Effect of photobiomodulation on serum neuron specific enolase (NSE) among patients with diabetic peripheral neuropathy - A pilot study.

BACKGROUND AND AIM: Photobiomodulation is an emerging therapy for Diabetic peripheral neuropathy (DPN) of which the management is still a dilemma for clinicians. Elevated Neuron Specific Enolase (NSE) is associated with neuropathy. We aimed this study to assess the effect of Low Level Laser Therapy (LLLT) on Serum Neuron Specific Enolase in Type II Diabetes Mellitus patients with DPN. METHODOLOGY: Pre post interventional study was done on 50 patients with DPN. DPN was confirmed using 10g Monofilament test, Vibration perception threshold (VPT) and Michigan Neuropathy Screening Instrument. All patients were provided with LLLT for 9 min on dorsal and plantar of foot with a dosage of 3.1 J/cm 2 for 10 days. A blood sample was collected at baseline and 4 weeks after LLLT for NSE estimation. RESULT: A significant reduction in serum NSE levels (0.006) after 4 weeks of laser therapy was observed in 42 patients when compared with baseline. A significant reduction in the vibration perception threshold (p = 0.003) and Numeric pain rating scale (p = 0.004) were observed. CONCLUSION: In this pilot study, we have assessed the effect of LLLT on serum NSE levels among patients with DPN and showed improved quality of life and decrease in serum NSE levels. These findings should be investigated in larger trials.

Low level laser therapy for the patients with painful diabetic peripheral neuropathy - A systematic review.

BACKGROUND: Low Level Laser Therapy (LLLT) is an emerging treatment modality for management of neuropathic pain. It works by triggering biochemical changes with in cells. OBJECTIVE: This systematic review focused on finding evidence on the effectiveness of LLLT on treatment of painful diabetic neuropathy. METHODS: We conducted a systematic review (PubMed, Web of Science, CINAHL and Cochrane) to find the evidence on effectiveness of LLLT on treatment of painful diabetic neuropathy. Randomized and non-randomized studies were included in the review. RESULTS: A total of 627 studies were screened. After the exclusion criteria (duplicate, animal studies, LLLT for treating other neuralgias) 6 studies were included in the study. The outcome measure that were considered were the difference in pain score and nerve conduction velocity test and quality of life questionnaire. CONCLUSION: The evidence obtained shows LLLT has a positive effect in controlling diabetic neuropathic pain.