the light therapy to a strict twice-daily regimen provided
means for structuring daily activities, which itself may be an
interesting possible mechanism underlying the beneficial effects of … light therapy,” Dr. Videnovic and colleagues said.
Future studies should address the optimal treatment parameters for light therapy in Parkinson’s disease, they added.
Whether light therapy produces direct alerting effects,
influences the circadian system, or works through another mechanism is not clear. A limitation of the study was
that light levels were not measured throughout the day,
so patients in the control group could have received more
light from other sources overall, compared with patients
in the active treatment group, the investigators noted.
The study shows that chronobiologic interventions “can
be used therapeutically in patients with Parkinson’s
disease” and “introduce a new concept into the much-
studied phenomenon of disturbed sleep and wakeful-
ness in Parkinson’s disease,” said Birgit Högl, MD, of
the Department of Neurology at the Medical University
of Innsbruck in Austria, in an accompanying editorial.
Although the study of chronobiology is complex, certain
aspects of chronobiology can be “integrated into routine
medical practice and improve outcomes for patients,”
Dr. Högl said. NR
Högl B. Circadian rhythms and chronotherapeutics-Underappreciated approach to improving sleep and wakefulness in Parkinson disease. JAMA Neurol. 2017;74( 4):387-388.
Videnovic A, Klerman EB, Wang W, et al. Timed light therapy for sleep and
daytime sleepiness associated with Parkinson disease: A randomized clinical
trial. JAMA Neurol. 2017;74( 4):411-418.
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