Bright light therapy for depression in Parkinson disease: A randomized controlled trial

Sonja Rutten, Chris Vriend, Jan H. Smit, Henk W. Berendse, Eus J.W. Van Someren, Adriaan W. Hoogendoorn, Jos W.R. Twisk, Ysbrand D. Van Der Werf, Odile A. Van Den Heuvel

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

To assess the efficacy of bright light therapy (BLT) in reducing depressive symptoms in patients with Parkinson disease (PD) and major depressive disorder (MDD) compared to a control light.MethodsIn this double-blind controlled trial, we randomized patients with PD and MDD to treatment with BLT (±10,000 lux) or a control light (±200 lux). Participants were treated for 3 months, followed by a 6-month naturalistic follow-up. The primary outcome of the study was the Hamilton Depression Rating Scale (HDRS) score. Secondary outcomes were objective and subjective sleep measures and salivary melatonin and cortisol concentrations. Assessments were repeated halfway, at the end of treatment, and 1, 3, and 6 months after treatment. Data were analyzed with a linear mixed-model analysis.ResultsWe enrolled 83 participants. HDRS scores decreased in both groups without a significant between-group difference at the end of treatment. Subjective sleep quality improved in both groups, with a larger improvement in the BLT group (B [SE] = 0.32 [0.16], p = 0.04). Total salivary cortisol secretion decreased in the BLT group, while it increased in the control group (B [SE] = -8.11 [3.93], p = 0.04).ConclusionBLT was not more effective in reducing depressive symptoms than a control light. Mood and subjective sleep improved in both groups. BLT was more effective in improving subjective sleep quality than control light, possibly through a BLT-induced decrease in cortisol levels.ClinicalTrials.gov identifier:NCT01604876.Classification of evidenceThis study provides Class I evidence that BLT is not superior to a control light device in reducing depressive symptoms in patients with PD with MDD.

Original languageEnglish
Pages (from-to)E1145-E1156
Number of pages12
JournalNeurology
Volume92
Issue number11
Early online date5 Feb 2019
DOIs
Publication statusPublished - 12 Mar 2019

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Phototherapy
Parkinson Disease
Randomized Controlled Trials
Depression
Major Depressive Disorder
Sleep
Light
Hydrocortisone
Melatonin
Therapeutics
Quality Control
Linear Models
Outcome Assessment (Health Care)
Equipment and Supplies
Control Groups

Cite this

Rutten, S., Vriend, C., Smit, J. H., Berendse, H. W., Van Someren, E. J. W., Hoogendoorn, A. W., ... Van Den Heuvel, O. A. (2019). Bright light therapy for depression in Parkinson disease: A randomized controlled trial. Neurology, 92(11), E1145-E1156. https://doi.org/10.1212/WNL.0000000000007090
Rutten, Sonja ; Vriend, Chris ; Smit, Jan H. ; Berendse, Henk W. ; Van Someren, Eus J.W. ; Hoogendoorn, Adriaan W. ; Twisk, Jos W.R. ; Van Der Werf, Ysbrand D. ; Van Den Heuvel, Odile A. / Bright light therapy for depression in Parkinson disease : A randomized controlled trial. In: Neurology. 2019 ; Vol. 92, No. 11. pp. E1145-E1156.
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abstract = "To assess the efficacy of bright light therapy (BLT) in reducing depressive symptoms in patients with Parkinson disease (PD) and major depressive disorder (MDD) compared to a control light.MethodsIn this double-blind controlled trial, we randomized patients with PD and MDD to treatment with BLT (±10,000 lux) or a control light (±200 lux). Participants were treated for 3 months, followed by a 6-month naturalistic follow-up. The primary outcome of the study was the Hamilton Depression Rating Scale (HDRS) score. Secondary outcomes were objective and subjective sleep measures and salivary melatonin and cortisol concentrations. Assessments were repeated halfway, at the end of treatment, and 1, 3, and 6 months after treatment. Data were analyzed with a linear mixed-model analysis.ResultsWe enrolled 83 participants. HDRS scores decreased in both groups without a significant between-group difference at the end of treatment. Subjective sleep quality improved in both groups, with a larger improvement in the BLT group (B [SE] = 0.32 [0.16], p = 0.04). Total salivary cortisol secretion decreased in the BLT group, while it increased in the control group (B [SE] = -8.11 [3.93], p = 0.04).ConclusionBLT was not more effective in reducing depressive symptoms than a control light. Mood and subjective sleep improved in both groups. BLT was more effective in improving subjective sleep quality than control light, possibly through a BLT-induced decrease in cortisol levels.ClinicalTrials.gov identifier:NCT01604876.Classification of evidenceThis study provides Class I evidence that BLT is not superior to a control light device in reducing depressive symptoms in patients with PD with MDD.",
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Rutten, S, Vriend, C, Smit, JH, Berendse, HW, Van Someren, EJW, Hoogendoorn, AW, Twisk, JWR, Van Der Werf, YD & Van Den Heuvel, OA 2019, 'Bright light therapy for depression in Parkinson disease: A randomized controlled trial' Neurology, vol. 92, no. 11, pp. E1145-E1156. https://doi.org/10.1212/WNL.0000000000007090

Bright light therapy for depression in Parkinson disease : A randomized controlled trial. / Rutten, Sonja; Vriend, Chris; Smit, Jan H.; Berendse, Henk W.; Van Someren, Eus J.W.; Hoogendoorn, Adriaan W.; Twisk, Jos W.R.; Van Der Werf, Ysbrand D.; Van Den Heuvel, Odile A.

In: Neurology, Vol. 92, No. 11, 12.03.2019, p. E1145-E1156.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - Bright light therapy for depression in Parkinson disease

T2 - A randomized controlled trial

AU - Rutten, Sonja

AU - Vriend, Chris

AU - Smit, Jan H.

AU - Berendse, Henk W.

AU - Van Someren, Eus J.W.

AU - Hoogendoorn, Adriaan W.

AU - Twisk, Jos W.R.

AU - Van Der Werf, Ysbrand D.

AU - Van Den Heuvel, Odile A.

PY - 2019/3/12

Y1 - 2019/3/12

N2 - To assess the efficacy of bright light therapy (BLT) in reducing depressive symptoms in patients with Parkinson disease (PD) and major depressive disorder (MDD) compared to a control light.MethodsIn this double-blind controlled trial, we randomized patients with PD and MDD to treatment with BLT (±10,000 lux) or a control light (±200 lux). Participants were treated for 3 months, followed by a 6-month naturalistic follow-up. The primary outcome of the study was the Hamilton Depression Rating Scale (HDRS) score. Secondary outcomes were objective and subjective sleep measures and salivary melatonin and cortisol concentrations. Assessments were repeated halfway, at the end of treatment, and 1, 3, and 6 months after treatment. Data were analyzed with a linear mixed-model analysis.ResultsWe enrolled 83 participants. HDRS scores decreased in both groups without a significant between-group difference at the end of treatment. Subjective sleep quality improved in both groups, with a larger improvement in the BLT group (B [SE] = 0.32 [0.16], p = 0.04). Total salivary cortisol secretion decreased in the BLT group, while it increased in the control group (B [SE] = -8.11 [3.93], p = 0.04).ConclusionBLT was not more effective in reducing depressive symptoms than a control light. Mood and subjective sleep improved in both groups. BLT was more effective in improving subjective sleep quality than control light, possibly through a BLT-induced decrease in cortisol levels.ClinicalTrials.gov identifier:NCT01604876.Classification of evidenceThis study provides Class I evidence that BLT is not superior to a control light device in reducing depressive symptoms in patients with PD with MDD.

AB - To assess the efficacy of bright light therapy (BLT) in reducing depressive symptoms in patients with Parkinson disease (PD) and major depressive disorder (MDD) compared to a control light.MethodsIn this double-blind controlled trial, we randomized patients with PD and MDD to treatment with BLT (±10,000 lux) or a control light (±200 lux). Participants were treated for 3 months, followed by a 6-month naturalistic follow-up. The primary outcome of the study was the Hamilton Depression Rating Scale (HDRS) score. Secondary outcomes were objective and subjective sleep measures and salivary melatonin and cortisol concentrations. Assessments were repeated halfway, at the end of treatment, and 1, 3, and 6 months after treatment. Data were analyzed with a linear mixed-model analysis.ResultsWe enrolled 83 participants. HDRS scores decreased in both groups without a significant between-group difference at the end of treatment. Subjective sleep quality improved in both groups, with a larger improvement in the BLT group (B [SE] = 0.32 [0.16], p = 0.04). Total salivary cortisol secretion decreased in the BLT group, while it increased in the control group (B [SE] = -8.11 [3.93], p = 0.04).ConclusionBLT was not more effective in reducing depressive symptoms than a control light. Mood and subjective sleep improved in both groups. BLT was more effective in improving subjective sleep quality than control light, possibly through a BLT-induced decrease in cortisol levels.ClinicalTrials.gov identifier:NCT01604876.Classification of evidenceThis study provides Class I evidence that BLT is not superior to a control light device in reducing depressive symptoms in patients with PD with MDD.

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Rutten S, Vriend C, Smit JH, Berendse HW, Van Someren EJW, Hoogendoorn AW et al. Bright light therapy for depression in Parkinson disease: A randomized controlled trial. Neurology. 2019 Mar 12;92(11):E1145-E1156. https://doi.org/10.1212/WNL.0000000000007090