A double-blind, controlled trial of circadian effective light therapy in patients with Parkinson's disease.

Abstract

Despite current medical therapy for Parkinson's Disease (PD), many experience persistent motor symptoms and significant unmanaged non-motor issues. Previous studies suggest that light therapy (LT) provides benefits for motor and non-motor features of PD. This study evaluated Circadian Effective LT (CELT) with a spectral band between 460 and 545 ​nm for the motor and non-motor features of PD. We conducted a multi-center, randomized, double-blind, controlled clinical trial of CELT in people with Parkinson's disease on standard-of-care therapy. Ninety-two participants (45 active, 47 control) were randomized 1:1 to active or control CELT for 1 ​h each evening for 6 months. Patients were evaluated in their 'ON state'. The mean (SE) change on the primary endpoint of the MDS-UPDRS parts 1-3 was -17.7(2.8) active vs -9.7(3.5) control, for a LSM difference of -8.0 (4.4) (p ​= ​0.074, 95% Confidence Interval: -16.7, 0.8), reflecting a trend toward improvement over control. Key secondary endpoints included PDQ-39 and CGI which favored active treatment (-5.7 ​± ​2.7; p ​= ​0.038, and -0.4 ​± ​0.2; p ​= ​0.066 respectively), while PDSS-2 Disturbed Sleep showed no difference between groups. Other secondary endpoints that supported the overall treatment effect of CELT included ESS (-1.52 ​± ​0.78; p ​= ​0.054) and CGI-E (-0.3 ​± ​0.2; p ​= ​0.088). Daily LT, with a circadian effective targeted spectrum of light, was well tolerated by PD patients, had no serious adverse effects and showed improvement in both motor and non-motor MDS-UPDRS and other scores. Larger double-blind studies are warranted to further assess the effectiveness of CELT in PD. CLINICALTRIALS.GOV REGISTRATION: NCT02175472.