Home-based light therapy for fatigue following acquired brain injury: a pilot randomized controlled trial

BMC Neurology

Gershon Spitz¹  Laura J. Connolly¹  Jennie L. Ponsford¹  Jade M. Murray²  Steven W. Lockley³  Shantha M. W. Rajaratnam³ 

[1] Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia;Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia;Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia;Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia;Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, USA;Division of Sleep Medicine, Harvard Medical School, Boston, USA;

关键词: Traumatic brain injury;    Stroke;    Light therapy;    Fatigue;    Sleepiness;    Sleep disturbance;   

DOI  :  10.1186/s12883-021-02292-8

来源: Springer

【 摘 要 】

Background and objectivesFatigue and sleep disturbance are debilitating problems following brain injury and there are no established treatments. Building on demonstrated efficacy of blue light delivered via a lightbox in reducing fatigue and daytime sleepiness after TBI, this study evaluated the efficacy of a novel in-home light intervention in alleviating fatigue, sleep disturbance, daytime sleepiness and depressive symptoms, and in improving psychomotor vigilance and participation in daily productive activity, following injuryMethodsThe impact of exposure to a dynamic light intervention (Treatment) was compared to usual lighting (Control) in a randomized within-subject, crossover trial. Outcomes were fatigue (primary outcome), daytime sleepiness, sleep disturbance, insomnia symptoms, psychomotor vigilance, mood and activity levels. Participants (N = 24, M ± SDage = 44.3 ± 11.4) had mild-severe TBI or stroke > 3 months previously, and self-reported fatigue (Fatigue Severity Scale ≥ 4). Following 2-week baseline, participants completed each condition for 2 months in counter-balanced order, with 1-month follow-up. Treatment comprised daytime blue-enriched white light (CCT > 5000 K) and blue-depleted light (< 3000 K) 3 h prior to sleep.ResultsRandom-effects mixed-model analysis showed no significantly greater change in fatigue on the Brief Fatigue Inventory during Treatment, but a medium effect size of improvement (p = .33, d = -0.42). There were significantly greater decreases in sleep disturbance (p = .004), insomnia symptoms (p = .036), reaction time (p = .004) and improvements in productive activity (p = .005) at end of Treatment relative to Control, with large effect sizes (d > 0.80). Changes in other outcomes were non-significant.ConclusionsThis pilot study provides preliminary support for in-home dynamic light therapy to address sleep-related symptoms in acquired brain injury.Trial registrationThis trial was registered with the Australian and New Zealand Clinical Trials Registry on 13 June 2017, www.anzctr.org.au, ACTRN12617000866303.

【 授权许可】

CC BY