Recently, we had the pleasure of interviewing Canadian light therapy expert, Anita Saltmarche on her 20+ years of research and clinical use of light therapy for conditions such as Parkinsons, dementia and traumatic brain injury. In an exclusive online interview, we explored her background, thoughts on field of light therapy as a treatment modality, and the current clinical trial underway in Ontario, Canada, testing the impact of photobiomodulation on Parkinson's. Anita is a co-lead investigator of this important clinical trial.
Interested? Keep reading to see Anita's responses...
Q: What makes light therapy a unique treatment modality?
A: Light therapy uses red and infrared light energy to promote changes within cell structures. It’s an amazing technology that doesn’t just mask symptoms but actually treats the underlying cause. Typical treatments address a single condition whilst light therapy treats multiple, leading to understandable scepticism in the medical community. Thankfully, its effectiveness is being shown by 50+ years of clinical research. Individuals can also treat themselves at home with easy-to-use light therapy devices and clinical support.
What's exciting is that this research area is expanding rapidly. When discussing the potential of what light can do, we are just scratching the surface!
Q: What are the common misconceptions related to light therapy?
A: We frequently hear “Oh, there’s no way light will reach the deeper target tissue, such as the hip, lower or brain.” Many physicians do not believe the light can even access the brain. However, fMRI and perfusion studies conducted by Margaret Naeser, Linda Chao and others demonstrate that light therapy can increase cellular activity and blood flow in the brain, suggesting it has reached deep tissue. Another misconception is that only high-powered lasers can penetrate the deep target tissue. However, low-level lasers and medical-grade LED devices with appropriate methods of delivery can still result in significant positive effects.
Q: From your clinical experience, what is the rate of response to light therapy?
A: That's a really good question. If you look at the research, it will suggest that over 75% of patients will receive significant benefits. It's worth noting that there are requirements to achieve these levels of effectiveness: an individualised treatment protocol, using the correct device parameters, delivery method & sequencing of the treatment.
Q: You mentioned a success rate of over 75% with light therapy. Is it normal to have such a high success rate with treatment modalities?
A: Yes, this is a high estimated success rate, especially if you compare these results to medications. For example, we conducted a small clinical trial in Toronto, treating mild to moderately severe Alzheimer's and dementia with light therapy. The clinical improvements on two standardised cognitive assessment tools, the Mini-Mental State Exam (MMSE) and the Alzheimer's Disease Assessment Scale for cognition (ADAS-cog), were between two to almost seven times, respectively, more effective compared to a large-scale Alzheimer's pharmaceutical study. Also, our participants did not experience any of the typical side effects from medications. Although the small sample size means the results are suggestive, more recent research has demonstrated similar findings. So, achieving an estimated improvement of over 75% is probably possible.
Q: Do people respond to light therapy the same way and have the same level of response?
This is where I think individualised protocol development, management and correct delivery method is important. People respond differently for a variety of reasons. A standardised treatment protocol can be a good starting point, but someone’s medical history and goals should guide the development of an individualised treatment protocol and be revised based on their response.
Q: What motivates you to push the boundaries with the potential new applications of light therapy?
A: Working with my patients and families and seeing you can make a positive difference motivates me. Many have tried numerous other treatments and were unsuccessful, resulting in hopelessness and a lack of physical or emotional resilience. These chronic, challenging conditions push you to go beyond what you previously have done.
For example, treating my first individual with traumatic brain injury (TBI). She had excellent clinical outcomes with light therapy for her knee arthritis. The patient and her husband were so pleased with the results, they asked if we could treat her TBI. Applying light to the head is commonplace, but not 21 years ago. After conducting a literature review and speaking with several knowledgeable clinicians and researchers, there was a consensus that it should not be harmful. So we started the transcranial treatment with full disclosure and saw a reasonably rapid, meaningful clinical response.
Q: How has your background in nursing prepared you for your clinical work and research?
A: I have diverse experience in various medical specialties across acute and long-term care settings, which provided me with a broad perspective of the healthcare system. It also highlighted how we deliver care is as essential as what we deliver. I try to never lose sight of the importance of the therapeutic relationship in all my interactions and treatments.
My research endeavours guide my clinical experience and vice versa. Asking 'why' and looking for more effective outcomes often leads to collaboration with other healthcare providers and disciplines. Many patients I work with have multiple chronic conditions requiring a combination of treatments. In my experience, an integrative approach generates a cross-pollination of ideas, improving clinical outcomes and intellectual stimulation.
Q: Why has Parkinson's become a particular area of interest for you and your research?
A: Treating neurological and neurodegenerative conditions with photobiomodulation has been my clinical and research focus for over 21 years. It started with treating traumatic brain injury, then aphasia post-stroke and later Alzheimer's and dementia. Along the way, I was treating children with various neurological challenges. Regardless of age or brain issues, most improved their symptoms and quality of life.
As effective as transcranial and intranasal light therapy was, could results be improved? A review of the research supported the use of photobiomodulation. Australian research by Ann Liebert, Brian Bicknell, and others demonstrated brain effects with indirect treatment (the gut and C2) and transcranial treatment significantly impacted Parkinson's motor and non-motor symptoms. I incorporated these protocols into my clinical practice and was impressed with the additional clinical benefits. Serendipity led to my introduction to experienced physiotherapist Orla Hares, whose clinical focus is Parkinson's and other neurological conditions. We became co-principal investigators in a clinical research trial to determine the effectiveness of light therapy (of the gut, C2 and the head) and exercise to improve the motor and non-motor symptoms of Parkinson's. The trial will include 66 participants and is progressing well. These results will provide further knowledge about combining exercise and photobiomodulation as a safe, effective, easy-to-use home treatment for Parkinson's.
How can you not be excited about the impact of light therapy on the lives of so many across various medical disorders? Now, light is expanding to enhance health and well-being.
Interested in the current Canadian trial? Click below to watch Anita and her co-lead investigator Orla Hares discuss the trial.