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Light Therapy in Parkinson's Disease

Overview

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Light Therapy in Parkinson's Disease

Overview

Mermaid diagram (expand to render)

This clinical trial investigates the effects of bright light therapy on motor symptoms and sleep disorders in patients with Parkinson's disease. The study is conducted at the Second Affiliated Hospital of Soochow University in Suzhou, China.

Bright light therapy is a non-invasive intervention that uses controlled exposure to bright artificial light to help regulate circadian rhythms. In Parkinson's disease, circadian rhythm disturbances are common and contribute to sleep disorders, mood disturbances, and potentially motor symptom fluctuations.

Trial Details

| Parameter | Value |
|-----------|-------|
| NCT Number | NCT06129942 |
| Title | Light Therapy in Parkinson's Disease |
| Status | Recruiting |
| Phase | Not Applicable |
| Sponsor | Second Affiliated Hospital of Soochow University |
| Principal Investigator | Chun-Feng Liu, PhD |
| Enrollment | 50 participants (estimated) |
| Start Date | September 1, 2021 |
| Primary Completion | May 16, 2026 (estimated) |
| Location | Suzhou, Jiangsu, China |

Study Design

| Design Element | Details |
|----------------|---------|
| Type | Interventional |
| Allocation | Randomized |
| Intervention Model | Crossover |
| Primary Purpose | Treatment |
| Masking | Double-blind (Participant, Investigator) |

Intervention Arms

Bright Light Group (Experimental)

Patients receive bright light therapy using a light box operating at 10,000 lux intensity:

Duration: 1 hour daily
Timing: 08:00-11:00 in the morning and 17:00-19:00 in the afternoon
Treatment Period: 1 month
Distance: Within 65cm from the light box
Instructions: Patients should move under the light source but should not fall asleep

The light box uses a spectrally transparent prism diffuser that blocks ultraviolet rays while preserving light quality.

Dim Light Group (Control/Placebo)

Patients receive placebo treatment using a device operating at 300 lux intensity:

Duration: 1 hour daily
Timing: 08:00-11:00 in the morning and 17:00-19:00 in the afternoon
Treatment Period: 1 month
Distance: Within 65cm from the light box

Mechanism of Action

Circadian Rhythm Dysfunction in PD

Parkinson's disease is associated with significant circadian rhythm disturbances:

Suprachiasmatic Nucleus (SCN) dysfunction: The master circadian clock shows impaired function in PD

Melatonin production alterations: Reduced melatonin secretion affects sleep-wake cycles

Dopaminergic regulation: Dopamine itself plays a role in circadian timing

Sleep architecture disruption: Common findings include reduced sleep efficiency, REM sleep behavior disorder, and periodic limb movements

Light Therapy Mechanism

Bright light therapy exerts its effects through:

Retinal-hypothalamic pathway: Light enters the eye and signals the suprachiasmatic nucleus

Melatonin suppression: Bright light in the morning reduces melatonin production, strengthening the circadian rhythm

Phase response curve: Timing of light exposure shifts circadian phase - morning light advances the rhythm

Dopamine modulation: Light may directly or indirectly influence dopaminergic function

Rationale for Light Therapy in PD

Clinical evidence suggests bright light therapy may benefit PD patients through:

Sleep improvement: Enhanced sleep quality and efficiency
Mood enhancement: Reduction in depressive symptoms
Motor symptom modulation: Potential improvement in motor function
Non-motor symptom relief: Addressing circadian-related non-motor symptoms

Eligibility Criteria

Inclusion Criteria

Meet MDS (Movement Disorder Society) diagnostic criteria for Parkinson's disease

Hoehn and Yahr stages 2-3 (mild to moderate PD)

Stable drug treatment for at least 1 month

Willing to maintain stable medication throughout the study period

Signed informed consent

Exclusion Criteria

Sleep-related

Using hypnotic or stimulating drugs
Sleep phase delay/advance syndrome
Shift work or jet lag

Visual

Visual impairment (cataract, glaucoma, blindness)

Cognitive

Cognitive impairment (MMSE < 24)

Psychiatric

Uncontrollable hallucinations
Mental diseases
Antidepressants (except if stable for >3 months)

Outcomes

Primary Outcomes

| Outcome | Assessment Timing |
|---------|-------------------|
| Total Sleep Time (TST) by polysomnography | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| Sleep Efficiency by polysomnography | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| REM Sleep Without Atonia (RWA) by PSG | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| Sleep Onset Latency by PSG | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| Periodic Limb Movement during Sleep (PLMS) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| Sleep Stage Duration and Percentage | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| Slow Wave Activity (SWA) and Slow Wave Energy (SWE) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |

Secondary Outcomes

| Outcome | Assessment Timing |
|---------|-------------------|
| MDS-UPDRS Score | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| Hoehn-Yahr Scale | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| PDSS-2 (Parkinson's Disease Sleep Scale-2) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| PSQI (Pittsburgh Sleep Quality Index) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| RBDQ-HK (REM Sleep Behavior Disorder Questionnaire-Hong Kong) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| ESS (Epworth Sleepiness Scale) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| MEQ (Morningness-Eveningness Questionnaire) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| HAMA (Hamilton Anxiety Scale) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| HAMD-24 (Hamilton Depression Scale-24) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| MoCA (Montreal Cognitive Assessment) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| NMSQ (Non-Motor Symptoms Questionnaire) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| PDQ-39 (Parkinson's Disease Questionnaire-39) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| FSS (Fatigue Severity Scale) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| EEG (Electroencephalogram) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| Melatonin rhythmic level (serum and saliva) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| Cortisol rhythmic level (serum and saliva) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |
| fMRI (functional Magnetic Resonance Imaging) | Visit 1 (baseline), Visit 2 (Week 4), Visit 3 (Week 8), Visit 4 (Week 12) |

Significance for Parkinson's Disease

Sleep Disorders in PD

Sleep disturbances are among the most common non-motor symptoms in Parkinson's disease:

REM Sleep Behavior Disorder (RBD): Present in up to 50% of PD patients
Insomnia: Difficulty initiating or maintaining sleep
Excessive daytime sleepiness: Present in up to 40% of patients
Periodic limb movement disorder: Affects sleep quality

Current Treatment Limitations

Current PD therapies primarily target:

Dopamine replacement (levodopa, agonists)
Deep brain stimulation
Physical therapy

However, these do not adequately address circadian rhythm disturbances.

Potential Benefits of Light Therapy

Light therapy offers several advantages:

Non-invasive: No surgical risk or drug side effects

Targeted: Addresses circadian rhythm dysfunction

Adjunctive: Can be combined with standard PD medications

Modular: Can be adjusted in timing and intensity

Physiological: Works with the body's natural circadian machinery

Comparison with Other Light Therapy Studies for PD

| Study | Intensity | Duration | Key Findings |
|-------|-----------|----------|--------------|
| This trial (NCT06129942) | 10,000 lux | 1 month | PSG sleep metrics, MDS-UPDRS |
| Videnovic et al. 2017 | 10,000 lux | 2 weeks | Improved sleep quality, daytime sleepiness |
| Rutten et al. 2019 | 10,000 lux | 6 weeks | Improved depression scores |
| Paus et al. 2007 | 5,000 lux | 4 weeks | Improved motor scores |

Cross-Links

[Parkinson's Disease](/diseases/parkinsons-disease)
[Sleep Disorders in Parkinson's Disease](/diseases/parkinsons-disease)
[Circadian Rhythm](/diseases/circadian-rhythm-disorders)
[Melatonin](/proteins/melatonin)
[Suprachiasmatic Nucleus](/brain-regions/suprachiasmatic-nucleus)
[Non-Motor Symptoms of PD](/diseases/parkinsons-disease)

Contact Information

Principal Investigator: Chun-Feng Liu, PhD
Institution: Second Affiliated Hospital of Soochow University
Department: Department of Neurology
City: Suzhou, Jiangsu, China
Phone: +86 512 67783307
Email: liuchunfeng@suda.edu.cn

References

[NCT06129942 - Light Therapy in Parkinson's Disease](https://clinicaltrials.gov/study/NCT06129942)

[Videnovic et al., Timed Light Therapy for Sleep and Daytime Sleepiness Associated With Parkinson Disease. JAMA Neurology (2017)](https://doi.org/10.1001/jamaneurol.2016.5192)

[Rutten et al., Bright light therapy for depression in Parkinson disease: A randomized controlled trial. Neurology (2019)](https://doi.org/10.1212/WNL.0000000000007090)

[Li and Tian, Light Therapy Promoting Dopamine Release by Stimulating Retina in Parkinson Disease. JAMA Neurol (2017)](https://doi.org/10.1001/jamaneurol.2017.1906)

[Paus et al., Bright light therapy in Parkinson's disease: a pilot study. Mov Disord (2007)](https://doi.org/10.1002/mds.21542)

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