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

doi:10.1212/WNL.0000000000007090

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

^*Corresponding author for this work

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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.

Original language	English
Pages (from-to)	e1145-e1156
Number of pages	12
Journal	Neurology
Volume	92
Issue number	11
Early online date	15 Feb 2019
DOIs	https://doi.org/10.1212/WNL.0000000000007090
Publication status	Published - 12 Mar 2019

Funding

This study was financially supported by research grants from Hersenstichting Nederland [fellowship F2011(1)-03, to Dr. van den Heuvel], Stichting Parkinson Fonds (to Drs. van der Werf and van den Heuvel), and de Parkinson Vereniging (to Drs. van den Heuvel and van der Werf). S. Rutten received commercial research support from Photo-pharmics Inc for another trial, unrelated to this study, that ran between 2015 and 2016. C. Vriend and J.H. Smit report no disclosures relevant to the manuscript. H.W. Berendse received research support from the Michael J. Fox Foundation. E.J.W. van Someren, A. Hoogendoorn, and J.W.R. Twisk report no disclosures relevant to the manuscript. Y.D. van der Werf received commercial research support from Photopharmics Inc for another trial, unrelated to this study, that ran between 2015 and 2016 and serves as associate editor for Human Brain Mapping. O.A. van den Heuvel received commercial research support from Photopharmics Inc for another trial, unrelated to this study, that ran between 2015 and 2016, and serves as associate editor for Journal of Obsessive-Compulsive and Related Disorders. Go to Neurology.org/N for full disclosures.

Funders	Funder number
Stichting Parkinson Fonds
Michael J. Fox Foundation for Parkinson's Research
Hersenstichting	F2011(1)-03

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Bright light therapy for depression in Parkinson diseaseFinal published version, 536 KBLicence: Article 25fa Dutch Copyright Act

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@article{b88c869d7c5046d4a19f7e45c6763b1c,

title = "Bright light therapy for depression in Parkinson disease: A randomized controlled trial",

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.",

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

year = "2019",

month = mar,

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doi = "10.1212/WNL.0000000000007090",

language = "English",

volume = "92",

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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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SP - e1145-e1156

JO - Neurology

JF - Neurology

IS - 11

ER -

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

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