Paolo Cassano MD, PhD, Massachusetts General Hospital, Assistant Professor of Psychiatry, Harvard Medical School discusses a new way of categorizing continuous-wave, near-infrared, transcranial treatments that have otherwise been lumped into one modality (tPBM).

1. Photobiomodulation
for Depression:
Roadmap Towards
Dose-Definition
Nov 14, 2020 – Virtual Session
celg – INOVACAO – Brazil
Paolo Cassano MD, PhD
Assistant Professor of Psychiatry
Harvard Medical School
Director of Photobiomodulation
Depression and Clinical Research Program
Division of Neuropsychiatry
Massachusetts General Hospital
@paolo_cassano
@paolocassanomd
@pcassano
in/paolo-cassano-md-phd

2. Disclosures
Niraxx Light Therapeutics Inc Advisory Board
Board Member
Equity
Royalties
Mass General Hospital – Patents No Applicable Royalties

8. Invisible Near-Infrared Light

9. Salehpour et al. 2018
Molecular Neurobiology

10. Salehpour et al. 2018
Molecular Neurobiology

12. High Irradiance
Small Surface
Treatment Resistant MDD
n=10 MDD
250 mW/cm2
2 cm2
0.12 kJ
t-PBM (CW) Sessions: 1
Follow up: 4 wks
Schiffer et al., 2009

14. TRD Study: Individual Depression Scores
Schiffer et al., 2009
Response: 40%
week 2
(HAMD-21)

15. TRD Study: Cerebral Blood Flow
Schiffer et al., 2009

16. High Irradiance
Small Surface
Attention Bias Modification for
Depressive Symptoms
n=51 MDD
250 mW/cm2
27 cm2
1.6 kJ
t-PBM (CW) Sessions: 2
Follow up: 2 wks
Disner et al. (2016)

18. Attention Bias Modification Study:
Overall Change in Depression Scores
Disner et al. (2016)

21. Low Irradiance
Large Surface
ELATED-2 Data
n=21 MDD
36 mW/cm2
57 cm2
3.4 kJ
t-PBM (CW) Sessions: 16
Follow up: 8 wks
Cassano et al. 2018 - Photomed Laser Surg.

23. ELATED-2: Depression Scores in Overall Sample
.
(Mann Whitney U-test – endpoint carried forward)
p=.047
Cassano et al. 2018 - Photomed Laser Surg.
Response:
50% NIR
vs.
27% sham
week 8
(HAMD-17)

24. Low Irradiance
Small Surface
ELATED-3 Data
n=49 MDD
55 mW/cm2
36 cm2
2.3 kJ
t-PBM (CW) Sessions: 12 -24
Follow up: 6 -12 wks
Iosifescu et al. 2020 SOBP Meeting - Virtual Poster Session

25. QIDS-C:
Depression
Scores in
Overall
Sample
NIR – NIR
Sham – NIR
Sham - Sham
SPCD pooled
p=ns
t-test
n=49 phase I
n=37 phase II
n=36 completers
8
9
10
11
12
13
14
15
16
17
y0 y1 y3 y5 y7 y9 y11 y13 y15 y17 y19 y21 y23 y25
Visit Number
QIDS-C Mean Score
rx 1 rx 2 rx 3
Iosifescu et al. 2020 SOBP Meeting - Virtual Poster Session
Response:
22-36% NIR
vs.
17-29% sham
week 6 -12
(QIDS)

26. ELATED-3
Fp1 and Fp2
51 mW/cm2
25 cm2
1.5 kJ per session
Fp1 Fp2
F3 F4
Iosifescu et al. 2020 SOBP Meeting - Virtual Poster Session

28. Low Irradiance
Large Surface
Chronic Traumatic Brain Injury
n=11 (n=8 with comorbid depression)
22 mW/cm2
247 cm2
3.2 kJ
t-PBM (CW) Sessions: 18
Follow up: 6 wks
Naeser, Zafonte, Kengel et al., 2014. J of Neurotrauma

30. Naeser et al., 2014
Response: 37%
week 6 (BDI-II)
Chronic TBI Study: Individual
Depression Scores

31. Naeser, Zafonte, Kengel et al., 2014. J of Neurotrauma
RawScore
Chronic TBI Study: Depression Scores in Overall Sample

32. High Irradiance
Large Surface
Chronic Traumatic Brain Injury
n=39 (all with comorbid depression)
8 -15 W
222 - 327 cm2
18 kJ (average)
t-PBM Sessions: 8 - 34
Follow up: 8 wks
Henderson & Morries et al., 2017

34. Henderson & Morries et al., 2017
Chronic TBI Study: Overall
Depression Scores
Response: 92%
week 8
(QIDS)

35. Chronic TBI Case: Cerebral Blood Flow (SPECT)
Adv Mind Body Med. 2015 Fall;29(4):27-33
Tc-99m HMPAO

36. 2 x 2 large – small & high low ROADMAP

37. High Irradiance
Irradiance: 700 mW/cm2
Total Energy 2.4 kJ
Irradiance: 300 mW/cm2
Total Energy 2.4 kJ
Low Irradiance
Irradiance: 50 mW/cm2
Total Energy 1.4 kJ
SMALL SURFACE
Wavelength: 808 nm
Locations: F3 and F4
Total Area: 24 cm2 (2 x 12 cm2)
TRIADE STUDY (CW)

39. Conclusions
@paolo_cassano
@paolocassanomd
@pcassano
in/paolo-cassano-md-phd
massgeneral.org/doctors/19402/Paolo-Cassano

40. MGH Depression Program
North Eastern University
Qianqian Fang
Anh Phong Tran
Yaoshen Yuan
Nathan Kline Institute, NY
Dan Iosifescu
LiteCure LLC.
Luis De Taboada
Mass General Hospital
Depression Program
Sam Petrie
Garrett Thomas
Richard Norton
David Mischoulon
Cris Cusin
Maurizio Fava
Andy Nierenberg
Anxiety Program
Meredith Ward
Eric Bui
Tatiana Sitnikova
Mari Franceschini
Michael Hamblin
Husam Katnani
Mass Eye and Ear.
Benjamin BleierUniversity of Pisa
Vincenza Spera
Marco Maiello

41. MGH Division of Neuropsychiatry