Expanding Traumatic Brain Injury treatment options for Veterans

Pictured above: Dr. Yelena Bogdanova, Clinical Psychologist at VA Boston Healthcare System, demonstrates the LED therapy headset.

March is the annual observance of Traumatic Brain Injury (TBI) Awareness Month, during which VA and other health care organizations draw attention to the latest developments in the treatment of TBI.

TBI is often caused by a strong impact to the head or from an object penetrating the brain that may or may not result in a loss of consciousness.  People with TBIs often experience problems with thinking or other neurological symptoms such as mental fogginess, changes in memory, problems with balance, and behavioral changes to include being more irritable or depressed.

After the initial injury has healed, treatments for TBI are focused on symptom management and may include medications, rehabilitation therapies, and assistive devices and technologies.

Light-emitting diode therapy, also known as LED therapy, is an emerging treatment for TBI that aims to help the brain heal.  It is a non-invasive and painless treatment modality that directly targets the repair of injured brain cells without disrupting healthy cells. LEDs have the lighting intensity of incandescent and fluorescent light, but without the heat.

Although the exact mechanism is unclear, evidence suggests that LED therapy has a healing and rejuvenating cellular response. This is due, in part, to increased blood flow to the treated area and increased production of adenosine triphosphate, which transports energy within cells for metabolism.  A published study reported that LED therapy can improve brain function, emotional health and sleep, and reduce chronic pain and TBI symptoms.

In late 2017, the VA Boston Healthcare System, Jamaica Plain campus, began a clinical demonstration project to offer Veterans with a history of mild to moderate TBI who continue to experience TBI symptoms access to LED therapy.

This treatment is contained in a lightweight frame that is placed on the head and a clip placed inside the nose. “The headpiece is similar in dimensions and weight to wearing headphones,” said Jocelyn Holguin, a VA Polytrauma/TBI Program Coordinator and the VA Boston LED Project Lead, “but the LED nostril attachments are pretty unusual and will take some getting used to.”

The LED headset allows light wavelengths to enter the brain at key points around and across the head that are integral to facilitate healing. The twin LED nostril attachments target another part of the brain that the headset can’t reach.

Dr. Saurabha Bhatnagar, Medical Director of the TBI/Polytrauma Network Site at VA Boston Healthcare System, has been actively involved in the development of the LED therapy program and is eager to see the results of this new effort.

These efforts are being spearheaded by VA’s Center for Compassionate Innovation (CCI).  CCI explores emerging treatments and therapies that may improve and enhance Veterans’ physical and mental well-being.

Home Treatments Now Underway

When Veterans complete their first LED therapy session at VA, they receive LED headsets and accessories and given instructions on how to use the equipment at home. Veterans must wear the equipment three times a week for 25 minutes and will receive weekly phone check-ins from clinic staff.

The clinic at Jamaica Plain will schedule follow-up appointments with Veterans at six and 12 weeks after their initial treatment session. At these appointments, Veterans will receive comprehensive assessments to determine their response to the LED treatments.

 Learn More

• VA article on use of LED treatments at VA Boston Healthcare System to improve brain function in Veterans with Gulf War Illness.
• Read the VA news release about the new treatment options at https://www.va.gov/opa/pressrel/pressrelease.cfm?id=3986.
• For more information about VA’s Center for Compassionate Innovation, visit https://www.va.gov/healthpartnerships.

Author: Lauren Korshak, M.S., RCEP, is a health system specialist at VA’s Center for Compassionate  Innovation and a member of the teaching faculty at the Milken Institute School of Public Health. She currently explores and has published on the relationship between chronic disease, exercise capacity and mortality.