Polychromatic light exposure as a therapeutic in the treatment and management of Parkinson's disease: A controlled exploratory trial

Abstract

Parkinson's disease (PD) is a disorder characterized by loss of dopamine (DA) in the nigro-striatal dopamine (NSD) system with the primary symptoms of bradykinaesia, rigidity, tremor, and altered gate. Secondary symptoms including depression, insomnia, involuntary movement, and psychiatric side effects are also commonly observed. While the treatment focus for the past 50 years has been aimed at replacing deficient DA, to relieve the primary symptoms, more recent studies have suggested that the circadian system plays a critical role in the etiology and treatment of this disorder. Several case studies and open label trials have implemented bright light therapy (BT) in an attempt to repair sleep, depression and even the primary motor symptoms of this disorder, however controlled studies are yet to be fully implemented. In this controlled trial, patients that had been maintained on BT daily for 4 months to 5 years previously were assigned to one of three groups: continued polychromatic light, continued with red light or discontinued polychromatic light for a 2 week period. The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDSUPDRS), The Parkinson's Disease Questionnaire (PDQ-39), The Beck Depression Inventory II, The Beck Anxiety Inventory, The Epworth Sleep Scale (ESS) and a global rating scale were used to assess patients prior to and at 1 and 2 weeks after commencing the trial. Patients continuing polychromatic BT showed significant improvement on the MDSUPDRS Rating Scale (12 points; p = 0.028), the PDQ-39 (10 points; p = 0.011), ESS (4 points; p = 0.013), and numerous motor and secondary symptoms on a global rating scale. Performance on standardized motor tests also incrementally improved in this group while those exposed to red light and those that discontinued BT treatment deteriorated. These results demonstrate that strategically applied polychromatic light was beneficial in reducing many primary motor and secondary symptoms of PD. Further work investigating the role of light in mitigating PD symptoms and involvement of the circadian system will provide further advances in the treatment of PD. Clinical Trial Registration: http://www.anzctr.org.au, identifier ACTRN12617001309370.