Bright light therapy for depression in Parkinson disease

Feb 17, 2019Neurology

Bright light therapy for depression in people with Parkinson's disease: A controlled clinical trial

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Abstract

Eighty-three participants were enrolled in a trial assessing bright light therapy (BLT) for depressive symptoms in Parkinson disease and major depressive disorder.

Both bright light therapy and control light conditions resulted in decreased depressive symptoms, but without significant differences between them.
Subjective sleep quality improved more in the bright light therapy group compared to the control group.
Total salivary cortisol secretion decreased in the bright light therapy group, while it increased in the control group.
Overall, bright light therapy was not found to be more effective than control light in reducing depressive symptoms.

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OBJECTIVE: 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.

METHODS: In 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.

RESULTS: We 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],= 0.04). Total salivary cortisol secretion decreased in the BLT group, while it increased in the control group (B [SE] = -8.11 [3.93],= 0.04). p p

CONCLUSION: BLT 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.

CLINICALTRIALSGOV IDENTIFIER: NCT01604876.

CLASSIFICATION OF EVIDENCE: This 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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Bright light therapy for depression in Parkinson disease

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