Advertisement

Acta Neurologica Belgica

, Volume 119, Issue 4, pp 607–613 | Cite as

Bright light therapy with a head-mounted device for anxiety, depression, sleepiness and fatigue in patients with Parkinson’s disease

  • Jean-Marc Raymackers
  • Mariana Andrade
  • Eugenie Baey
  • Margaux Vanneste
  • Frédéric EvrardEmail author
Original article
  • 60 Downloads

Abstract

The beneficial effects of bright light therapy (BLT) on the disabling non-motor symptoms of Parkinson’s disease (PD) remain uncertain. The objective of this study was to investigate if daily BLT, with a head-mounted device (Luminette®), has a beneficial effect on depression, anxiety, daytime sleepiness and fatigue in patients with PD. In this double-blind, placebo-controlled study, 16 patients with PD were randomized to receive either 1 month of BLT or 1 month of placebo therapy, separated by a 2-week washout period, in a crossover fashion. Patients completed questionnaires for the Hospital Anxiety and Depression Scale (HADS), the Epworth Sleepiness Scale (ESS) and the Fatigue Impact Scale (FIS) before and after each treatment period. The primary outcome measures were changed from baseline in scores between treatment groups. No significant changes were observed in the HADS anxiety scores and FIS scores after BLT and after placebo. The ESS scores decreased non-significantly only after BLT. A post hoc analysis of patients who had baseline ESS scores > 11 revealed a significantly greater decrease in ESS scores after BLT than after placebo. Future studies investigating the effect of BLT on sleepiness could focus specifically on patients with high ESS scores.

Keywords

Parkinson’s disease Sleepiness Phototherapy Depression Anxiety 

Notes

Acknowledgements

We would like to thank Doctors Marie-Céline Duray and Michel Dupuis from the Neurology Department at Clinique Saint-Pierre Ottignies, Belgium for their help in recruiting patients. We would like to thank Lucimed SA, Villers-le-Bouillet, Belgium for providing the Luminette® light therapy devices.

Funding

No funding was received for this study.

Compliance with ethical standards

Conflict of interest

Lucimed SA, Villers-le-Bouillet, Belgium provided the active and placebo light therapy devices (Luminette®) but did not fund the study nor were they involved in any aspect of the study management (design, collection of data, data analysis or preparation of the manuscript). There were no conflicts of interest with this donation. Neither the authors nor the institution conducting the study have a conflict of interest with Lucimed. Patients were aware of the brand name on the product.

Ethical approval

The study protocol, questionnaires and consent forms were approved by the institutional ethics committee of Clinique Saint Pierre, Ottignies, Belgium and the study was performed in accordance with the ethical standards of this committee and those of the 1964 Declaration of Helsinki [34] and its amendments.

Informed consent

All participants gave written informed consent prior to study start.

References

  1. 1.
    GBD 2016 Neurology Collaborators (2019) Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol 18:459–480.  https://doi.org/10.1016/S1474-4422(18)30499-X CrossRefGoogle Scholar
  2. 2.
    MDS clinical diagnostic criteria for Parkinson’s disease—Postuma—2015—Movement Disorders—Wiley Online Library. https://onlinelibrary.wiley.com/doi/10.1002/mds.26424. Accessed 4 May 2019
  3. 3.
    Gallagher DA, Lees AJ, Schrag A (2010) What are the most important nonmotor symptoms in patients with Parkinson’s disease and are we missing them? Mov Disord 25:2493–2500.  https://doi.org/10.1002/mds.23394 CrossRefPubMedGoogle Scholar
  4. 4.
    Chaudhuri KR, Healy DG, Schapira AHV, National institude for Clinical Excellence (2006) Non-motor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol 5:235–245.  https://doi.org/10.1016/S1474-4422(06)70373-8 CrossRefPubMedGoogle Scholar
  5. 5.
    Reijnders JSAM, Ehrt U, Weber WEJ et al (2008) A systematic review of prevalence studies of depression in Parkinson’s disease. Mov Disord 23:183–189.  https://doi.org/10.1002/mds.21803 CrossRefPubMedGoogle Scholar
  6. 6.
    Richard IH (2005) Anxiety disorders in Parkinson’s disease. Adv Neurol 96:42–55PubMedGoogle Scholar
  7. 7.
    Aarsland D, Kramberger MG (2015) Neuropsychiatric symptoms in Parkinson’s disease. J Parkinsons Dis 5:659–667.  https://doi.org/10.3233/JPD-150604 CrossRefPubMedGoogle Scholar
  8. 8.
    Tholfsen LK, Larsen JP, Schulz J et al (2015) Development of excessive daytime sleepiness in early Parkinson disease. Neurology 85:162–168.  https://doi.org/10.1212/WNL.0000000000001737 CrossRefPubMedGoogle Scholar
  9. 9.
    Gjerstad MD, Alves G, Wentzel-Larsen T et al (2006) Excessive daytime sleepiness in Parkinson disease: is it the drugs or the disease? Neurology 67:853–858.  https://doi.org/10.1212/01.wnl.0000233980.25978.9d CrossRefPubMedGoogle Scholar
  10. 10.
    Bjørnarå KA, Dietrichs E, Toft M (2014) Clinical features associated with sleep disturbances in Parkinson’s disease. Clin Neurol Neurosurg 124:37–43.  https://doi.org/10.1016/j.clineuro.2014.06.027 CrossRefPubMedGoogle Scholar
  11. 11.
    Xiang Y, Xu Q, Sun Q et al (2019) Clinical features and correlates of excessive daytime sleepiness in Parkinson’s disease. Front Neurol.  https://doi.org/10.3389/fneur.2019.00121 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Cochen De Cock V, Bayard S, Jaussent I et al (2014) Daytime sleepiness in Parkinson’s disease: a reappraisal. PLoS One 9:e107278.  https://doi.org/10.1371/journal.pone.0107278 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Videnovic A, Golombek D (2013) Circadian and sleep disorders in Parkinson’s disease. Exp Neurol 243:45–56.  https://doi.org/10.1016/j.expneurol.2012.08.018 CrossRefPubMedGoogle Scholar
  14. 14.
    Videnovic A, Noble C, Reid KJ et al (2014) Circadian melatonin rhythm and excessive daytime sleepiness in Parkinson disease. JAMA Neurol 71:463–469.  https://doi.org/10.1001/jamaneurol.2013.6239 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Shirani A, St Louis EK (2009) Illuminating rationale and uses for light therapy. J Clin Sleep Med 5:155–163PubMedPubMedCentralGoogle Scholar
  16. 16.
    PURLs: light therapy for nonseasonal major depressive disorder? PubMed—NCBI. https://www.ncbi.nlm.nih.gov/pubmed/27565102. Accessed 30 Apr 2019
  17. 17.
    Perera S, Eisen R, Bhatt M et al (2016) Light therapy for non-seasonal depression: systematic review and meta-analysis. BJPsych Open 2:116–126.  https://doi.org/10.1192/bjpo.bp.115.001610 CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Slama H, Deliens G, Schmitz R et al (2015) Afternoon nap and bright light exposure improve cognitive flexibility post lunch. PLoS One.  https://doi.org/10.1371/journal.pone.0125359 CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Botanov Y, Ilardi SS (2013) The acute side effects of bright light therapy: a placebo-controlled investigation. PLoS One 8:e75893.  https://doi.org/10.1371/journal.pone.0075893 CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Bragard I, Coucke PA (2013) Impact of the use of Luminette® on well-being at work in a radiotherapy department. Cancer Radiother 17:731–735.  https://doi.org/10.1016/j.canrad.2013.05.014 CrossRefPubMedGoogle Scholar
  21. 21.
    Schmidt C, Xhrouet M, Hamacher M et al (2018) Light exposure via a head-mounted device suppresses melatonin and improves vigilant attention without affecting cortisol and comfort: head-mounted light, melatonin, vigilance, & comfort. PsyCh J 7:163–175.  https://doi.org/10.1002/pchj.215 CrossRefPubMedGoogle Scholar
  22. 22.
    Langevin RH, Laurent A, Sauvé Y (2014) Évaluation préliminaire de l’efficacité de la Luminette® chez des adolescents atteints du syndrome de retard de phase du sommeil (SRPS): essai randomisé en simple insu et contrôlé par placebo. Médecine du Sommeil 11:91–97.  https://doi.org/10.1016/j.msom.2014.03.003 CrossRefGoogle Scholar
  23. 23.
    Paus S, Schmitz-Hübsch T, Wüllner U et al (2007) Bright light therapy in Parkinson’s disease: a pilot study. Mov Disord 22:1495–1498.  https://doi.org/10.1002/mds.21542 CrossRefPubMedGoogle Scholar
  24. 24.
    Willis GL, Moore C, Armstrong SM (2012) A historical justification for and retrospective analysis of the systematic application of light therapy in Parkinson’s disease. Rev Neurosci 23:199–226.  https://doi.org/10.1515/revneuro-2011-0072 CrossRefPubMedGoogle Scholar
  25. 25.
    Videnovic A, Klerman EB, Wang W et al (2017) Timed light therapy for sleep and daytime sleepiness associated with parkinson disease: a randomized clinical trial. JAMA Neurol 74:411–418.  https://doi.org/10.1001/jamaneurol.2016.5192 CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Willis GL, Boda J, Freelance CB (2018) Polychromatic light exposure as a therapeutic in the treatment and management of Parkinson’s disease: a controlled exploratory trial. Front Neurol 9:741.  https://doi.org/10.3389/fneur.2018.00741 CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Rutten S, Vriend C, Smit JH et al (2019) Bright light therapy for depression in Parkinson disease: a randomized controlled trial. Neurology 92:e1145–e1156.  https://doi.org/10.1212/WNL.0000000000007090 CrossRefPubMedGoogle Scholar
  28. 28.
    Research randomizer. https://www.randomizer.org/. Accessed 26 Apr 2019
  29. 29.
    Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370CrossRefGoogle Scholar
  30. 30.
    Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545CrossRefGoogle Scholar
  31. 31.
    Fisk JD, Ritvo PG, Ross L et al (1994) Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clin Infect Dis 18(Suppl 1):S79–S83CrossRefGoogle Scholar
  32. 32.
    Johns M, Hocking B (1997) Daytime sleepiness and sleep habits of Australian workers. Sleep 20:844–849CrossRefGoogle Scholar
  33. 33.
    Epworth Sleepiness Scale—The Official Website of the Epworth Sleepiness Scale (ESS & ESS-CHAD). http://epworthsleepinessscale.com/. Accessed 26 Apr 2019
  34. 34.
    WMA—The World Medical Association-WMA declaration of Helsinki—ethical principles for medical research involving human subjects. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/. Accessed 26 May 2019

Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  1. 1.Neurology DepartmentClinique Saint-Pierre OttigniesOttignies-Louvain-La-NeuveBelgium
  2. 2.Medical WriterAndrade-Evrard SPRLTourinnes Saint LambertBelgium
  3. 3.Nuclear Medicine DepartmentGrand Hôpital de CharleroiCharleroiBelgium
  4. 4.Student at Faculté des Sciences de la MotricitéUniversité Catholique de LouvainLouvain-La-NeuveBelgium

Personalised recommendations