Oldham Mark A, Ciraulo Domenic A
Department of Psychiatry, Boston University Medical Center , Boston, MA , USA.
Chronobiol Int. 2014 Apr;31(3):305-19. doi: 10.3109/07420528.2013.833935. Epub 2014 Jan 7.
Bright light therapy (BLT) is considered among the first-line treatments for seasonal affective disorder (SAD), yet a growing body of literature supports its use in other neuropsychiatric conditions including non-seasonal depression. Despite evidence of its antidepressant efficacy, clinical use of BLT remains highly variable internationally. In this article, we explore the autonomic effects of BLT and suggest that such effects may play a role in its antidepressant and chronotherapeutic properties. After providing a brief introduction on the clinical application of BLT, we review the chronobiological effects of BLT on depression and on the autonomic nervous system in depressed and non-depressed individuals with an emphasis on non-seasonal depression. Such a theory of autonomic modulation via BLT could serve to integrate aspects of recent work centered on alleviating allostatic load, the polyvagal theory, the neurovisceral integration model and emerging evidence on the roles of glutamate and gamma-hydroxybutyric acid (GABA).
强光疗法（BLT）被视为季节性情感障碍（SAD）的一线治疗方法之一，然而，越来越多的文献支持其在包括非季节性抑郁症在内的其他神经精神疾病中的应用。尽管有证据表明其具有抗抑郁疗效，但强光疗法在国际上的临床应用仍然存在很大差异。在本文中，我们探讨了强光疗法的自主神经效应，并认为这些效应可能在其抗抑郁和时间治疗特性中发挥作用。在简要介绍强光疗法的临床应用后，我们回顾了强光疗法对抑郁症患者和非抑郁症患者的抑郁及自主神经系统的生物钟学效应，重点关注非季节性抑郁症。通过强光疗法进行自主神经调节的这一理论可以整合近期围绕减轻应激负荷、多元迷走神经理论、神经内脏整合模型以及谷氨酸和γ-羟基丁酸（GABA）作用的新证据等方面的研究工作。
