Parkinson Disease Clinical Trial
Official title:
Sixty Minute Exposure of Specific Bandwidth Light for the Treatment of Idiopathic Parkinson's Disease
Light treatment was originally employed in Parkinson's disease (PD) to determine if it might be effective in treating co-existing symptoms of depression and insomnia. However, a preliminary double-blind study as well as other studies reported significant improvement in both motor and co-existing Parkinsonian symptoms. As of yet, no long term double blind study has validated these findings. This study will use a double-blind design to evaluate the safety and efficacy of a non-invasive light therapy device to be used with ongoing pharmacotherapy for PD, over a six month treatment period.
Parkinson's disease (PD) is traditionally described as a disorder of compromised dopamine
(DA) function in the nigro-striatal dopamine (NSD) system. This system extends from the
midbrain, through the hypothalamus and into the forebrain to critical areas involved in the
control of motor performance. Restoration of DA content in this system by administering the
DA precursor L-dopa or DA agonists reinstates motor control, but provides only symptomatic
relief with waning efficacy as the disease advances. Symptoms of depression and sleep
disturbances are also commonly seen in PD patients, and the manifestation of these symptoms
suggests impaired circadian function.
Although the involvement of the circadian system in PD was intimated in the first formal
account of the disorder provided by James Parkinson, it was not until recently that circadian
malfunction has been specifically cited as playing a major role in the development and
progression of the disease. In addition to scattered reports depicting circadian-like
features of PD and related syndromes, a large body of evidence describes the benefits of
light therapy in PD from both the preclinical and clinical perspectives.
While the development of a formal understanding has been largely omitted as to the basis for
any therapeutic effect exerted by light, recent studies have shown that the nigro-striatal
dopamine system is comprised of the same cell type as cells in the retina and the pineal.
Such cells are driven by visual input whereby dopamine and melatonin sit in functional
opposition to regulate day night activities including sleep, mood, reproduction,
anti-oxidation and movement. Hence one may conclude that the circadian system plays a major
role in many aspects of PD.
Recent work in PD has also suggested that the efficacy of light therapy is mediated by
melatonin and dopamine function in the retina. On this basis it would be reasonable to assume
that intervention into the function of the circadian system with light therapy in PD patients
might well serve to modify the course and consequences of the disease. The present study
serves to extend this finding to the point of providing a practical, non-invasive method for
helping patients.
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