Borja Ignacio Ferreras

Background: Down syndrome (DS) is associated with persistent language and cognitive impairments and with abnormalities in cortical oscillatory activity, including in the gamma range. Transcranial photobiomodulation (tPBM) is a noninvasive neuromodulatory intervention with potential benefits for cortical physiology, language, and cognition. Methods: We conducted a pilot randomized, double-blind, sham-controlled trial of repeated 40-Hz near-infrared tPBM in adolescents and young adults with DS. Fourteen participants were randomized 1:1 to active tPBM or sham and received 18 sessions over 6 weeks, followed by short-term and long-term follow-up. Outcomes included resting-state EEG gamma power, connected-speech measures, language and cognitive indices, and selected computerized tasks. Results: Active tPBM did not significantly increase global resting-state EEG gamma power relative to sham at either follow-up. Pre-registered analyses did not show broad treatment benefit across outcomes, although they did identify a significant short-term advantage for active tPBM on grammatical morpheme accuracy in connected speech; in contrast, picture naming favored sham at long-term follow-up. Exploratory mechanistic analyses did not show a robust biological treatment signal. Both active and sham procedures were well tolerated, with no serious adverse events. Conclusions: In this underpowered pilot sample, 6 weeks of 40-Hz near-infrared tPBM–delivered unilaterally, at low power, on target areas–did not demonstrate a meaningful effect size in DS. A dose-finding study for tPBM in DS, also accounting for age of participants, is recommended.

Developmental stuttering (DS) is a complex neurodevelopmental disorder affecting approximately 5% of children, characterized by involuntary disruptions in speech fluency. Despite its prevalence, the precise pathophysiology remains elusive, and current behavioral and pharmacological interventions often yield variable long-term efficacy. This scoping review evaluates the therapeutic potential of transcranial photobiomodulation (t-PBM), a non-invasive neuromodulation technique, by summarizing its mechanisms of action with the known neurophysiological deficits of DS. Evidence indicates that DS is associated with reduced regional cerebral blood flow (rCBF) in Broca’s area, mitochondrial dysfunction, and impaired neural connectivity. t-PBM may address these deficits by stimulating cytochrome c oxidase, thereby increasing ATP production and triggering nitric oxide-mediated vasodilation to enhance rCBF. Furthermore, t-PBM promotes neuroplasticity, modulates astrocyte function—potentially counteracting GNPTAB-related deficits—and exhibits anxiolytic effects that may alleviate the secondary psychological burden of DS. By targeting these multifactorial underpinnings, t-PBM may represent a promising, low-risk adjunct or primary intervention for DS, though this remains to be tested empirically. While the theoretical framework is robust, clinical trials are needed to determine whether t-PBM has therapeutic utility, to optimize treatment parameters, establish longitudinal efficacy, and explore synergistic effects with established speech-language therapies.

Objetivo: El siguiente artículo tiene como propósito la revisión de la literatura existente cuyo enfoque sea las herramientas tecnológicas utilizadas para el abordaje del paciente con síntomas de salud mental, de manera virtual, para describir las ventajas, la eficacia, la efectividad y los beneficios de estas herramientas, a partir de la literatura encontrada. Métodos: se realizó una búsqueda en las bases de datos Pubmed, Elsevier, UpToDate, Journal of Medical Internet Research y Google Académico. Se identificó un total de 58 artículos que versan sobre la eficacia y efectividad de las diferentes modalidades digitales (tales como aplicaciones, cuestionarios en línea, mensajes de texto, etc.) que tratan la salud mental. Resultados: la búsqueda realizada arrojó un total de 58 artículos. Tras la eliminación de duplicados, el número fue de 50 artículos. Después de la caracterización de la información basada en la revisión de la totalidad del contenido, fueron elegidos 30 artículos para que sirvieran como base para la construcción de la síntesis de datos. Conclusiones: las herramientas virtuales utilizadas en salud mental ofrecen un sin fin de beneficios para prestar un servicio con un acceso más sencillo a la población, de forma económica y efectiva, sin temor a que los pacientes sean estigmatizados al momento de buscar ayuda, como se pudo evidenciar en los artículos presentados. Además, las herramientas digitales utilizadas en psiquiatría han demostrado ser eficaces y seguras, sin embargo, son de reciente aparición y cuentan con una cantidad limitada de estudios que demuestren objetivamente su eficacia en esta área.