Connolly Laura J, Rajaratnam Shantha M W, Spitz Gershon, Lockley Steven W, Ponsford Jennie L
Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, VIC, Australia.
School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.
Front Neurol. 2021 Jul 15;12:651392. doi: 10.3389/fneur.2021.651392. eCollection 2021.
Fatigue and sleep disturbance are common and debilitating problems after brain injury. Light therapy shows promise as a potential treatment. We conducted a trial of in-home light therapy to alleviate fatigue and sleep disturbance. The aim of the current study was to identify factors moderating treatment response. Participants were 24 individuals with traumatic brain injury (TBI) ( = 19) or stroke ( = 5) reporting clinically significant fatigue. Outcomes included fatigue on Brief Fatigue Inventory (primary outcome), sleep disturbance on Pittsburgh Sleep Quality Index, reaction time (RT) on Psychomotor Vigilance Task and time spent in productive activity. Interactions of demographic and clinical variables with these outcomes were examined in linear mixed-model analyses. Whilst there were no variables found to be significantly associated with change in our primary outcome of fatigue, some variables revealed medium or large effect sizes, including chronotype, eye color, injury severity as measured by PTA, and baseline depressive symptoms. Chronotype significantly moderated sleep quality, with evening chronotype being associated with greater improvement during treatment. Injury type significantly predicted mean RT, with stroke participants exhibiting greater post-treatment reduction than TBI. Age significantly predicted productive activity during Treatment, with younger participants showing stronger Treatment effect. Light therapy may have a greater impact on sleep in younger individuals and those with an evening chronotype. Older individuals may need higher treatment dose to achieve benefit. www.anzctr.org.au, identifier: ACTRN12617000866303.
疲劳和睡眠障碍是脑损伤后常见且使人衰弱的问题。光疗法显示出作为一种潜在治疗方法的前景。我们进行了一项居家光疗法试验,以减轻疲劳和睡眠障碍。本研究的目的是确定调节治疗反应的因素。参与者为24名患有创伤性脑损伤(TBI)(n = 19)或中风(n = 5)且报告有临床显著疲劳的个体。结果包括简明疲劳量表上的疲劳(主要结果)、匹兹堡睡眠质量指数上的睡眠障碍、心理运动警觉任务中的反应时间(RT)以及从事生产性活动的时间。在线性混合模型分析中检查了人口统计学和临床变量与这些结果的相互作用。虽然未发现有变量与我们的主要疲劳结果的变化显著相关,但一些变量显示出中等或较大的效应量,包括昼夜节律类型、眼睛颜色、用伤后遗忘期(PTA)衡量的损伤严重程度以及基线抑郁症状。昼夜节律类型显著调节睡眠质量,晚睡型昼夜节律类型与治疗期间更大的改善相关。损伤类型显著预测平均反应时间,中风参与者治疗后的降低幅度大于创伤性脑损伤参与者。年龄显著预测治疗期间的生产性活动,年轻参与者显示出更强的治疗效果。光疗法可能对年轻人和晚睡型昼夜节律类型的人在睡眠方面有更大影响。老年人可能需要更高的治疗剂量才能获益。www.anzctr.org.au,标识符:ACTRN12617000866303。