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Light therapy for multiple sclerosis-associated fatigue: a randomized, controlled phase II trial

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Abstract

Background

Bright white light therapy (LT) can improve fatigue in several disease states but has not been studied in multiple sclerosis (MS).

Objective

To determine whether controlled home-based LT is feasible, tolerable, and well-adhered to in MS-associated fatigue.

Methods

A randomized, controlled trial of twice-daily 1-h bright white LT (BWLT) (10,000 lx, active arm) versus dim red LT (DRLT) (< 300 lx, control arm) was performed. Adults with MS-associated fatigue were enrolled for 10 weeks: 2-week baseline, 4-week intervention, 4-week washout.

Results

41 participants were enrolled; 35 were randomized (average age 42 years, 80% female; BWLT n = 20; DRLT n = 15). 31 were in the intention to treat analysis. The average duration of LT sessions was similar between groups (BWLT 60.9 min, DRLT 61.5 min, p = 0.70). The most commonly reported adverse event was headache. There were no events that led to discontinuation. Baseline fatigue was severe in both arms (each 53/63 points on the Fatigue Severity Scale (FSS), p = 0.92). FSS was lower following BWLT (FSS 45.8 post-LT, p = 0.04; 44.9 post-washout, p = 0.02 intra-group compared to baseline FSS) and DRLT (FSS 46.7 post-LT, p = 0.03; 43.9 post-washout, p = 0.002 intragroup compared to baseline FSS). There was no difference between BWLT and DRLT groups in the magnitude of reduction of FSS scores (p = 0.81 after LT; p = 0.77 after washout for between group comparisons). Similarly, MS quality of life metrics improved in both arms but were not significantly different between groups after LT (p = 0.22) or washout.

Conclusions

LT is safe, feasible, and well-tolerated in people with MS-associated fatigue. Improvement in both light spectra likely indicates a strong placebo effect for the DRLT group.

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Data availability

Study data will be provided upon reasonable request to qualified investigators by the authors.

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Acknowledgments

We thank Dr. Eric Klawiter, Dr. Rebecca Gillani, and Dr. Marcello Matiello, and all of the Massachusetts General Hospital for patient referrals to the study. We are grateful for the ad hoc study coordination assistance provided by Hans Erickson and Jessica Tran of the Massachusetts General Hospital.

Funding

This study was supported through a pilot grant from the National Multiple Sclerosis Society and a spark grant from the Department of Neurology at Massachusetts General Hospital.

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Authors and Affiliations

  1. Department of Neurology, Massachusetts General Hospital, 165 Cambridge St., Office 627, Boston, MA, 02114, USA

    Farrah J. Mateen, Andre C. Vogel, Sara J. Grundy, Kathryn B. Holroyd, Natalie Manalo, Matthew Stauder & Aleksandar Videnovic

  2. Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA

    Tamara B. Kaplan

  3. Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA

    Gladia C. Hotan

Authors
  1. Farrah J. Mateen
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  2. Andre C. Vogel
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  3. Tamara B. Kaplan
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  4. Gladia C. Hotan
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  5. Sara J. Grundy
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  6. Kathryn B. Holroyd
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  7. Natalie Manalo
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  8. Matthew Stauder
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  9. Aleksandar Videnovic
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Corresponding author

Correspondence to Farrah J. Mateen.

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Conflicts of interests

The authors declare that there are no conflicts of interest.

Ethical approval

This study was reviewed and approved by the Partners Human Research Committee.

Informed consent

All participants provided written informed consent prior to enrollment.

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Mateen, F.J., Vogel, A.C., Kaplan, T.B. et al. Light therapy for multiple sclerosis-associated fatigue: a randomized, controlled phase II trial. J Neurol 267, 2319–2327 (2020). https://doi.org/10.1007/s00415-020-09845-w

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  • DOI: https://doi.org/10.1007/s00415-020-09845-w

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