Xie Wei-Ye, Lou Hui, Liu Jia-Ying, Yin Jie-Yun, Zhang Tian-Qi, Mao Cheng-Jie, Wang Fen, Liu Chun-Feng, Shen Yun
Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
Department of Ophthalmology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
BMC Psychiatry. 2025 May 12;25(1):476. doi: 10.1186/s12888-025-06915-z.
Bright light therapy (BLT) has been proved to have beneficial effects on Parkinson's disease (PD), the mechanisms remained unclear. Improvements of visual pathways might be key to BLT.
The aim of this study is to validate whether BLT improves clinical symptoms in PD and explore the possible mechanisms of visual pathways evaluated by optical coherence tomography (OCT), pattern electroretinogram (PERG) and visual evoked potentials (VEP).
Twenty-three PD patients were enrolled in this crossover randomized placebo-controlled study. Participants received either one month of BLT or dim light therapy (DLT), separated by one-month wash-out period, followed by another intervention. Participants underwent clinical scales, and visual-related evaluations including OCT, PERG and VEP before and after each intervention. Mixed-effects regression models were used to determine the effect between BLT and DLT on improving the differentials of clinical scales (Δscales), OCT (Δretinal thickness), PERG (ΔPERG values) and VEP (ΔP100 latencies). Correlations between clinical symptoms and visual evaluations improvements were analyzed in PD patients receiving BLT.
Excessive daytime sleepiness, anxiety, life quality and autonomic function were improved after BLT. Compared with DLT, bilateral ΔN95 latencies for PERG and ΔP100 latencies for VEP were improved after BLT. We did not observe the changes of four quadrants retinal nerve fiber layer (RNFL) thickness after BLT or DLT.
BLT is a valuable and safe non-pharmacological intervention for improving visual function in PD patients.
These findings extend neural mechanisms of BLT to visual pathways improvements.
强光疗法（BLT）已被证明对帕金森病（PD）有有益影响，但其机制仍不清楚。视觉通路的改善可能是BLT的关键。
本研究旨在验证BLT是否能改善PD患者的临床症状，并通过光学相干断层扫描（OCT）、图形视网膜电图（PERG）和视觉诱发电位（VEP）探索视觉通路的可能机制。
23例PD患者纳入本交叉随机安慰剂对照研究。参与者接受为期1个月的BLT或暗光疗法（DLT），中间间隔1个月的洗脱期，然后进行另一种干预。参与者在每次干预前后接受临床量表以及包括OCT、PERG和VEP在内的视觉相关评估。采用混合效应回归模型确定BLT和DLT对改善临床量表差异（Δ量表）、OCT（Δ视网膜厚度）、PERG（ΔPERG值）和VEP（ΔP100潜伏期）的影响。对接受BLT的PD患者分析临床症状改善与视觉评估改善之间的相关性。
BLT后白天过度嗜睡、焦虑、生活质量和自主神经功能得到改善。与DLT相比，BLT后PERG的双侧ΔN95潜伏期和VEP的ΔP100潜伏期得到改善。我们未观察到BLT或DLT后四个象限视网膜神经纤维层（RNFL）厚度的变化。
BLT是一种有价值且安全的非药物干预措施，可改善PD患者的视觉功能。
这些发现将BLT的神经机制扩展到视觉通路的改善。
