness of movement. It can also cause neurological problems such as depression, poor sleep, memory loss and confusion. It is a condition that is estimated to affect approximately 10 million people around the world and cause over 100 000 deaths annually . Its cause remains a mystery but it is known to be associated with dopamine depletion and loss of neurons in the basal ganglia region of the brain.
The current mainstay of treatment involves physical therapy as well as medications which act to increase dopamine levels in the brain. These medications can provide significant improvements but their effectiveness tends to wear off with time, and they can cause a number of side effects. In addition, they treat the symptoms only, without actually slowing, or reversing, the natural course of the disease. Deep brain stimulation neurosurgery is also sometimes used in refractory cases, but it too treats the symptoms only and carries the additional risk of surgery.
One avenue of research that has shown unexpected promise in the quest for more effective treatment is infrared light therapy. Controlled exposure to this light appears to improve wound healing and reduce inflammation and pain . Over the past decade a number of studies have been published showing that it may also decrease the level of damage and improve motor function in animal testing for Parkinson’s disease .
John Mitrofanis, Professor of Anatomy at the University of Sydney’s Medical School, has spent more than two decades trying to find effective methods to protect the brain against degeneration and is considered an international luminary in Parkinson’s disease research. Despite being excited by the laboratory results on infrared light therapy he had no choice but to tell Burr that all the work was pre-clinical, and he couldn’t recommend light therapy to humans just yet.
Aware that his condition would not wait while scientists went through the long process of obtaining approval for human trials, Burr told Mitrofanis that he was going to try the light therapy anyway. “John replied by email and said, ‘Well, good luck, I’ll keep my fingers crossed, but I hope you don’t fry your brain’,” Burr tells me, laughing.
With the help of two friends, medical practitioner Dr Catherine Hamilton and her physicist husband David Hamilton, Burr went ahead and constructed a homemade device comprised of an aluminium foil-covered lampshade lined with strips of 670 nm LED lights.
Before he began to use his make-shift contraption he completed a baseline report for Nicklason and Mitrofanis, outlining the severity of his symptoms. Once he started using the infrared device – resting on his head, with the lights switched on, for twenty minutes twice a day – he continued doing a fortnightly report detailing the changes he was experiencing. “It was quite incredible,” Mitrofanis says. “Much to my surprise, Max started getting some positive results.”
Burr’s description is even more remarkable. “I recovered my sense of smell, my writing is now firm and concise, my gait has improved and I can climb stairs,” he says. “From week to week, it might have only been a subtle change, but the cumulative effect over the months has been quite significant. Now I regularly give public addresses, I play bowls, I do Tai Chi twice weekly.” Even though Burr remains on medications he now views his Parkinson’s disease as little more than an inconvenience.
For sceptics, it is certainly possible that Burr’s improvement was at least partially due to the placebo effect, the well-known phenomenon whereby patients experience an improvement in symptoms that cannot be attributed to the physical or biochemical properties of the placebo treatment itself. This is especially the case in Parkinson’s, where some placebo treatments have been shown to actually increase the release of dopamine in the brain .
Burr, however, believes there are physiological reasons behind his improvement. “The benefits of the infrared light must be being transferred by a mechanism in the body – either by the vascular system or by the immune system,” he says.
Dr Daniel Johnstone, a medical scientist and lecturer at the University of Sydney’s medical research centre the Bosch Institute, agrees with Burr’s reasoning. Johnstone has been involved in a number of experiments on the use of photobiomodulation in animal testing for Parkinson’s disease and believes that infrared light therapy can definitely provide benefit.
“The exact mechanisms are still not totally known, but we do know that there’s a key enzyme in the cells that absorbs light at certain wavelengths and triggers this intracellular cascade signalling that seems to collectively lead to a protective effect,” he explains. “Light is actually a low-level stress to the cells, and when you deliver this stress, it either stimulates repair processes or it conditions the cells to upregulate a whole lot of stress-response systems that conditions that tissue against a more severe insult down the line. Almost like a vaccination where you’re giving a low-level pathogen as a way to stimulate your body’s own defences against a more severe exposure.”
From an early age Johnstone, 35, was drawn to science and felt an urge to understand how things worked. As he grew older, the machine that captivated him the most was the human body, in particular the brain. “I was fascinated by the connection and interaction of the mind and the brain,” he says. “I decided to focus specifically on the brain as a physical entity and how we can protect this against damage.”
A vital component in Parkinson’s research is the chemical 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). This potent neurotoxin was accidently discovered in the early 1980s when a number of intravenous drug users developed severe Parkinsonism at a very young age. Further investigation revealed that MPTP – a by-product of synthetic opioid production – crosses the blood brain barrier and is metabolised into a compound that destroys dopamine producing neurons in the substantia nigra, which is part of the basal ganglia.
Johnstone has utilised this unfortunate side effect of MPTP in several experiments. In one, 40 mice were divided into groups. Half were injected with MPTP and were given either no infrared light, bursts of infrared light to their head and body, or to their body alone. Six days later, all the mice were euthanised and their brains were examined.
As expected, the researchers found that mice injected with MPTP had increased neural cell loss in the substantia nigra, compared to mice that had not been injected. But this loss was significantly reduced in mice exposed to infrared light. Interestingly this benefit was also seen in the mice who had exposure to their body only, although to a lesser extent than the mice who had exposure to both the head and body.
This lent support to the theory that infrared light therapy can work via direct stimulation as well as through the release of as yet unknown circulating protective factors. “Similar findings are coming out from researchers all over the world,” Johnstone says.
His supervisor at The Bosch Institute is executive director Professor Jonathan Stone. Stone, whose research specialties include retinal and cerebral neurobiology, first heard about infrared light therapy 13 years ago when he was presented with data from work that NASA had done in the 1990s showing that infrared light could not only be used to help grow plants in space but could also speed the healing of wounds. Since then, Stone has been researching light therapy in his own laboratory and has observed similar interest in other research centres across the globe.
“It is clear to me that the pace of studies on photobiomodulation is increasing exponentially,” Stone, 74, says. “Despite a lot of scepticism, people are being drawn into it by the fact that it works. There’s growing evidence that it works against depression and stroke and in the cognitive aspects of Alzheimer’s disease. And it’s so blessedly free of side effects that you can use it without having to know down to the last molecular detail how it works.”
Although most studies on photobiomodulation have been performed on animals, to date there have been a total of 9 human studies, as well as numerous case reports, published in peer reviewed journals on the use of infrared light therapy for various neurological conditions including stroke, traumatic brain injury, Alzheimer’s disease and depression . The only human trial on photobiomodulation for Parkinson’s disease that has been reported so far has been a small, non-randomised University of Arizona study where eight volunteers with Parkinson’s disease received daily light therapy to their head. All of the volunteers subsequently reported an improvement in their symptoms .
Encouragingly there have been no known complications from the use of photobiomodulation in humans.
“Given the huge health impact of Parkinson’s and other neurodegenerative diseases like Alzheimer’s, and how safe and easily administered light treatment is, I didn’t see what we had to lose by pursuing further research in this area,” Johnstone says. “There’s no guarantee that it will work yet, but I can pretty much guarantee that it’s not going to cause any harm.”
Just because infrared light therapy appears to work on rodents, however, doesn’t necessarily mean that it would also work in humans. With this in mind Johnstone travelled to a specialised primate research facility in Grenoble, France, in order to conduct further experiments. Initially, a small number of MPTP-infected macaque monkeys had an infrared light source implanted into their brains. “The results were extraordinary,” Johnstone said. “We found that infrared light treatment offered really strong neuroprotection, and reduced clinical symptoms of Parkinsonism in the monkeys ”.
In a further experiment in 2015, three MPTP-infected macaque monkeys received external infrared light therapy to different areas of their bodies. Remarkably, the monkey that received light therapy to the legs showed no signs of Parkinsonism by the end of the three-week experimental period. “It was pretty amazing,” Johnstone said. “The more I’ve been presenting this to people, the more they’re impressed by the strength of the effect.”
Burr’s geriatrician, Nicklason, is a staff specialist at the Royal Hobart Hospital. He sees many patients with Parkinson’s disease and other neurological conditions. Although he advises prudence he sometimes provides research information about light therapy to his patients. To his knowledge a dozen or so have given it a try.
“Changes are often subtle and tend to be noticed by spouses,” Nicklason told me. “Changes that have been reported include a better sense of wellbeing, better sleep, less anxiety and improved mental clarity. Given that non-motor symptoms like anxiety, depression and confusion are major drivers of reduced quality of life, even minor improvements are likely to be valuable.”
Not all of Nicklason’s patients’ changes have been subtle though. A member of Tasmania’s informal infrared light therapy group is Peter Cheatham. Cheatham, 58, is a former mountaineer and rescue-work trainer who was diagnosed with Parkinsonism following a series of strokes in his basal ganglia. A vocal advocate for light therapy Cheatham is currently using one of several mobile infrared light devices produced and marketed by Vielight, a company based in Toronto, Canada. Cheatham’s device delivers infrared light via something that looks like an oversize pair of headphones connected to a clip that he attaches to the inside of his nostril. “Within a couple of weeks of usage my twitching stopped and I started remembering things I had forgotten,” Cheatham said to me. He has a strong, steady voice and when I phoned him he was out collecting donations for the Salvation Army. “Now I can hold a conversation again and I can write legibly too. I’ve come off a lot of my medications and everything around me is clearer.”
Gold Coast-based general practitioner Dr Mark Jeffery is a clinician with over 30 years’ experience who has a number of patients with Parkinson’s disease in his practice. A native Zimbabwean who migrated to Australia he first came to learn about photobiomodulation through his use of lasers for pain relief.
Although Jeffery believes patients with Parkinson’s as well as Alzheimer’s disease could potentially benefit from infrared light therapy, he is cautious about recommending devices like those produced by Vielight, due to the tricky nature of what he calls “off-label” prescribing. “If you don’t investigate a patient properly and they deteriorate, it would be hard to justify in court that you prescribed a device that wasn’t proven to help,” he said. “The science behind light therapy is amazing, but it will not be part of mainstream medicine until we get conclusive, evidence-based studies.”
Vielight founder, naturopath and doctor of natural medicine Lew Lim, is eager to argue that there is evidence behind his devices. He claims his company, which has sold in excess of 30 000 units, has undertaken studies showing their neuroprotective benefits. “We’ve had some really dramatic, positive outcomes,” he told me recently, on a trip to Australia to meet with researchers at the Bosch Institute. “People have told me that this has literally saved their lives.”
When I asked him whether all his customers have noticed a benefit he was more circumspect. “It really depends on the person,” he said. “We have had people who have contacted us to say, ‘We’ve had this for months and nothing’s happening’ and they are entitled to return the device.”
Mitrofanis confirms that The Bosch Institute is collaborating with Lim for future clinical trials to test the Vielight unit’s effectiveness against both Parkinson’s and Alzheimer’s disease. “People have been using these devices and the company has published a study on the effectiveness against Alzheimer’s disease. It’s not a rigorous study, but it’s positive nonetheless,” Mitrofanis said. “We are currently putting a team together which will include Frank and Catherine from Tasmania and hopefully some interested neurologists from Sydney and Melbourne.”
Professor Simon Lewis is a consultant neurologist at the Royal Prince Alfred Hospital and Professor of Cognitive Neuroscience at the University of Sydney. He is the Director of the Parkinson’s Disease Research Clinic at the Brain & Mind Research Institute and advises that more studies are needed before photobiomodulation is used as a mode of treatment.
“It’s encouraging research, and in the absence of a cure, we shouldn’t disregard any suggestion, but we must strike a balance between hope and hype,” Lewis, who has not been involved in any studies on photobiomodulation, said to me. “The concern is that people might go out and buy a device which might be expensive, whereas in reality they may be better off spending money on proven therapies, such as exercise therapy or speech therapy, which are definitely going to help everybody with Parkinson’s.”
Despite his note of caution, Lewis believes that photobiomodulation is an avenue of research that should be pursued. “The bottom line is, there is very reasonable science behind infrared light therapy, and I think we should be very open to conducting a well-constructed clinical trial,” he said.
Unfortunately there is a major impediment behind commencing a large, placebo-controlled, double-blind study of infrared light therapy in humans and that is funding; or more specifically the lack of it. “We are in the process of trying to get funds for the human trial but it’s difficult because a trial like this costs five to six million dollars,” Mitrofanis said.
Despite these barriers Mitrofanis remains optimistic about the long-term future of infrared light therapy. A career-defining moment came for him recently when he travelled to Tasmania to meet the people with whom he had been corresponding with for over a year. “It was a wonderful experience,” he said, recalling the emotional meeting where those affected by neurodegenerative disorders told their stories about light therapy and how it had improved their lives. “No one can say the light treatment has completely reversed all their symptoms, but they’re all showing signs of improvement.
“I’ve been in the laboratories for 30 years now,” he continued. “And to see everything that I’ve ever worked for come to this, to see these people experiencing improvements, it’s just been immensely satisfying. I’m sick of treating mice. I’m sick of treating monkeys. I want to focus now on getting this out there and helping people with Parkinson’s.”
Burr believes that Mitrofanis has already helped him immensely. He is aware of Vielight’s portable infrared therapy units, but he has no intention of giving up his own tailor-made device. He has been using infrared light for 18 months now and has not required any increase in his anti-Parkinson’s medications. In the meantime his LED-lined lampshade has also received an upgrade. “We’ve made it out of a bucket from Bunnings,” he said. “We’ve also added 810 nm LED lights as well as the 670 nm lights. Both LED wavelengths are in alternate rows, and each wavelength has its own switch. So I do 15 minutes on one wavelength and then 15 minutes on the other wavelength.”
True to his party there is another reason why Burr, a fiscal conservative, has stuck to his own device. “The Vielight can cost up to nearly two-and-a-half thousand dollars. A plastic bucket from Bunnings costs three bucks,” he told me with a dry chuckle. “Which one would you use?”

Let There Be Light

Suvi  Mahonen

Surfers Paradise, Australia

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