Objective: To determine the effectiveness of photobiomodulation (light therapy) on MDS-UPDRS-III scores over a five-year period

Background: As a progressive neurodegenerative disease, worsening of motor symptoms in Parkinson’s disease is both expected and inevitable. To date there is no medication that can reverse the progression in motor signs of the disease, despite the utility of dopamine replacement and dopamine agonist medications. The outcome measure most often used to describe the changes in motor symptoms is the MDS-UPDRS-III score, with a mean increase of approximately 1.5 points per year for those receiving dopaminergic therapy. Photobiomodulation therapy (PBMt) is a non-thermal light therapy using laser or LED sources, that has a long history in clinical therapy. Recently, PBMt has been trialled as a treatment for neurodegenerative diseases, including Parkinson’s disease, in pre-clinical models and clinical trials

Method: 12 participants with idiopathic Parkinson’s disease were assessed with the MDS-UPDRS rating scale. Participants were treated with PBMt transcranially (4 LEDs, 810 nm, 70 or 100 mW, 20 minutes), intranasally (1 LED, 810 nm, 25mW, 25 minutes) and transdermally to the abdomen and neck (2 laser diodes, 904 nm, 30mW, 10 points, 1 minute/point). Treatment was in-clinic 3 times per week for 12 weeks, and then continued at home. Seven participants continued treatment for 5 years (sometimes with treatment breaks) and agreed to be reassessed using MDS-UPDRS-III.

Results: 2 participants showed a decrease in MDS-UPDRS-III scores of above a minimal clinical important difference (MCDI) for improvement, defined as greater than 3. 3 participants showed a decrease in score of less than 3. 1 participant showed an increase in score of less than 5 (MCDI for decline). 1 participant showed an increase in score of 11; this participant was diagnosed with multi-system atrophy during the 2^nd year of the clinical trial but decided to continue treatment.

Conclusion: The expected trajectory of motor symptoms for Parkinson’s disease is a decline over 5 years, estimated to be between 1.5 and 6 points per year of MDS-UPDRS-III score. 6 of 7 participants in this study did not follow this expected trajectory, suggesting that PBMt is worthy of consideration as an adjunctive treatment for Parkinson’s disease and deserving of further, appropriately powered longitudinal clinical trials.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/five-year-changes-in-mds-updrs-iii-after-light-treatment-photobiomodulation/