Treatment of pediatric epilepsy relies on antiepileptic drugs (AEDs), but the response rates to AEDs are $\sim 72$ to 76%.¹ New effective and noninvasive treatments for AED-refractory pediatric epilepsy are critically needed. Transcranial photobiomodulation (tPBM) with near-infrared (NIR) light refers to applying NIR transcranially according to the principle of photobiomodulation (PBM, previously termed low-level laser therapy).² The mechanism of tPBM is based on photon absorption by mitochondrial cytochrome c oxidase (CCO).³ PBM has been studied in neurological diseases for 30 years.⁴ We recently demonstrated that tPBM (808 nm) attenuates seizures and status epilepticus (SE) induced by pentylenetetrazole (PTZ) in peripubertal rats.⁵ The behavioral and histopathological results showed that the treatment accomplished this (i) by reducing neuronal damage in the cortex, hippocampus (both GABAergic interneurons and principal cells), thalamus, and hypothalamus; (ii) by protecting hippocampal parvalbumin-positive interneurons—GABAergic interneurons that powerfully inhibit principal cells but are vulnerable to SE-induced apoptosis—from SE-induced apoptosis;⁶ and (iii) by preserving the integrity of the PV-immunoreactive perisomatic neuronal network surrounding the principal cells.⁷ Vogel et al.⁸ further revealed that repetitive tPBM (780 nm) reduced epileptiform discharges in a rat model of stroke-induced epilepsy. Regarding neuroprotection, tPBM has shown effects in reducing neuroinflammatory cytokines,^7,9 which along with neuron-specific enolase (NSE) increased in the hippocampus after convulsive status epilepticus (CSE).^10,11

Spinal sarcopenia is a complex and multifactorial disorder associated with a loss of strength, increased frailty, and increased risks of fractures and falls. In addition, spinal sarcopenia has been associated with lumbar spine disorders and osteoporosis, which renders making decisions on treatment modalities difficult. Patients with spinal sarcopenia typically exhibit lower cumulative survival, a higher risk of in-hospital complications, prolonged hospital stays, higher postoperative costs, and higher rates of blood transfusion after thoracolumbar spine surgery. Several studies have focused on the relationships between spinal sarcopenia, appendicular muscle mass, and bone-related problems—such as osteoporotic fractures and low bone mineral density—and malnutrition and vitamin D deficiency. Although several techniques are available for measuring sarcopenia, each of them has its advantages and shortcomings. For treating spinal sarcopenia, nutrition, physical therapy, and medication have been proven to be effective; regenerative therapeutic options seem to be promising owing to their repair and regeneration potential. Therefore, in this narrative review, we summarize the characteristics, detection methodologies, and treatment options for spinal sarcopenia, as well as its role in spinal disorders.

Convulsive status epilepticus is the most common neurological emergency in children. Transcranial photobiomodulation (tPBM) reverses elevated rodent neurotransmitters after status epilepticus (SE) yet whether tPBM can attenuate seizure behaviors remains unknown. Here, we applied near‐infrared laser at wavelength 808 nm transcranially to peripubertal Sprague‐Dawley rats prior to pentylenetetrazole (PTZ) injection. Hematoxylin‐eosin, immunofluorescence (IF) staining with anti‐parvalbumin (PV) and terminal deoxynucleotidyl transferase dUTP nick‐end labeling (TUNEL) assay after IF staining was performed. Behaviorally, tPBM attenuated the mean seizure score and reduced the incidence of SE and mortality. Histochemically, tPBM reduced dark neurons in the cortex, hippocampus, thalamus and hypothalamus, lessened the apoptotic ratio of parvalbumin‐positive interneurons (PV‐INs) and alleviated the aberrant extent of PV‐positive unstained somata of PCs in the hippocampus. Conclusively, tPBM attenuated PTZ‐induced seizures, SE and mortality in peripubertal rats and reduced PTZ‐induced neuronal injury, apoptosis of PV‐INs and preserved PV positive perisomatic inhibitory network in the hippocampus.

Background: Convulsive status epilepticus (CSE) prevention is critical for pediatric patients with epilepsy. Immediate intervention before CSE reduce severity. Despite its wide usage as an anticonvulsant, valproic acid (VPA) results in harmful side effects such as dose-dependent hepatotoxicity. Hence, reducing VPA dosage to minimize side effects while maintaining its efficacy is necessary, and transcranial photobiomodulation (tPBM) add-on therapy could facilitate this. We recently demonstrated for the first time that tPBM at a wavelength of 808 nm attenuated CSE in peripubertal rats. However, the effects of VPA with the add-on therapy of tPBM prior to seizures have not yet been explored. This study investigated whether adding tPBM to VPA exerts synergistic effect for CSE prevention in peripubertal rats.Methods: A gallium-aluminum-arsenide laser (wavelength of 808 nm with an exposure duration of 100 s and irradiance of 1.333 W/cm²at the target) was applied transcranially 30 min after VPA injection in Sprague Dawley rats. All the rats received 90 mg/kg of pentylenetetrazole (PTZ). Except for the saline (n = 3), tPBM + saline (n = 3), and PTZ group (n = 6), all the rats received a PTZ injection 30 min after VPA injection. The rats received add-on tPBM with PTZ immediately after tPBM. In the VPA + PTZ group, the rats received low-dose (100 mg/kg,n = 6), medium-dose (200 mg/kg,n = 6), and high-dose (400 mg/kg,n = 7) VPA. In the VPA + tPBM + PTZ group, the rats received low (100 mg/kg,n = 5), medium (200 mg/kg,n = 6), and high (400 mg/kg,n = 3) doses of VPA. Seizures were evaluated according to the revised Racine’s scale in a non-blinded manner.Results: Adding tPBM to low-dose VPA reduced the incidence of severe status epilepticus and significantly delayed the latency to stage 2 seizures. However, adding tPBM to high-dose VPA increased the maximum seizure stage, prolonged the duration of stage 4–7 seizures, and shortened the latency to stage 6 seizures.Conclusions: Adding tPBM to low-dose VPA exerted a synergistic prevention effect on PTZ-induced seizures, whereas adding tPBM to high-dose VPA offset the attenuation effect.