Research Reports - Behavioral and brain imaging changes in patients receiving bright light therapy following a mild traumatic brain injury

Bradley Shane, Johnny Vanuk, Sahil Bajaj, Melissa Millan, William Killgore

Neurology Apr 2018, 90 (15 Supplement) S49.003;

Objective: We hypothesized that morning blue light therapy (MBLT) will cause changes in the brain’s function and structure that align with improved cognitive performance, mood, and sleep in patients recovering from an mTBI.

Background: Patients who suffer an mTBI may develop post-concussion syndrome symptoms including issues with concentration, mood, and sleep. Research shows that morning blue light exposure leads to regular entrainment of one’s circadian rhythm, resulting in improved sleep efficiency and daytime alertness.

Design/Methods: In this double-blind randomized control trial, thirty-one participants with sleep disturbances following documented mTBI in the past 18 months were assigned to the active treatment of MBLT (7M, 8F, mean age = 23 ± 7.5 years) or placebo condition of amber light therapy (ALT) (7M, 9F, mean age = 23 ± 7.1 years). Neurocognitive testing and brain magnetic resonance imaging were conducted at baseline and after 6 weeks of treatment.

Results: In the MBLT group, voxel based morphometry showed increased gray matter volume in the left (p <.001) and right pulvinar (p=.009) between pre-and post treatment. Resting state functional connectivity demonstrated a significant positive correlation between the pulvinar and parietal area in the left (p-FDR=.003) and right (p-FDR<.001) hemispheres in the MBLT group. Further, the MBLT group showed a significant relationship between right pulvinar connectivity change and Epworth Sleepiness Scale residual change (r=0.59), left pulvinar connectivity change and patient health questionnaire score residual change (r=−0.56), and left pulvinar connectivity change and Repeatable Battery for the Assessment of Neuropsychological Status residual change (r=0.44). ALT did not show any significant brain changes or correlations with behavior.

Conclusions: MBLT appears to promote structural and functional pathways within the visuospatial processing system after an mTBI. The improvement in the brain’s functional and structural strength, daytime alertness, mood, and neurocognitive performance suggests MBLT may be an effective and safe non-pharmacological treatment for mTBI.

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