Department of Neurology, Union Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China; Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou 350001, Fujian, China; Department of Clinical Medicine, Fujian Medical University, Fuzhou 350001, Fujian, China.
College of Information Engineering, Guangdong University of Technology, Guangzhou, 510006, Guangdong, China.
Sleep Med. 2021 Jul;83:280-289. doi: 10.1016/j.sleep.2021.03.035. Epub 2021 Apr 3.
BACKGROUND: Depression and sleep disturbance are well-recognized non-motor features in patients with Parkinson's disease (PD). This meta-analysis aimed to explore the potential role of bright light therapy (BLT) in depression and sleep disturbances in Parkinson's Disease (PD). METHODS: Four databases were independently searched by two reviewers: PubMed, Cochrane, Web of Science and Embase until February 2021. We evaluated the following depression related scales: Beck's Depression Inventory (BDI); the Geriatric Depression Rating Scale, 30-item (GDS-30); the Hamilton Depression Rating Scale (HDRS); the Hospital Anxiety and Depression Scale (HADS); the Epworth sleepiness scale (ESS); the Fatigue Severity Scale (FSS); the Pittsburgh sleep quality index (PSQI); the Parkinson's disease sleep scale (PDSS); Scales for Outcomes in Parkinson's disease Sleep Scale (SCOPA) and the Insomnia severity index (ISI) to access the effects of bright light therapy on depression and sleep disturbances in patients with PD. Effect size (standardized mean deviation [SMD] and 95% confidence interval [CI]) were used to analyze the continuous results data of intervention group and control light group. Data from five randomized, controlled trials totaling 173 patients with PD was included. RESULTS: BLT significantly improved depression symptoms (BDI, GDS-30, HDRS and HADS) of PD patients (0.34, 95% CI = 0.06-0.61). Insomnia symptoms (SCOPA and ISI) for patients with PD were significantly improved by BLT as well (1.15, 95% CI = 0.71-1.60). Whereas, no difference was observed in the control light group in improving the depression or insomnia symptoms of PD patients. CONCLUSION: BLT is an effective intervention for improving depressive symptoms and sleep disturbances in patients with PD.
背景:抑郁和睡眠障碍是帕金森病(PD)患者公认的非运动特征。本荟萃分析旨在探讨强光治疗(BLT)在帕金森病(PD)患者抑郁和睡眠障碍中的潜在作用。
方法:由两位审查员独立对四个数据库(PubMed、Cochrane、Web of Science 和 Embase)进行检索,检索时间截至 2021 年 2 月。我们评估了以下与抑郁相关的量表:贝克抑郁量表(BDI);老年抑郁量表,30 项(GDS-30);汉密尔顿抑郁量表(HDRS);医院焦虑和抑郁量表(HADS);Epworth 嗜睡量表(ESS);疲劳严重程度量表(FSS);匹兹堡睡眠质量指数(PSQI);帕金森病睡眠量表(PDSS);帕金森病睡眠量表评定量表(SCOPA)和失眠严重程度指数(ISI),以评估 BLT 对 PD 患者抑郁和睡眠障碍的影响。采用标准化均数差(SMD)和 95%置信区间(CI)分析干预组和对照组的连续结果数据。共纳入五项随机对照试验,共 173 例 PD 患者。
结果:BLT 可显著改善 PD 患者的抑郁症状(BDI、GDS-30、HDRS 和 HADS)(0.34,95%CI=0.06-0.61)。BLT 也显著改善了 PD 患者的失眠症状(SCOPA 和 ISI)(1.15,95%CI=0.71-1.60)。然而,对照组在改善 PD 患者的抑郁或失眠症状方面没有差异。
结论:BLT 是改善 PD 患者抑郁症状和睡眠障碍的有效干预措施。
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