Effects of Bright Light Therapy in Mild Traumatic Brain Injury
| Status: | Completed |
|---|---|
| Conditions: | Insomnia Sleep Studies, Hospital, Neurology |
| Therapuetic Areas: | Neurology, Psychiatry / Psychology, Other |
| Healthy: | No |
| Age Range: | 18 - 50 |
| Updated: | 11/8/2014 |
| Start Date: | December 2010 |
| End Date: | December 2013 |
| Contact: | Maia Kipman |
| Email: | mkipman@mclean.harvard.edu |
| Phone: | 617-855-2239 |
Effects of Bright Light Therapy of Sleep, Cognition, Brain Function, and Neurochemistry in Mild Traumatic Brain Injury
Mild traumatic brain injuries (mTBI) or "concussions" are an increasingly prevalent injury
in our society. Patients with post-concussion syndrome have been shown to have deficits on
tests of short term memory, divided attention, multi-tasking, information processing speed,
and reaction time, as well as alteration in mood and emotional functioning. Many patients
have other vague complaints including fatigue, dizziness, irritability, sleep disturbances,
and chronic headaches. Furthermore, sleep disruption of one of the most common complaints in
patients suffering from traumatic brain injuries, with as many as 40 to 65% of patients with
mTBI complaining of insomnia. Sleep problems in these patients are associated with poorer
outcome, while resolution of the sleep disturbance is associated with improvement in
cognitive functioning.
Despite recent evidence of the correlation between sleep quality and recovery from traumatic
brain injury, and the well-established role of sleep in neural plasticity and neurogenesis,
there have been virtually no direct studies of the causal effects of sleep on recovery
following mTBI. However, it is quite likely that sleep plays a critical role in recovery
following brain injury.
A particularly promising non-pharmacologic approach that shows potential in
improving/modifying abnormalities of the circadian rhythm and sleep-wake schedule is bright
light therapy. For the proposed investigation, we hypothesize that bright light therapy may
be helpful in improving the sleep of patients with a recent history of mTBI and may also
have other mood elevating effects, both of which should promote positive treatment outcome
in these individuals. Bright light therapy may increase the likelihood that they will
recover more quickly, benefit more extensively from other forms of therapy, and build
emotional and cognitive resilience.
in our society. Patients with post-concussion syndrome have been shown to have deficits on
tests of short term memory, divided attention, multi-tasking, information processing speed,
and reaction time, as well as alteration in mood and emotional functioning. Many patients
have other vague complaints including fatigue, dizziness, irritability, sleep disturbances,
and chronic headaches. Furthermore, sleep disruption of one of the most common complaints in
patients suffering from traumatic brain injuries, with as many as 40 to 65% of patients with
mTBI complaining of insomnia. Sleep problems in these patients are associated with poorer
outcome, while resolution of the sleep disturbance is associated with improvement in
cognitive functioning.
Despite recent evidence of the correlation between sleep quality and recovery from traumatic
brain injury, and the well-established role of sleep in neural plasticity and neurogenesis,
there have been virtually no direct studies of the causal effects of sleep on recovery
following mTBI. However, it is quite likely that sleep plays a critical role in recovery
following brain injury.
A particularly promising non-pharmacologic approach that shows potential in
improving/modifying abnormalities of the circadian rhythm and sleep-wake schedule is bright
light therapy. For the proposed investigation, we hypothesize that bright light therapy may
be helpful in improving the sleep of patients with a recent history of mTBI and may also
have other mood elevating effects, both of which should promote positive treatment outcome
in these individuals. Bright light therapy may increase the likelihood that they will
recover more quickly, benefit more extensively from other forms of therapy, and build
emotional and cognitive resilience.
Inclusion Criteria:
- Age range between 18 and 50.
- Subjects must be right handed.
- The primary language of the subjects must be English.
- Subjects have experienced a "concussion" or mTBI within the preceding 18 months, but
no sooner that 4 weeks prior to their screening. The occurrence of a concussion or
mTBI must be documented by a medical report or other professional witness
documentation.
- If documented, Glasgow Coma Scale in the range of 13-15 following the injury.
- Subjects must have complaints of sleep difficulties that emerged or worsened
following the most recent head injury.
- At least half of subjects must have evidence of sleep onset insomnia or delayed sleep
phase disorder.
Exclusion Criteria:
- Any other history of neurological illness, current DSM-IV Axis I disorder, lifetime
history of psychotic disorder, or head injury with loss of consciousness > 30 minutes
- Complicating medical conditions that may influence the outcome of neuropsychological
assessment or functional imaging (e.g., HIV, brain tumor, etc.)
- Mixed or left-handedness
- Abnormal visual acuity that is not corrected by contact lenses
- Contraindicated conditions noted by the manufacture of the light device such as the
use of photosynthesizing medications, history of cataract surgery, and pre-existing
eye conditions.
- Metal within the body, claustrophobia, or other contraindications for neuroimaging
- Less than 9th grade education
- Excess current alcohol use (more than 2 instances of intake of 5+ drinks (men) when
or 4+ drinks (women) when drinking in the past two months, and/or on average drinking
> 2 drinks per day (men); > 1 drinks per day (women) during the past two months
- History of alcoholism or substance use disorder
- Significant use of illicit drugs
- History of marijuana use within the past 6 weeks, use of marijuana before the age of
16, and/or use of > 20 marijuana cigarettes throughout the participant's lifetime.
- Subjects who engage in shift-work, night work, or who have substantially
desynchronized work-sleep schedules (i.e., sleeping later than 10:00 a.m. more than
once a week) will be excluded
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