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Light Therapy for PD - Dose Selection

Primary Purpose

Parkinson Disease, Sleep Disorder, Fatigue

Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
SunRay Light Boxes
Sponsored by
Massachusetts General Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Parkinson Disease focused on measuring Parkinson Disease, Light therapy

Eligibility Criteria

45 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Diagnosis of idiopathic PD as defined by the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease;
  2. PD Hoehn and Yahr stage 2-4;
  3. A score of 2 (mild) or above on the Sleep Problems question of the MDS-UPDRS Part 1;
  4. Stable dose of all PD medications for at least 30 days prior to randomization;
  5. Willingness to wear an Actiwatch and complete daily sleep logs;
  6. Age 45 or above

Exclusion Criteria:

  1. Atypical or secondary forms of parkinsonism;
  2. Co-existent significant sleep apnea at screening, as determined by the PI's clinical assessment; adequately treated sleep apnea, as assessed by sleep apnea machine download (CPAP download) will be permitted;
  3. Co-existent symptomatic restless legs syndrome (RLS) (as assessed by the International Classification of Sleep Disorders (ICDS) diagnostic criteria for RLS) at screening;
  4. Cognitive impairment as determined by a Mini Mental State Examination score <25 at screening;
  5. Presence of moderate depression defined as a Beck Depression Inventory II (BDI-II) score ≥20 at screening;
  6. Current untreated hallucinations or psychosis (drug-induced or spontaneous) with a score of 2 or above on the Hallucinations and Psychosis question of the MDS-UPDRS Part 2;
  7. Use of hypno-sedative drugs for sleep or stimulants, unless the participant has been on a stable dose for at least 60 days prior to the screening;
  8. Ongoing or recent (within 30 days prior to screening) Cognitive Behavioral Therapy for Insomnia;
  9. Use of antidepressants, unless the participant has been on a stable dose for at least 60 days prior to the screening;
  10. Work hours between 10 PM and 6 AM, within 60 days prior to randomization or anticipated during the 16 weeks after screening;
  11. Travel between 3 or more time zones within 45 days prior to study screening or anticipated such travel during the 16 weeks after screening;
  12. Unstable or serious medical illness;
  13. History of significant eye trauma or disease, retinopathy, or cataract Grade 4 that would significantly affect transmission or processing of light through either eye;
  14. Current use, use at any time during study participation, or use within the 30 days prior to screening of photosensitizing or other medications that in the opinion of the investigator would interfere with the safety of the participant during the trial, including: amiodarone, porfimer, psoralens, chlorpromazine, quinidine, demeclocycline, temoporfin, tetracycline, fleroxacin, oral isoretinoin, voriconazole, nalidixic acid, thioridazine, St. John's wort, ofloxacin, and piroxicam;
  15. Pregnant women will be excluded from participation; if a participant is pre-menopausal, a urine pregnancy test will be conducted at randomization to determine eligibility.

Sites / Locations

  • University of Alabama
  • Barrow Neurological Institute
  • UC Irvine
  • UC Davis
  • Yale University
  • University of Miami
  • Northwestern University
  • University of Iowa
  • Massachusetts General Hospital
  • Beth Israel Deaconess Medical Center
  • University of Michigan
  • Washington University in St. Louis
  • Weill Cornell
  • Mount Sinai - Icahn School of Medicine
  • University of Rochester
  • SUNY Stonybrook
  • SUNY Upstate
  • Wake Forest University
  • University of Cincinnati
  • Ohio State University
  • University of Pennsylvania
  • University of Pittsburgh
  • Vanderbilt University
  • University of Utah
  • University of Virginia

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

BWLT once daily

BWLT twice daily

BWLT weekly

DRLT twice daily

Arm Description

Participants in this arm will receive bright white light therapy daily once a day (in the evening)

Participants in this arm will receive bright white light therapy daily twice a day (morning and evening).

Participants in this arm will receive bright white light therapy once weekly (in the evening).

Participants in this arm will receive dim red light twice daily (morning and evening).

Outcomes

Primary Outcome Measures

PDSS-2
The PDSS-2 is a 15-question instrument designed to simultaneously capture the multidimensional aspects of sleep-related problems and changes in sleep quality.

Secondary Outcome Measures

PFS-16
The PFS-16 is a patient-rated scale that measures fatigue. The scale allows the measurements of the presence of fatigue (seven items) and its impact on daily function (nine items).

Full Information

First Posted
February 27, 2020
Last Updated
December 13, 2022
Sponsor
Massachusetts General Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT04291014
Brief Title
Light Therapy for PD - Dose Selection
Official Title
A Dose Selection Trial of Light Therapy for Impaired Sleep in Parkinson's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 11, 2020 (Actual)
Primary Completion Date
November 12, 2022 (Actual)
Study Completion Date
April 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Massachusetts General Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study aims to determine the most effective dose of light therapy to improve sleep in people with Parkinson's Disease. Four groups of participants will receive bright-white or dim-red light therapy at different times throughout the day.
Detailed Description
This is a 16-week, randomized, phase II, parallel-group, dose-selection clinical trial of LT in participants with PD and co-existing sleep disruption using a comparative selection trial design.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Parkinson Disease, Sleep Disorder, Fatigue
Keywords
Parkinson Disease, Light therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
This is a 16-week, randomized, phase II, parallel-group, dose-selection clinical trial of LT in participants with PD and co-existing sleep disruption using a comparative selection trial design.
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
144 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
BWLT once daily
Arm Type
Experimental
Arm Description
Participants in this arm will receive bright white light therapy daily once a day (in the evening)
Arm Title
BWLT twice daily
Arm Type
Experimental
Arm Description
Participants in this arm will receive bright white light therapy daily twice a day (morning and evening).
Arm Title
BWLT weekly
Arm Type
Experimental
Arm Description
Participants in this arm will receive bright white light therapy once weekly (in the evening).
Arm Title
DRLT twice daily
Arm Type
Experimental
Arm Description
Participants in this arm will receive dim red light twice daily (morning and evening).
Intervention Type
Device
Intervention Name(s)
SunRay Light Boxes
Intervention Description
SunRay light boxes will be used to administer the light therapy.
Primary Outcome Measure Information:
Title
PDSS-2
Description
The PDSS-2 is a 15-question instrument designed to simultaneously capture the multidimensional aspects of sleep-related problems and changes in sleep quality.
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
PFS-16
Description
The PFS-16 is a patient-rated scale that measures fatigue. The scale allows the measurements of the presence of fatigue (seven items) and its impact on daily function (nine items).
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of idiopathic PD as defined by the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease; PD Hoehn and Yahr stage 2-4; A score of 2 (mild) or above on the Sleep Problems question of the MDS-UPDRS Part 1; Stable dose of all PD medications for at least 30 days prior to randomization; Willingness to wear an Actiwatch and complete daily sleep logs; Age 45 or above Exclusion Criteria: Atypical or secondary forms of parkinsonism; Co-existent significant sleep apnea at screening, as determined by the PI's clinical assessment; adequately treated sleep apnea, as assessed by sleep apnea machine download (CPAP download) will be permitted; Co-existent symptomatic restless legs syndrome (RLS) (as assessed by the International Classification of Sleep Disorders (ICDS) diagnostic criteria for RLS) at screening; Cognitive impairment as determined by a Mini Mental State Examination score <25 at screening; Presence of moderate depression defined as a Beck Depression Inventory II (BDI-II) score ≥20 at screening; Current untreated hallucinations or psychosis (drug-induced or spontaneous) with a score of 2 or above on the Hallucinations and Psychosis question of the MDS-UPDRS Part 2; Use of hypno-sedative drugs for sleep or stimulants, unless the participant has been on a stable dose for at least 60 days prior to the screening; Ongoing or recent (within 30 days prior to screening) Cognitive Behavioral Therapy for Insomnia; Use of antidepressants, unless the participant has been on a stable dose for at least 60 days prior to the screening; Work hours between 10 PM and 6 AM, within 60 days prior to randomization or anticipated during the 16 weeks after screening; Travel between 3 or more time zones within 45 days prior to study screening or anticipated such travel during the 16 weeks after screening; Unstable or serious medical illness; History of significant eye trauma or disease, retinopathy, or cataract Grade 4 that would significantly affect transmission or processing of light through either eye; Current use, use at any time during study participation, or use within the 30 days prior to screening of photosensitizing or other medications that in the opinion of the investigator would interfere with the safety of the participant during the trial, including: amiodarone, porfimer, psoralens, chlorpromazine, quinidine, demeclocycline, temoporfin, tetracycline, fleroxacin, oral isoretinoin, voriconazole, nalidixic acid, thioridazine, St. John's wort, ofloxacin, and piroxicam; Pregnant women will be excluded from participation; if a participant is pre-menopausal, a urine pregnancy test will be conducted at randomization to determine eligibility.
Facility Information:
Facility Name
University of Alabama
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
Facility Name
Barrow Neurological Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Facility Name
UC Irvine
City
Irvine
State/Province
California
ZIP/Postal Code
92697
Country
United States
Facility Name
UC Davis
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Yale University
City
Fairfield
State/Province
Connecticut
ZIP/Postal Code
06824
Country
United States
Facility Name
University of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Iowa
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Washington University in St. Louis
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Weill Cornell
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Mount Sinai - Icahn School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
University of Rochester
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
SUNY Stonybrook
City
Stony Brook
State/Province
New York
ZIP/Postal Code
11794
Country
United States
Facility Name
SUNY Upstate
City
Syracuse
State/Province
New York
ZIP/Postal Code
13210
Country
United States
Facility Name
Wake Forest University
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27104
Country
United States
Facility Name
University of Cincinnati
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
Ohio State University
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43221
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
University of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
Vanderbilt University
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22903
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
This trial will follow the NINDS policy for data sharing.
Citations:
PubMed Identifier
17612949
Citation
Willis GL, Turner EJ. Primary and secondary features of Parkinson's disease improve with strategic exposure to bright light: a case series study. Chronobiol Int. 2007;24(3):521-37. doi: 10.1080/07420520701420717.
Results Reference
background
PubMed Identifier
17516492
Citation
Paus S, Schmitz-Hubsch T, Wullner U, Vogel A, Klockgether T, Abele M. Bright light therapy in Parkinson's disease: a pilot study. Mov Disord. 2007 Jul 30;22(10):1495-1498. doi: 10.1002/mds.21542.
Results Reference
background
PubMed Identifier
10584776
Citation
Terman M, Terman JS. Bright light therapy: side effects and benefits across the symptom spectrum. J Clin Psychiatry. 1999 Nov;60(11):799-808; quiz 809.
Results Reference
background
PubMed Identifier
7832227
Citation
Gallin PF, Terman M, Reme CE, Rafferty B, Terman JS, Burde RM. Ophthalmologic examination of patients with seasonal affective disorder, before and after bright light therapy. Am J Ophthalmol. 1995 Feb;119(2):202-10. doi: 10.1016/s0002-9394(14)73874-7.
Results Reference
background
PubMed Identifier
28241159
Citation
Videnovic A, Klerman EB, Wang W, Marconi A, Kuhta T, Zee PC. Timed Light Therapy for Sleep and Daytime Sleepiness Associated With Parkinson Disease: A Randomized Clinical Trial. JAMA Neurol. 2017 Apr 1;74(4):411-418. doi: 10.1001/jamaneurol.2016.5192.
Results Reference
background
PubMed Identifier
21312275
Citation
Trenkwalder C, Kohnen R, Hogl B, Metta V, Sixel-Doring F, Frauscher B, Hulsmann J, Martinez-Martin P, Chaudhuri KR. Parkinson's disease sleep scale--validation of the revised version PDSS-2. Mov Disord. 2011 Mar;26(4):644-52. doi: 10.1002/mds.23476. Epub 2011 Feb 10.
Results Reference
background
PubMed Identifier
15619463
Citation
Brown RG, Dittner A, Findley L, Wessely SC. The Parkinson fatigue scale. Parkinsonism Relat Disord. 2005 Jan;11(1):49-55. doi: 10.1016/j.parkreldis.2004.07.007.
Results Reference
background

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Light Therapy for PD - Dose Selection

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